PLUMBING PERMITit v,-"Zi i ! IC1 Job Address N43 ci 1 f_54"• Tax Folio /1- ' 4 OD0)
,ag 1 Description pr & / . /07.7
wner / Lessee / Tenant s I Y'C_ ) Master Permit #.3...5e
maser Address N; 1 Tr -' -c-1.- Phone
ontracting Co. LA 4 _es is trim. a = Address U NIA/ 1 D
qualifier 'fr)1G, G
1-4U- 1811(; aS 1_ _- - Phone - 7 - 1
.tate 1i 4 =71 - -- Municipal # Competency #_C„E )E ns.Co. GCf�i�f ✓f
architect /Engineer Address
Bonding Company Address
lortgagor Address
°ermit Type(circle one): BUILDING ELECTRICAL PLUMBING") MECHANICAL ROOFING PAVING FENCE SIGN
IORK DESCRIPTION . 1I i 1 I I ng c3cti. e,,--'
square Ft. Estimated Cost(value) C%
IARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
XO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
'O OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
( OTICE OF COMMENCEMENT).
application is hereby made to obtain a permit to do work and installation as indicated above, and
'n the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
►WNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
ped•` e in com• iance with all applicable laws regulatin construction and zoning. Furthermore, I
ize . 4 V '.ve - -contractor to do the work stated. y
e of owner
d /or Condo President
to, aryvfis to • r &nd /or Condo President
Iyk„Commission Expires:
. *. * *
TES: PERMIT
PPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
•
GLORIA E SUVILLAGC
My�
Commission CC308759
*vireo Aug. *B, 1997*
Bonded by HAI
800- 422.1555
Zoning
ce _
* * * * * 41; GLORIA E SUVILLAGO
M*Commisa*n CC308 *9 **
f * Expires Aug. 18, 1997
RADON C.C.F. NOTARY % , # as l DUE
Fire Other
Buildin
Mechanical Plumbin
Signature of Contractor or r- Builder
Date:
Mary a .t rector or Owner- Builder
/My Commission Expires:
Electrical
6
%gineering
ITEM
•BATH TUB
UNIT
.FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM .
SPACE HEATERS
UNIT
FEE
,BIDET •
LIGHT OUTLETS
CENTRAL HEATING
`BISIVIASKR
RECEPTACLES
A/C (WIN))
DISPOSAL
SERVICE TEW1 RARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN MPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIRAETER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCiPTOR t,
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
.SINK, POT/3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK. SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEAPORARY WATER CLOSET
MOTORS OVER 10- 25 FP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
• •
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
,
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
-
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4' TILE/RES.
VIOLATION
•
PUMP S ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
_
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
.
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
•
LAWN SPRINKLER SYSTEM
GAS RANGE
DETER SET (GAS)
GAS PIPING
"
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
Permit No !� Date ..._. 1 a173 0- Z4- - -.... . -- - - .-.— --
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.
Amount of Permit $
Richard Boggs
Owner's Name and Address
Registered Architect and /or Engineer .---
Employing Plumber's Name. Brooks Ame ,can Sprinkler Co, No ,.... -- . ?410 ,,....m.,,..,.. street. N.W.79th , Street
Location and Legal Description Lot
Street and Number where work is to be performed —No 40
State work to be performed and purpose of building (By Floors) ___.____._._
New Building _----- ---•--- ....... -._ Remodelling__ _ __ . -- Addition
Size Septic Tank_ -- .---- ------- . - - - - -- Typo of Tank__
8.00
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
191ock
(Signed)
40 N.E. 91st Street
No._ StreeL.__._�._.........._.. _.
__.. —
Street N.E. 91st Street
Repairs No. of Stories
Capacity Cals
Feet of Drain Tile.__ — - -- -- -Dist. Feet of 'lank or Drain Field from Well.
exist
Nature of Water Supply: City— WeL1 __. ._ - __ -- -- - - - - -- -Size of Soakage Pit
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 5968, Compiled General Laws of Florida Permanent Supplement, and Isar 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 t}ie Act. The undersigned agrees to employ only such sub - contractors, on wrk to be performed under ells permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
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.
Notary Public, State of Florida
Plumbing Inspector.
Muter Plumber.
NOTE: A re inspection fee of $1.00 will be made when sum re- lnspsatfon is made.neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
.MOWERS
LAVA-
TORIES
61kKS
SLOP
SINK[
LAUNDRY
Tus•
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
—
CHICK
,_
,_,
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
CREAMY
TRAP
SOLAR
EATER
DEEP
1.✓[LL
SPRKLR.
S
SWIM'O
P001.
