149 NE 93 St (4)_ Building Department
RECE t �� 1 t50 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
JUN 3
BUILDLN _ 0
Permit No. y-,6
PERMIT APPLICATION Master Permit No46 P.2 001- -R.09
FBC 2001
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) \C -kEL r, . NA-C rPhone #
Owner' Address 1 �- e 3rd. 5r �e cr
City AC o{ estate t d-& Zip 3 3 1 3 i;3
Tenant/Lessee Names\(. L ' ' 8_ 1 10 GA r .l Phone #
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES NO +�
Contractor's Company Name c rn1�eNt7/t �9� Phone # / �7
Contractor's Address �r (/L
City / // *f �� State ��" Zip
Qualifier { cq tr/7/-
State Certificate or Registration No. ( / c cr.5 .ef- 4 Certificate of Competency No.
(Continued on opposite side)
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 50 • `'T
Type of Work: ❑Addition! ❑Alteration
10)9scribe Work: �� / (' 1 L...
Total Fee Now Due $ 1 7.
Miami Shores Village
County Miami -Dade Zip
Square Footage Of Work:
* ** **** **** ** ** ******* ***** * * ** ******** * * * ** * *** ********
Mechanical Roofing
33 t 3�
❑ Demolition
( 1 / ,l
Submittal Fee $ S(7 , 0 v Permit Fee $ f(® CCF $ • h (/ CO /CC
0
Notary $ Training/Education Fee $ Technology Fee $
Scanning ° 6 Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 _, by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
************************ * * * * * * * * * * * * * * * * * * * * * * * * *, * * * **
* * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **
APPLICATION APPROVED BY;
Chc 05/13/03
Contractor
The foregoing instrument was acknowledged before me thi
day , 20 A
who is personally known to me or who has produced
as identification and , h . did take an oath.
NOTARY PUB e
s• Ale
rkfoilifik
My Conunission Expire
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * **
****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
- 7 Plans Examiner
Engineer
Zoning
•
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
1
RECEPTACLES
A/C (WIND)
DISPOSAL
k
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP,
MOTORS OVER 3- 5 If
MECHANICAL VENTILATION
SINK, RESIDENCE
1
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 If
,,
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
- FIXTIRES
SEPTIC TANK
ANTENNA
RELAY
;TELEVISION OUTLETS
DRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & 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
METER.SET (GAS)
GAS PIPING
ADDENDUM T41BUILDING PERMIT AOLICATION
(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.)
P zaoy _ 9L99
MECHANICAL
PLUMBING
ELECTRICAL
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Plumbing Permit
Permit Number: PL2004 -186
Printed: 7/7/2004 Page 1 of 1
Applicant: ELLEN GARRETT
Owner: GARRETT ELLEN
JOB ADDRESS: 149 NE 93 ST
Contractor SILVER PLUMBING & SEWER SERVICE INC Contractor's Address: 1071 NE 79 ST
Local Phone:
Parcel # 1132060133030 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 21 & W1/2 LOT 22 BLK
Fees: Description Amount
FEE2004 -6834 Building Fee $180.00
FEE2004 -6835 CCF $0.60
FEE2004 -6836 Training and Education Fee $0.20
FEE2004 -6837 Technology Fee $4.50
FEE2004 -6838 Scanning Fee $3.00
Total Fees: $188.30
Permit Status: APPROVED Permit Expiration: 12/27/2004 Construction Value: $500.00
Work: PLUMBING FOR KITCHEN REMODELING
9 7(
Total Fees: $8.30
Total Receip 0.00
3e.3 a
\
JUL 0 9 PAID
Signed: (INSPECTOR)
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 pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Permit NoJe2F
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 s specified
/ not. A copy of approved plans and specifications must be ke t at buildin durin a rogress of work.
