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PLUMBING PERMITDate.c Legal Description Owner/Lessee / Tenant Owner's Address Contracting Co. 11/2 Address aX. /I! kJ. , / .5' Qualifier Z C-2 / (•�. � - - - Phone 7 5 /©Z,S v State # Municipal # Competency # ,>®6e0/ 22. Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION e e� L"/ i7. ,�2 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE �1 "� JTax 00 Job Address /0 70 ! / � Folio , ��„ O FEES: PERMIT RADON 714.& /1/26/4„,./ APPROVED: Zoning Building Mechanical Plumbing Historically Designated: Yes Master Permit # Phone Square Ft. Estimated Cost (value) / ® No WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on 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. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction ning. Fprt ermore, I authorize the above -named contractor to do the work stated. C 6 4; i i ature of o er 6 y -5,.;eop Notary as to Omer and/or Condo President # _ My Commission Expires: j � f ;� C? ADV1`; G3:c5T9fa 11 COMMISSION NO. CC71 1V1V CON 15 ∎ON rat' ' RA. 11 14 Y1. Notary , t o tr o" rs m, My C.nunission Eitpires: GLADI i,; iir,i YO :('r' ;\r i..-: i :7 ;13 'L= ' , N:i\lisso t=.;:, . i %. 1 3,N, C.C.F. ' NOTARY BOND Electrical . - 4teg D/ / Date Structural Engineer • 1 ICt 3 3111Ri ANI`®'^ ® 111 ' ii6Qa :aIQ ^IHLW®:IZIIY:Y'JdlUItmI: ®® wS! ®'RY 1.1. �.uu IRS 11111M MI'RR .4 3m 1111 414 NH Mr! !fl: "1131 AR. ilil Yll 1111 1E11 AA.ID1' 41/1 AR AR All IN 1313 IRS All :51::[11 IM IRI 131 Mil 1111:111• :[H Ail', Ali WI la '1e; Gil sk6,1 D " p f ITEM BATH TLB UNIT FEE ITEM SWITCH OUTLETS' UNIT FEE ITEM SPACE HEATERS UNIT FEE 3IOET LIGHT OUTLETS CENTRAL HEATING OISHMHER RECEPTACLES A/C (WIND) 01S?OSAL SERVICE TEAPORARY A/C (CENTRAL) :RINKING FOUNTAIN • SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION :PEASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TCP UNDERGROUND TANKS _AVATCRY OVEN ABOVE (MOUND TANKS _AUNORY TRAY WATER HEATER U.F. PRESSURE VESSELS :LOTHES WASHER MOTORS 0— 1 EP STEAM BOILERS SHOWER MOTORS OVER 1— 3 HP HOT WATER BOILERS SINK, POT/3 CORP. MOTORS OVER 3- 5 I•P MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5— 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8— 10 EP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10— 25 HP FIRE SPRINKLER SYSTEMS .RINAL MOTORS OVER 25-100 HP COOLING TOWERS iATER CLOSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION iATER SLPPLY 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 SW I IfI I NG POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES EWER CONNECTIONS ■ SIGN TRANSFORMERS TILITY —SEWER SIGN TIME CLOCK TILITY —WATER FIXTLRES _PT IC TANK ANTENNA _LAY TELEVISION OUTLETS iAINFIELO, 4' TILE/RES. _ VIOLATION AP & ABANDON SEPTIC TANK REINS?ECTION )AKAGE PIT CU. FT. aTCH BASIN iSCHARGE WELL :MESTIC WELL IEA DRAIN AF INLET %LAR WATER HEATER RE STANDPIPE AL PIPING WN SPRINKLER SYSTEM S RANGE TER SET (GAS) S PIPING es ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 5 - X) - `'‘a Job Address \ VY t IV . 9/ (cc' Legal Description I 1 0-1‹ 't >00 RA&E Nh) S (�IcAELs S Owner / Lessee / Tenant M aster Permit 4 32 CSS j(9-b7 7 Owner's Address Phone Contracting Co.lRtiA -T'($S C Addressfl 1Aolipldot tOE N14woo Qualifier G (YO f\_ kik50 iJ SS# - - Phone 1i) 1- 9 rkd State #U(.041 Municipal IP Competency # fa Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION NE.`ts1 l.v 0 6, a(. FVx V1 (\T OAr\4(r RI. PAIRS Square Ft. Estimated Cost(value) Signature of owner and /or Condo President Date: Signa Date; Tax Foii0 \ 3) g 01'1'001 0 7. 0 06 _ i WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on 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. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Contracto r er- Builder ?N Notary as to Owner and /or Condo President Notary as to Contractor or Owner- Builder My Commission Expires: My Commission Expires:,, :., Cc. Csa:,:;; r cia- Lruran ** * * * * * * * * * * * * * * ** .11 FEES: PERMIT RADON C.C.F. NOTARY TOTAL DUE APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbing s S Engineer Permit No /IP/ Owner's Name and Address Amount of Permit $ M IA My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is bereby 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. No i ° s E Z. Registered Architect and/or Engineer .. --....