PLUMBING PERMIT,
BUILDING
ELECTIIICAL
PLUMBING
ROOFING
Owner of
Building '=
Architect
Contractor
or Builder
Legal
Description
Address of
Building
This permit is granted
herefor in stria comnlianoe
drawings, statements or
time if the work is not done
granted is the undmtan
done agents, servants
In consideration of the issuance to me of this permit I agree to with the pleas, drawings, 0-
In accepting this permit assin ne for all kk done by either,
[] DA
0 PERMIT N? 15505
0 Work to be peed under this %emit
Value of
II
And. At
.,r i """" t Project $ +' ► ..w+. P mt
to the contractor or builder named above to conatruet the building or to fiasau the Wpm* all ordinances peratining thereto and with the understanding that
sp that may have been subloOttod to and awed by the
! compliance with such tbs ptsaksit thanged
contractor ractor or lmifder omen abovr ee
w hether shown on the plans;. the
MIAMI SHORES VILLAGE, F'L.ORIO A
WTR
NACTOP; bra BUILDER
Subdi-
vision
Signed' i .
ff,py�r� � .F� Q
the work Wen in compliance w
or specifications a to the Proper
myself, my agent, serves or employee.
MIAMI SHORES VILLAGE, FLORIO
BUILDING ❑ DA
=alum Q PERMIT N? 14030
MINIM A
ROOFING ❑ work t b. p. fos:s.d undo: this Pormit
=1.f o .
ng
Architect
Contractor
or Builder
Legal
Descriptio
Address of
Building
This permit is
herefor in strict oom
drawings, statements or
time if the work ls not done
vanted is the understanding
pertaining to the work
done by agents,
elf
In consideration of the issuance
pertaining thereto and in strict conformity with
In accepting this permit I assume responeibdity for all
BUILDER
BY
Permit No
Application is hereby made for the approval of the detailed statement of th:, plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and coafor ty with the ratilding 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 07 nnt. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address /. � < - 1 111 U _ 11fo. — — Street
Registered Arch'tect and /or Engineer ___ _ ` " "' L` ..u.
22 ) W. iOli 0J i Hi/ s
Employing Plumber's Name
Location and Legal Description Lot_________________________ c � ]� l
Street and Number where work is to be performed —No fr o
o L / Street
State work to be performed and purpose of building (By Floors)_.
New Building ____________. _______ Remodeling_____ _ __ Addition- ___ -_•_._ Repairs No. of Stories
Size Septic Tank_ ........ -----...... - .....--- - - - - -- -------Type of Tank Capacity Gals.
Feet of Drain Tile______/ 9_ - _ _____ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well
Amount of Permit $ __
STATE OF FLORIDA, }
;.!',TUFTY OF DADE.
Commission Expires
MIAMI SHORES VIL:40,GE
PLUMBING INSPECTION DEPARTMEi:'
APPLICATION FOR PLUMBING
No.
.Size of Soakage Pit
( Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo •d 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 p lic notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfor -d under this permit, as are
licensed by Miami Shores Village.
( Signed ) _
�_ Ga
Date J/
Street
Su bdivision
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to r«e well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of boe above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
icerek ky him stated are true.
Notary Public, State of Florida
Master Plumber.
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 worlananship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CoNTN.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
` - --
CHECK
Permit No
Application is hereby made for the approval of the detailed statement of th:, plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and coafor ty with the ratilding 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 07 nnt. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address /. � < - 1 111 U _ 11fo. — — Street
Registered Arch'tect and /or Engineer ___ _ ` " "' L` ..u.
22 ) W. iOli 0J i Hi/ s
Employing Plumber's Name
Location and Legal Description Lot_________________________ c � ]� l
Street and Number where work is to be performed —No fr o
o L / Street
State work to be performed and purpose of building (By Floors)_.