Owner's Name and Address G�VS No,/ 4 Street ✓ 7—
✓ a" No. Street
Registered Architect and/or Engineer
E loyin PI er's ame
7 �
Locatioand Legal escription L t l I ��'!/ - t 0 Block 2
Street and Number where work is to be performed — No. / 4. 9 1# /
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
Size Septic Tank
Feet of Drain Tile
Nature of Water Supp
Amount of Permit $ °~5 ^ W
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank l ' f r "
(Signed) 9
Capacity Gals.
SS.
ss.
Date / —?
Subdivision
w.
1)
No. of Stories
r 7
Dist. Feet of Tank or Drain Field from Well
ell 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 complied with the provisions
thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the ork 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 e d bJ he Act. The undersigned agrees to employ
only such sub - contractors, on work to be performed under this permit, as are licensed by Miami �- s�
(Signed) i
Master Plumber.
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
NOTE: A re- inspection fee of $25.00 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
FOUNTAINS
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 NoJe2F
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 s specified
/ not. A copy of approved plans and specifications must be ke t at buildin durin a rogress of work.
Owner's Name and Address G�VS No,/ 4 Street ✓ 7—
✓ a" No. Street
Registered Architect and/or Engineer
E loyin PI er's ame
7 �
Locatioand Legal escription L t l I ��'!/ - t 0 Block 2
Street and Number where work is to be performed — No. / 4. 9 1# /
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
Size Septic Tank
Feet of Drain Tile
Nature of Water Supp
Amount of Permit $ °~5 ^ W
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank l ' f r "
(Signed) 9
Capacity Gals.
SS.
ss.
Date / —?
Subdivision
w.
1)
No. of Stories
r 7
Dist. Feet of Tank or Drain Field from Well
ell 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 complied with the provisions
thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the ork 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 e d bJ he Act. The undersigned agrees to employ
only such sub - contractors, on work to be performed under this permit, as are licensed by Miami �- s�
(Signed) i
Master Plumber.
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
NOTE: A re- inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials
and /or workmanship.
Name of Owner
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
„/f
Date of Application
9/
T5
Type of .
012 spd"Co
stablishment
AUDITCON ROL NO. N9 244801
HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used)
(Stock Number: 5744-001-4015-1)
Authority: Chapter 381, FS
Chapter 10D -6, FAC
PART I - APPLICATION
. 3 s/
ail
ing Address of Ow er y
Owner's Agent /-/ Builder
// 1 '7
Agent's Mailing Addres7� � G� C° / T elephone No d 0
- " qoperty Street Address
Lot No. Block No. Subdivision Date Subdivided
NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BOUNDS DESCRIPTION
This Application is for: New System Repair Existing System
TOTAL FLOW =
Sewage Flow Sewage Flow
(Gallons per day) Based On
Telephone NTnber
r
Permit Application Number
Type of No. Bedrooms Heated or Cooled Area No. Dwelling Sewage Flow
Residential (each dwelling unit) (each dwelling unit) Units (Gallons per day)
ft
ft
Exact Directions to Property
Applicant's Signa ure
Page 1 of 3
Owners Name and Address
Amount of Permit $
Registered Architect and /or En
Employing Plumber's Name
Location and Legal Description Lot_
Street and Number where work is to be performed —No
Size Septic Tank_
Feet of Drain Tile
Nature of Water Sup y: City—Well.—
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No.../ .6 Llf
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 Dopy of approved plans and specifications must be kept at
building during progress of work.
State work to be performed end purpose of building (By Floors) —__. ------- w_.___ .__.._..._ _._.._.._._ .... ..............._ ....._.
New Building.__-_.-_ - _ _ Remodeling _.-__. Addition -- -__ —. _ _... Repairs. ' No. of Stories.
_Type of TAn
Nat. Feet of Tank or Drain Field from Well
o 4 S/> eet_
Date... 7 - » 7
Subdivldon.—__
Street. 7 - _ --
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 5968, Compiled General Laws of Florida Pennanent 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 k to be performed under this . permit, as are
ltceased by Miami Shores Village.
