152 NE 92 St (4)MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit N 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./ ' -
vv
Owner's Name and Address . l : , No Street
Registered Architect and /or Engineer r
Employing Plumber's Name__ JL_{ A nlLs -J' ^ l i„_ , 7
...L.:...::..,.. - — — - No sr� �Z Street i
Location and Legal Description Lot Block Subdivision_
,r i `/ \ -
Street and Number where work is to be performed —No % 1 Street ft '
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
Nature of Water Supply: City —Well Size of Soakage Pit
Amount of Permit $
ss.
-------- - - - --- ( Signed)
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 he
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, at are
2 G,
licensed by Miami Shores Village. -i) ( r � r ^ ' , _ '
r n
(Signed) aµ /--
D
Plumbing Inspector.
Master Plumber.
STATE OF FLORIDA, t
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
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
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAI<AGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL.
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
-
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit N 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./ ' -
vv
Owner's Name and Address . l : , No Street
Registered Architect and /or Engineer r
Employing Plumber's Name__ JL_{ A nlLs -J' ^ l i„_ , 7
...L.:...::..,.. - — — - No sr� �Z Street i
Location and Legal Description Lot Block Subdivision_
,r i `/ \ -
Street and Number where work is to be performed —No % 1 Street ft '
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
Nature of Water Supply: City —Well Size of Soakage Pit
Amount of Permit $
ss.
-------- - - - --- ( Signed)
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 he
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, at are
2 G,
licensed by Miami Shores Village. -i) ( r � r ^ ' , _ '
r n
(Signed) aµ /--
D
Plumbing Inspector.
Master Plumber.
STATE OF FLORIDA, t
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
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.
;UILDING
LECTRICAL -
'LUMBING
)wner of
; uilding
,rchitect
PERMIT N? 4862
: ontractor ,r
)r Builder
,egal Lot Bl.
)escription
MIAMI SHORES VILLAGE, FLORIDA
DATE
Work to be performed under this Permit
Subdi-
vision
-
194_
Contractor's
License„ No.
.o-
'address of ` ',jam ,. r j Value of Amt. of - Project /
luilding Project Permit
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 appli-
.ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
flans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
-t any time if the work is not done in compliance with such ordinances or if the plans are changed ' + out uthor' f: tion. A further condition upon which this
iermit is granted is the understanding that the contractor or builder named above assures the re . sibi for orough knowledge of the ordinances and
egulations pertaining to the work covered hereby whether shown on the plans or **eggs- Or s m e... ,.. specifications and that he assumes respon
ibility for work done by his agents, servants or employees. i 1..)
Signed: INS TOR By
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
.ertaining thereto and in strict conformity, with the plans �r awings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n acyepting} its permit I assume Amonsib • y for all wgrlc done by eitbe yself,..asy agent, servant or employee.
t
f'
•
•
CONTRACTOR OR BUILDER
BY
AUTHORITY
BUILDING
ELECTRICA
PLUMBING
Contractor M
or Builder
{
PERMIT N° 4862
r Work to be performed under this Permit r
Owner of t
Building �
'
Architect
Legal Lot Bl.
Description
Address of -�, --- ` Y:
Building '� i s t - l.,.
This permit is granted to the contractor or lbuilder named above to construct the building or to install the equipment or &vice described in the appli-
cation 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 areehanged .without:authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assu.Ces the res ' - • sibility for orough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or f . yam �� )ecifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA,.
Signed.
Subdi-
vision
Value of
Project
BY
DATE 194
Contractor's / `N,#.
Licensg, No.
By
Amt. of
Permit
In consideration of the issuance to me of this permit I agree to perform the work covere s ereunder in compliance with all ordinances and ;egulatipns
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities" of Miami Shores'Villdge.
In ac ' ng.Pis permit I' assume responsibility for all work done by either myself, my agent, servant or employee.
AUTHORITY