New Building ____________. _______ Remodeling_____ _ __ Addition- ___ -_•_._ Repairs No. of Stories
Size Septic Tank_ ........ -----...... - .....--- - - - - -- -------Type of Tank Capacity Gals.
Feet of Drain Tile______/ 9_ - _ _____ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well
Amount of Permit $ __
STATE OF FLORIDA, }
;.!',TUFTY OF DADE.
Commission Expires
MIAMI SHORES VIL:40,GE
PLUMBING INSPECTION DEPARTMEi:'
APPLICATION FOR PLUMBING
No.
.Size of Soakage Pit
( Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo •d 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 p lic notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfor -d under this permit, as are
licensed by Miami Shores Village.
( Signed ) _
�_ Ga
Date J/
Street
Su bdivision
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to r«e well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of boe above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
icerek ky him stated are true.
Notary Public, State of Florida
Master Plumber.
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 worlananship.
- - -+
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
S INKS
SLOP
SINKS
LAUN
Tune
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIETUREI
- - T-
CONTR.
LIST
CHECK
_ _
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H [ATLR
DEEP
WELL
SPRKLR.
SYSTEM
SWIM 0
POOL
Comm.
LIST
/
Permit No. ( Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or °thin
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address .__
Registered Architect and /or Engineer
Employing Plumber's Name _.____ __.� __ _ 19 "
Location and Legal Description Lot - ..-_ ...... - _
._.-
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors)_
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit $_
Type of Tank._ _
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No
New Building . Remodeling Addition.
Dist. Feet of Tank or Drain Field from Well
(Signed)
Size of Soakage Pit._
The undersigned applicant for this building permit does hereby certify that • understands and acts his o gations as elf mployer of labor
under the Florida Workmen s Compensation Act, being Section 5988, Compel- General Laws of Flo da Pe anent Suppleni nt, and h.ls r._
plied with the provisions thereof, and will require similar complian • . "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 remit, as an
licensed by Miami Shores Village.
(Signed)...
Repairs
Street.
Capacity Gals.
No _ 1.. : Street. g? 7 +�►"
-._ -_ _ -_ --
Subdivision .......
__..___
Street_ - ......f f'
No. of Stories
My Commission Expires Notary Public, State of Florida
Insv ctor.
Master Plumber.
STATE OF FLORIDA, 1,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .,ppeare
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 tat.
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 t, ul
materials and /or workmanship.
Location and Legal Description Lot
Street and Number where work is to be performed —No. w __-C.)
New Building Remodeling Addition Repairs
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-
Permit No ---- --- ------ -- ----- - - ---- Date , — =?
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.
1 ,
Owner's Name and Address 1, _ri__i - L ::•1 _ '` "Lt-' No Street
Registered Architect and /or Engineer
Employing Plumber's Name 1 PL E = z No. Street
Block Subdivision
Street
State work to be performed and purpose of building (By Floors)
No. of Stories i
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of SO cage Pit
Amount of Permit $
rf
STATE OF FLORIDA,
r ss.
COUNTY OF DADE.
( Signed)
( Signed)
My Commission Expires Notary Public, State of Florida
Plumbing lhspector.
The undersigned applicant for this building permit does hereby certify that he unde stands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Geneital Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contract s 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. ,
1 1/'
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.
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
INKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
/ '
J
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
/ �WELL
�_
SPRKLR.
SYSTEM
SWIM'G
POOL
nn
\ ( 4 1 'i
« - ,-1
GLST
LIST
CHECK
Location and Legal Description Lot
Street and Number where work is to be performed —No. w __-C.)
New Building Remodeling Addition Repairs
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-
Permit No ---- --- ------ -- ----- - - ---- Date , — =?
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.
1 ,
Owner's Name and Address 1, _ri__i - L ::•1 _ '` "Lt-' No Street
Registered Architect and /or Engineer
Employing Plumber's Name 1 PL E = z No. Street
Block Subdivision
Street
State work to be performed and purpose of building (By Floors)
No. of Stories i
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of SO cage Pit
Amount of Permit $
rf
STATE OF FLORIDA,
r ss.