Co. NTl1
X
LIST
CHECK
Permit No !� Date ..._. 1 a173 0- Z4- - -.... . -- - - .-.— --
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.
Amount of Permit $
Richard Boggs
Owner's Name and Address
Registered Architect and /or Engineer .---
Employing Plumber's Name. Brooks Ame ,can Sprinkler Co, No ,.... -- . ?410 ,,....m.,,..,.. street. N.W.79th , Street
Location and Legal Description Lot
Street and Number where work is to be performed —No 40
State work to be performed and purpose of building (By Floors) ___.____._._
New Building _----- ---•--- ....... -._ Remodelling__ _ __ . -- Addition
Size Septic Tank_ -- .---- ------- . - - - - -- Typo of Tank__
8.00
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
191ock
(Signed)
40 N.E. 91st Street
No._ StreeL.__._�._.........._.. _.
__.. —
Street N.E. 91st Street
Repairs No. of Stories
Capacity Cals
Feet of Drain Tile.__ — - -- -- -Dist. Feet of 'lank or Drain Field from Well.
exist
Nature of Water Supply: City— WeL1 __. ._ - __ -- -- - - - - -- -Size of Soakage Pit
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 5968, Compiled General Laws of Florida Permanent Supplement, and Isar 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 t}ie Act. The undersigned agrees to employ only such sub - contractors, on wrk to be performed under ells permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
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.
Notary Public, State of Florida
Plumbing Inspector.
Muter Plumber.
NOTE: A re inspection fee of $1.00 will be made when sum re- lnspsatfon is made.neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
B
«,y,. Zq?TS .:TH
TUBS
SHOWERS
LAVA-
TORIES
SIS
SINKS
SLOP
SINKS
LAUNDRY
Tues
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
Comm.
LI6T —�
CAxcic
—I—
—
-
— _
S. - . PTIC
T..NK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIS?
CHECK
remelt No../ 1. C� _
Location and Legal Description Lot ___-_------ _- __- __ - - -__— _ Block
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
Size Septic Tank_______ _-_ .
-A
Feet of Drain Tile_
Nature of Water Supply: if y —Well
3.
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)- -
( Signed ).___
Date
!2p )lication is hereby mac a for the approval of the detailed statement of the plans and specifications herewith submi for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of M mi 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'6 Name and Address 0 'S. — No -- _ Streeti '._._ Ns/F
Employing Plumber's Name -- Wiz : nP,!/`* __--_ No.__ / _7 _ 6 Street--- — — °S6 ,_.lXM
Subdivision
—
Street_
Repairs No. of Stories . . ........ . ...... .......
Type of Tank_— Capacity Gals
_t _Dist. Feet of Tank or Drain Field from Well
_ ----------- - -• - -- _ _ -- - Size of Soakage Pit
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 5986, Compiled General 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 lfe per under this permit, as are
licensed by Miami Shores Village.
Fta
STATE OF FLORIDA, }
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.
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.
Owner's Name and Address
Registered Architect and /or Engineer
_t__ _ No. / Street
Location and Legal Description Lot 7 X Block ��J L� Subdivisio _
Street and Number where work is to be performed —No. � / e - Street ?/ S
State work to be performed and purpose of building (By Floors)
New Building II"" Remodeling Addition Repairs
Employing Plumber's Name
Amount of Permit $
'ATE OF FLORIDA,
'JNTY OF DADE.
ss.
a lb
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed) _____ 21*
X
Size Septic Tank sr Type of Tank Capacity Gals.____t.S
---- --- -------------- ------
---------------------- ----------- -------------------------------- ------ ------------------------------------- ---------------------------------------------
My Commission Expires Notary Public, State of Florida
eV n Z/ -c.5"
No Street
No. of Stories
Feet of Drain Tile 7 $ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
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 5966, Compiled General 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.
- x-14-- .
Master Plumber.
efore me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
known, and who, being by me first duly sworn, upon oath deposes and says that he is the
'e described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
m stated are true.
lspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
kmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
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
SWIM'G
POOL
CONTR.
LIST
CHECK
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.
Owner's Name and Address
Registered Architect and /or Engineer
_t__ _ No. / Street
Location and Legal Description Lot 7 X Block ��J L� Subdivisio _
Street and Number where work is to be performed —No. � / e - Street ?/ S
State work to be performed and purpose of building (By Floors)
New Building II"" Remodeling Addition Repairs
Employing Plumber's Name
Amount of Permit $
'ATE OF FLORIDA,
'JNTY OF DADE.
ss.
a lb
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed) _____ 21*
X
Size Septic Tank sr Type of Tank Capacity Gals.____t.S
---- --- -------------- ------
---------------------- ----------- -------------------------------- ------ ------------------------------------- ---------------------------------------------
My Commission Expires Notary Public, State of Florida
eV n Z/ -c.5"
No Street
No. of Stories
Feet of Drain Tile 7 $ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
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 5966, Compiled General 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.