- . N EVenYlurfehiestr) . . _.._ . No. INIMMIVIMO. , . Ss • 1.1111.0111•11■1 Of .111•TV • Location and Legal pti Lot ‘.-- Block Subdion& 7..e.4A 0, Street and Number where work is to be performed—No State work to be performed and purpose of building (By Floors)__ 13NT 1 l - r 1 New Building_________ .... ____ Remodeling__ _.--- Addition Repairs No. of Stories .. ... (Si Street Size Septic Tank_ __Type of Tank____. Feet of Drain Tile _—Dist. Feet of Tank or Drain Field from Well . Nature of Water Supply: City—WelL Size of Soakage Pit (Signed)-' 1 oq' Notary Public, State of Florida Master Phunbee. .... . ..... .._ Plumbing Inipector. 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 Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and Iii corn- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the wore to he performed under this permit; and will post or cause to be posted' fc% inspection on the site of the work such public , .. ce or no as SIT .9 e f thispermit, AS are / required by the Act. The undersigned agrees to employ only such sub-coutr • o k to .I, . licensed by Miami Shores Village. , 7 ■'>,. STATE OF FLORIDA.' as. 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 be is the . of the above described construction, that be has carefully read the foregoing application, and that be 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 Boob se•lospootfoo atedensammitry by improper sodas for Inspection, or faulty materials and/or workmanship. CLosrra BATH Tue. "" LAVA. TORIES gl"" SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINK1NO POUNT'NS TOTAL F111 CONTR. LIST / / CHECK — .... SIEPTIC TANK SIWER CONN. DRAIN FISLO SOAKAGIS PIT G TRAP SOLAR HCATIER DRIP WILLL SPRKLR. 8 ISV•11C0 POOL Comm. LIST CHICK Permit No /IP/ Owner's Name and Address Amount of Permit $ M IA My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is bereby 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. No i ° s E Z. Registered Architect and/or Engineer .. --....- . N EVenYlurfehiestr) . . _.._ . No. INIMMIVIMO. , . Ss • 1.1111.0111•11■1 Of .111•TV • Location and Legal pti Lot ‘.-- Block Subdion& 7..e.4A 0, Street and Number where work is to be performed—No State work to be performed and purpose of building (By Floors)__ 13NT 1 l - r 1 New Building_________ .... ____ Remodeling__ _.--- Addition Repairs No. of Stories .. ... (Si Street Size Septic Tank_ __Type of Tank____. Feet of Drain Tile _—Dist. Feet of Tank or Drain Field from Well . Nature of Water Supply: City—WelL Size of Soakage Pit (Signed)-' 1 oq' Notary Public, State of Florida Master Phunbee. .... . ..... .._ Plumbing Inipector. 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 Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and Iii corn- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the wore to he performed under this permit; and will post or cause to be posted' fc% inspection on the site of the work such public , .. ce or no as SIT .9 e f thispermit, AS are / required by the Act. The undersigned agrees to employ only such sub-coutr • o k to .I, . licensed by Miami Shores Village. , 7 ■'>,. STATE OF FLORIDA.' as. 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 be is the . of the above described construction, that be has carefully read the foregoing application, and that be 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 Boob se•lospootfoo atedensammitry by improper sodas for Inspection, or faulty materials and/or workmanship. 'G rUYCAL iBI NG : ect 1 MIAMI SHORES VILLAGE, FLORIDA DATE 4° 3 195/ Contractor's License No Work to be performed under this Permit PERMIT N? 10892 actor ! ft r 1,4 ilder iption =SS of ,ng Lot Value of Amt. of i l 76 �r l l 1'' f ;a . Project $ Permit $ i eo, :.nowaxe,on mlosts 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 in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, gs, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations =ng to the work covered hereby whether shown on the plans or drawings or ilythe statements or specifications and that he assumes responsibility for work y his agents, servants or employees. In consideration of the issuance to me of this permit I agree to erform the work covered hereunder in compliance with all ordinances and regulations rig thereto and in strict conformity with the plans, drawings st ements or