898 NE 91 Terr (12)Permit No
New Building_____ _ Remodeling__
Size Septic Tank... _ _ _
Amount of Permit $
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herem described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of th Building Du sion
of Miami Shores Village shall be complied with, whether herein specified or not A copy of approved plans and specifications must be kept at
building during progress of work.
SEPTIC_ TANK SERVICE N 3123 N .W. . Street Owner's Name and Address_ ____________
Registered Architect and/or Engineer _ .
Employing Plumber's Name _ HENRY E . PRIEST N 3123 N . W. 94th street _ .... -
Location and Legal Description Lot_____ _ _ __ _____ 321 licck_ _ —Subdivision.
Street and Number where work is to be performed—No _ 898 N .E. 91st Tegicape _
State work to be performed and purpose of building (By Floats). _ 1 floor__ .. .... .... _ . . .......
_ Addition__
Type of Tank __
Feet of Drain Tile. _ _ _ _Dist. Feet of Tank or Drain Field from Well_ _
Nature of Water Supply. City—Well. ___ _ _ Si of Soakage Pit
_ (Signed).
The undersigned applicant for this building permit does hereby certify that he understands and cccepts his obl tions as an e nployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penn t Supplzment, nntl I a'. • om•
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors emp oyed by bin in the wo:k to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
__ Capacity Gals.
XXK — _ No. of Stories .
- - Master Plumber.
- - - —
My Commission Expires Notary Public, State of Florida
. .
Plcmb rig In :pecto. _
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledge ents, personall appeared
to me well known, and who, being by me first duly sworn upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all 'acts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made 'necessary by improper notice for inspection, or faulty
materials and/or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU T' NS
TOTAL
F XTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWING
POOL
CONTR.
LIST
CHECK
Permit No
New Building_____ _ Remodeling__
Size Septic Tank... _ _ _
Amount of Permit $
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herem described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of th Building Du sion
of Miami Shores Village shall be complied with, whether herein specified or not A copy of approved plans and specifications must be kept at
building during progress of work.
SEPTIC_ TANK SERVICE N 3123 N .W. . Street Owner's Name and Address_ ____________
Registered Architect and/or Engineer _ .
Employing Plumber's Name _ HENRY E . PRIEST N 3123 N . W. 94th street _ .... -
Location and Legal Description Lot_____ _ _ __ _____ 321 licck_ _ —Subdivision.
Street and Number where work is to be performed—No _ 898 N .E. 91st Tegicape _
State work to be performed and purpose of building (By Floats). _ 1 floor__ .. .... .... _ . . .......
_ Addition__
Type of Tank __
Feet of Drain Tile. _ _ _ _Dist. Feet of Tank or Drain Field from Well_ _
Nature of Water Supply. City—Well. ___ _ _ Si of Soakage Pit
_ (Signed).
The undersigned applicant for this building permit does hereby certify that he understands and cccepts his obl tions as an e nployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penn t Supplzment, nntl I a'. • om•
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors emp oyed by bin in the wo:k to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
__ Capacity Gals.
XXK — _ No. of Stories .
- - Master Plumber.
- - - —
My Commission Expires Notary Public, State of Florida
. .
Plcmb rig In :pecto. _
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledge ents, personall appeared
to me well known, and who, being by me first duly sworn upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all 'acts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made 'necessary by improper notice for inspection, or faulty
materials and/or workmanship.