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PLUMBING PERMITPermit No. _.i ` `f t MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein 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 the Building Division 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. Owners Name and Address_A4___CF___FQ3dLez No.3D.0 AL.E.___9Ls-t Street .91- st--- Street- - - . - - - - Registered Architect and /or Engineer _____ ----- �-- _ - - - -__ — __ -- Employing Plumber's Name ABC_., EPTIC_..TANK___SFRVTC..F No.`l1 22 Street__54th__Stseet- -___.. ...... Location and Legal Description Block__ Subdivision Street and Number where work is to be performed— No._ —_ __ Street State work to be performed and purpose of building (By Floors) New Building Remodeling. ___ Addition Size Septic Tank Type of Tank____ Capacity Gals 32' Feet of Drain Tile — ____Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Amount of Permit $ 1.99__ STATE OF FLORIDA, /s. COUNTY OF DADE. Size of Soakage Pit (Signed) Repairs Date (9 12 No. of Stories. _ . __ __..._. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and Ilas com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work 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 notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed -- Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 facts therein by him stated are true. My Commission Expires Notary Public, State of Florida 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 TUBS UR URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK - SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•G POOL CONTR. LIST 1C - -- CHECK Permit No. _.i ` `f t MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein 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 the Building Division 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. Owners Name and Address_A4___CF___FQ3dLez No.3D.0 AL.E.___9Ls-t Street .91- st--- Street- - - . - - - - Registered Architect and /or Engineer _____ ----- �-- _ - - - -__ — __ -- Employing Plumber's Name ABC_., EPTIC_..TANK___SFRVTC..F No.`l1 22 Street__54th__Stseet- -___.. ...... Location and Legal Description Block__ Subdivision Street and Number where work is to be performed— No._ —_ __ Street State work to be performed and purpose of building (By Floors) New Building Remodeling. ___ Addition Size Septic Tank Type of Tank____ Capacity Gals 32' Feet of Drain Tile — ____Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Amount of Permit $ 1.99__ STATE OF FLORIDA, /s. COUNTY OF DADE. Size of Soakage Pit (Signed) Repairs Date (9 12 No. of Stories. _ . __ __..._. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and Ilas com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work 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 notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed -- Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 facts therein by him stated are true. My Commission Expires Notary Public, State of Florida 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. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Lot iat Work to be performed under this Permit ,; r . • oos rte MIAMI SHORES VILLAGE, FLORIDA PERMIT N ? 4518 Bl. Subdi- vision DATE Contractor's License No. 1944 1 Address of I Value of Amt. of e Building ,C v 1 1/ i, t4' r Project Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device descr'.ed i he appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in com ; lia e with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition u- on which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. g .- ,a41 B > , Si ned By INSPECtOR 4 • In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances anct regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all :Work done by ei myself, my agent, servant or employee. CONTR4 OR BUILDER BY • AUTHORITY