specifications submitted to the proper authorities' of Miami Shores Village. sting this permit I assume responsibility for all work done/ either, mysel ny agent, servant or employee. CONTRACTOR OR BUILDER BI. f fF Signed: BY k " IN OR Subdi- vision BY 1 -w11211. AUTHORITY _�itect tractor • uilder 1 :ription dress of ..iilding BUILDING trCTRICAL UMBING OFING ier of ding '`•\ e -f I r -rt Lot I 1 � 5 - - N rRA- cfb - a - oR mftrir,r MIAMI SHORES VILLAGE. FLORIDA PERMIT IT? 11044 n Work to be performed under this Permit Bl. Signed• Subdi- vision DATE J 195._ Contractor's License No BY /II INSP consideration of the issuance to me of this permit I agree perform the work covered hereunder in compliance with all ordinances and regulations thereto and in strict conformity with the plans, drawings, . tatements or specifications submitted to the proper authorities of Miami Shores Village. .ng this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. " Value of Amt. of C / 0 ,• / Project $ Permit $ .......�.r. This permit is gr nted to the contractor or builder named above to construct the building or to install the equipment or device described in the applicatioiir- efor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at4a... if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is ` `ed is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulati ty ..� � rp ining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for w . fi' m by his agents, servants or employees. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. /„:1 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 Shore; 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. 4- Owner's Name and Address �x - No Street Registered Architect and /or Engineer F !c-_-' Employing Plumber's Name ._. - -`ti ` � -' ` N o / '' s ' ,,Street. if '� i ICS .0 p 1, i,...�.•- it. - 1 01t .a... -Z_./ ,. Location and Legal Description Lot- ,i Block_ Subdivision Street and Number where work is to be performed— No.__t �^ _e : r' ' c_____r___ 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. Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $___ -- (Signed) f "`_4_2 2 ' STATE OF FLORIDA, 1 ss. COUNTY OF DADE. (Signed) My Commission Expires Notary Public, State of Florida 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, an f} 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. 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. 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 URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS r �, 1 TOTAL FIXTURES C CONTR. LIST 2 CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'S POOL 1 � 1 V% � , / W k , 1 CONTR. LIST f CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. /„:1 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 Shore; 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. 4- Owner's Name and Address �x - No Street Registered Architect and /or Engineer F !c-_-' Employing Plumber's Name ._. - -`ti ` � -' ` N o / '' s ' ,,Street. if '� i ICS .0 p 1, i,...�.•- it. - 1 01t .a... -Z_./ ,. Location and Legal Description Lot- ,i Block_ Subdivision Street and Number where work is to be performed— No.__t �^ _e : r' ' c_____r___ 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. Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $___ -- (Signed) f "`_4_2 2 ' STATE OF FLORIDA, 1 ss. COUNTY OF DADE. (Signed) My Commission Expires Notary Public, State of Florida 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, an f} 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. 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. 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. _ ___ 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 ,r � Employing Plumber's Namo ,/ i F \ 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) _ Bloel, Subdivision / 0 7 O str ._ ..M.. �. .L -C =� \- _ (- A 3_62L.....2 4.. 0.K....._ . .1 _�. .... ............. New Building - ___ Remodeling-- _....- .___ -__ Addition. Amount of Permit $ licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. 0 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT F,Or✓!�/� No. / O 70 (Signed)- Z47 (Sign Repairs _L..-- Size Septic of Tank.__ Feet of Drain Tile. - .__.___.___..._._ _ — _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well Size of Soakage Pit Capacity Gals. No. of Stories...... ............ ------ - - - - -- Plumbing Inspector. The undersigned applicant for this building pp g permit does hereby certify that he understands and acceptxliis obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of FloridePermanent Supplement, and bus 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 e work suc . u . lic notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on to be o n . _ permit, as are aster 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 ead the foregoing _..__ f .. - s therein by him stated are true. y mg�g applicatiory and that he did sign the same, and that all facts My Commission Expires Notary Public, State of Florida mater OTT: e inspection fee of $1.00 will be made when such re-inspection is made•neoeuary by improper notice for inspection, or faulty CLOE[rn BATH TUBE SHOWERS LAVA. TORI[6 SINKS SLOP SINK[ LAUNDRY Tins URINALS CATCH BASIN FLOOR DRAIN —. DRINKING FCUNT'NE TOTAL FIXTURES CONTR. List CHECK —� SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER Dm. WELL SPRKLR. SYSTEM SW1M'0 POOL CONTR. LIST CHECK Permit No. _ ___ 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 ,r � Employing Plumber's Namo ,/ i F \ 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) _ Bloel, Subdivision / 0 7 O str ._ ..M.. �. .L -C =� \- _ (- A 3_62L.....2 4.. 0.K....._ . .1 _�. .... ............. New Building - ___ Remodeling-- _....- .___ -__ Addition. Amount of Permit $ licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. 0 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT F,Or✓!�/� No. / O 70 (Signed)- Z47 (Sign Repairs _L..-- Size Septic of Tank.__ Feet of Drain Tile. - .__.___.___..._._ _ — _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well Size of Soakage Pit Capacity Gals. No. of Stories...... ............ ------ - - - - -- Plumbing Inspector. The undersigned applicant for this building pp g permit does hereby certify that he understands and acceptxliis obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of FloridePermanent Supplement, and bus 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 e work suc . u . lic notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on to be o n . _ permit, as are aster 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 ead the foregoing _..__ f .. - s therein by him stated are true. y mg�g applicatiory and that he did sign the same, and that all facts My Commission Expires Notary Public, State of Florida mater OTT: e inspection fee of $1.00 will be made when such re-inspection is made•neoeuary by improper notice for inspection, or faulty wik Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the bidding 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 he 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___ __ _ __ _______ _ __ _ - ..._ _ Employing Plumber's Name ' I' No. __, /_. - . `/ Street , Location and Legal Description Lot 4'r, /c '''� ¢i 1 ° 4 __ Block_ _ Subdivision/._;.-, �' Street and Number where work is to be performed —No. Street •__ 1_:e . r -r /, State work to be performed and purpose of building (By Floors) New Building - . CONTR. LIST CHECK CONTR. LIST CHECK CLOSETS SEPTIC TANK Size Septic Tank B 4TH Tues SEWER CONN. STATE OF FLORIDA, COUNTY OF DADE. SHOWERS DRAIN FIELD Feet of Drain Tile l • Nature of Water Supply: City —Well. ss. LAVA- TORIES SOAKAGE PIT MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Remodeling _ _ _ _ Addition . - Repairs No. of Stories SINKS SLOP LAUNDRY S INKS TUBS GRZASE TRAP SOLAR HEATER DEEP SPRKLR. SW IM 'G WELL SYSTEM POOL - _ Type of Tank. -- - 1- ;` ___ Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Amount of Permit $ _ - -- (Signed) (Signed) No -- -- . Street URINALS CATCH BASIN FLOOR DRI NI<INC DRAIN I FOUNT NS Capacity Cals. My Commission Expires Notary Public, State of Florida Date / FIXTURES 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 Pe,:uc::,c'nt Snpplci eit, and has corn - plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be perfonned 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 arc licensed by Miami Shores Village. 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. NOTE: A re- inspection ice of $1.00'will be made when such re- inspection is made necessary by improper notice for inspec. ion, or faulty materials and /or workmanship. TOTAL