- x-14-- .
Master Plumber.
efore me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
known, and who, being by me first duly sworn, upon oath deposes and says that he is the
'e described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
m stated are true.
lspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
kmanship.
Permit No to 3 /
Nature of Water Supply:
TE OF FLORIDA, t
TY OF DADE.
SS.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) , ,
(
Date4e
-
- 0
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 2 No I/ 6 /4
Street
Registered Architect and/or Engineer
Employing Plumber's Name .4. J../ P L No I "'Street
Location and Legal Description Lot 2j Block Subdivision_ 7 / II" 2
Street and Number where work is to be performed—No ki 4). /" F 9 ,sT 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 Drai Tile . Dist. Feet of Tank or Drain Field from Well
n
Size of Soakage Pit
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 5966, Compiled General 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.
i
(Signed) ' 7
Master Plumber.
me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
and who, being by me first-duly sworn, upon oath deposes and says that he is the
ribed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
1 are true.
"lommission Expires Notary Public, State of Florida
'-e of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
i r
II 4•1,
CLOSETS
BATH
Tuas
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuas
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
p )7
fti 6 c kr
/
i' ig CO
h , H
TOTAL 4
FIXTURE(
CONTR.
LIST
/
/
CHECK
,---:>"
• •
7 :)
' -
....-
7..3'
1 7
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW !AVG \ d i , e
POOL
h
1 .4.
CONTR.
CHECK
-5Ecl
Permit No to 3 /
Nature of Water Supply:
TE OF FLORIDA, t
TY OF DADE.
SS.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) , ,
(
Date4e
-
- 0
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 2 No I/ 6 /4
Street
Registered Architect and/or Engineer
Employing Plumber's Name .4. J../ P L No I "'Street
Location and Legal Description Lot 2j Block Subdivision_ 7 / II" 2
Street and Number where work is to be performed—No ki 4). /" F 9 ,sT 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 Drai Tile . Dist. Feet of Tank or Drain Field from Well
n
Size of Soakage Pit
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 5966, Compiled General 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.
i
(Signed) ' 7
Master Plumber.
me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
and who, being by me first-duly sworn, upon oath deposes and says that he is the
ribed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
1 are true.
"lommission Expires Notary Public, State of Florida
'-e of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
i r
II 4•1,
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
11
� 1
PERMIT N° 10302
Work to be performed under this Permit
Owner of
Building " j /'c car—.
/
This permit is granted to the contractor or
herefor in strict compliance with all ordinances thereto and wi
drawings, statements or specifications that may have been submitted to an
time if the work is not done in compliance with such ordinances or if the p
granted is the understanding that the contractor or budder named above
pertaining to the work covered hereby whether shown on the plans or
done by his agents, servants or employee's.
MIAMI SHORES VILLAGE, FLORIDA
zd
Si
IsC' dderation of the issuance to me of this permie••I
-pertaining thereto and in strict conformity with the plane, drawings,
In accepting this permit I assume responsibility for all work done by either,
It 01 BUILDS*
a
runt the building or to install the equipment or device descnbid in the application
the and ' . g that ' i • work will be performed in compliance with any plans,
prov ` . the proper 'cipal authorities. This Permit may be revoked at any
singed withou - %. • citation. A further condition u which this permit i•
respo ,, or •rough knowled of the 0
imescrost
the work covered hereunder in compliance with
oc fications submitted to the proper a
orYs my agent. eerva or employee.
4
Value of
Project $
DATE `
Contractor's
License No.
Amt. of
Permit
Acr[mtrr?
195_
reersork
BUILDING
ELECTRICAL
PLUMBING
PERMIT N? 10312
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal Lot '-1 (I BL
Description
Addries of
Building + .. .:,
MIAMI SHORES VILLAGE, FLORIDA
DATE � ..::,`, , J, . ! 195_1_
Subdi-
vision
•
Value of
Project $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may. be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without u nation. A further condition u which this permit is
granted is the understanding that the contractor or builder named above assumes the respo bitty or thorough knowledge of the or sad re �ulatlons
pertaining to . the work covered hereby whether shown on the plans or drawings or in . responsibility 'cations and rat he assumes
done by his agents, servants or employees.
Signed. • -• -
s INSPECTOR
In consideration of the issuance to me of this permit I agree tp p4rform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, stints or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by eikhee, m self, my agent,}a , tt or employee. -
CONTRACTOR CIR ' BUILDER
Contracts -
License No
Amt. of
Permit
$
AUTHORflT