COUNTY OF DADE.
( Signed)
( Signed)
My Commission Expires Notary Public, State of Florida
Plumbing lhspector.
The undersigned applicant for this building permit does hereby certify that he unde stands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Geneital Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contract s 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. ,
1 1/'
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.
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.
Permit No. i!2_67._
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.
Owner's Name and Address 13 4(4-
Registered Architect and /or Engineer �,,
Employing Plumber's Name �/i Z r NL_f'�'rI.
Location and Legal Description Lot " Block Subdivision
Street and Number where work is to be performed— No.___3 J D N & 7 /
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile ____ Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Nature of Water Supply: City —Well
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-y it.
6-6
( Signed) �-
No. Street.
No Street
Repairs
j i bing Inspector.
The undersigned applicant for this building permit does hereby certify that hytrstands and accepts his obligation an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled G al Laws of Florida Permanent Supplement, and has 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) (1)-C'L 1.
Date d ` L Z -
Street
No. of Stories__
OF FLORIDA,
ss.
COUNTY OF DADE.
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
Master Plumber.
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
LAUNDR
TUBS
URINALS
CATCH
BASI
FLOOR
DRAIN
DRINKING
FOUNT' NS
L
�
TOTAL
/SIXTURES
CONTR.
LIST
° r
al.,,,
/
/
{
I
(
/
/
1 /
7
CHECK
SEPTIC
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
LIST
/ TANK
CHECK
Permit No. i!2_67._
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.
Owner's Name and Address 13 4(4-
Registered Architect and /or Engineer �,,
Employing Plumber's Name �/i Z r NL_f'�'rI.
Location and Legal Description Lot " Block Subdivision
Street and Number where work is to be performed— No.___3 J D N & 7 /
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile ____ Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Nature of Water Supply: City —Well
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-y it.
6-6
( Signed) �-
No. Street.
No Street
Repairs
j i bing Inspector.
The undersigned applicant for this building permit does hereby certify that hytrstands and accepts his obligation an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled G al Laws of Florida Permanent Supplement, and has 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) (1)-C'L 1.
Date d ` L Z -
Street
No. of Stories__
OF FLORIDA,
ss.
COUNTY OF DADE.
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
Master Plumber.
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
Tue.
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURE,
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DRIP
WELL
SPRKLR.
SYSTEM
SWIM 0
P001.
CONTR.
LIST
CHECK
—
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. / Date
-
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address .
Registered Architect and /or Engineer
Employing Plumber's Name _, „.. ___,
Size Septic Tank - --
Feet of Drain Tile
Nature of Water Supply: City -Well .
Type of Tank_ _
No
Street_. ;
No..___ ...___.._ -__ Street -_-t. '
Location and Legal Description Lot -- __ -.---- -_-...... - - ..... ____ __M ___ Block- __w____.____.______-_ . Subdivision
Street and Number where work is to be performed -No
State work to be performed and purpose of building (By Floors)_
New Building Remodeling Addition__._.___.`__.. _._.. Repairs
_ Size of Soakage Pit__
Street_ .......
Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Amount of Permit $- - -- -a .- - - --- - - - -_- __ _._ —_ -_ -- - _ ___._.___ (Signed) '
/
No. of Stories. _.... _ ..
My Commission Expires Notary Public, State of Florida
r
Plumbing In si-cr;. tor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as a%, employer of lab
under the Florida Workmen s Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent Supplement, and h.'. ,n-
plied with the provisions thereof, and will require similar compliance from all contractors or sub contractors employed by him 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 notires as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this as are
licensed by Miami Shores Village.
(Signed)- - - -- _ -- - - - - -- - _ ....___ ....... - -
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
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 tat'
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessaay by mproper notice for inspection, or t, ul
materials and /or workmanship.