( Signed) r I
Master Plumber.
STATE OF FLORIDA, t 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.
M Commission Expo Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when web swiaspeotlan is made•naosaaary by Wimps: notice for hispection, or faulty
materials and /or workmanship.
CLOSETS
BATH
Tun•
Tuns
LAVA•
TORIES
SIN"
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' HS
TOTAL
FEATURES
CONTR.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOA KAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DIP
WILL
SPRKLR.
SYSTEM
SW IM•G
POOL
LIST
CHICK
Owners Name and Address
Amount of Permit $
Registered Architect and /or En
Employing Plumber's Name
Location and Legal Description Lot_
Street and Number where work is to be performed —No
Size Septic Tank_
Feet of Drain Tile
Nature of Water Sup y: City—Well.—
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No.../ .6 Llf
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 Dopy of approved plans and specifications must be kept at
building during progress of work.
State work to be performed end purpose of building (By Floors) —__. ------- w_.___ .__.._..._ _._.._.._._ .... ..............._ ....._.
New Building.__-_.-_ - _ _ Remodeling _.-__. Addition -- -__ —. _ _... Repairs. ' No. of Stories.
_Type of TAn
Nat. Feet of Tank or Drain Field from Well
o 4 S/> eet_
Date... 7 - » 7
Subdivldon.—__
Street. 7 - _ --
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 5968, Compiled General Laws of Florida Pennanent 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 k to be performed under this . permit, as are
ltceased by Miami Shores Village.
( Signed) r I
Master Plumber.
STATE OF FLORIDA, t 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.
M Commission Expo Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when web swiaspeotlan is made•naosaaary by Wimps: notice for hispection, or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE, FLORIDA
BUILDING n DATE //�.. ` � " 194_45
Owner of
Building
ELECTRICAL �1 PERMIT NT° 7246
PLUMBING
Work to be perfo
ed under this Permit
Contractor's
License No
Architect —
Contractor
or Builder,
Legal
Descriptio
Address
Building
This permit is (ranted to the contractor or .,i1der named above to construct the building or t6 install the equipment o device described in the appli-
cation herefor in stric compliance with all ordin ces pertaining thereto and w th 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 authorization. A further condition u.on which this
permit is granted is the understanding that the contractor or builder named above assumeesp. s .ility for a thorou nowledge of - or.. ances and
regulations pertaining to the work covered hereby whether shown on the plans or avyAte, or in . - tatements or sic' ca ions and yes respon-
sibility for work done by his. agents, servants or effi T6Tees.
Signed.
SP CTtM1 - ,,. .
In consideration of the issuance to me of this permit I agree to perf . u e w covered hereunder in compliance with all ordinance s and --
pertaining thereto and in strict conformity with the plans, drawings, state - nt8 or specifications submitted to the proper authorities of Miami
In acceptin: this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
BY
AUTHORITY
lUILDING
--LECTRICAL
'LUMBING
Owner of
Building
Architect 1
Contractor
In Builder
Legal Lot
Description r
Address of / / f
3uilding d/' !
This permit is
F
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 7246
Work to be performed under this Permit
sibility for work done by his agents, servants or employees.
Signed.
.
Subdi-
vision
Value of
Project
BY
/ _s
DATE //
•
ranted to the contractor or der named ab ve to construct the building or to install the equipment oydevice described in the appli-
cation herefor in strict compliance with all ordina ces 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 authorization. A further condition u on which this
permit is granted is the understanding that the contractor or builder named above assumes he resp sibility for a thoroug nowledge of - ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or draw or in esitatements or speci ations and e a r...es respon-
In consideration of the issuance to me of this permit I agree to perform tl'ie work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statenrrnts or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I bi
aassume responsibility for all work done by either myself, my agent, servant or employee.
/CONTRACTOR OR BUILDER
Contractor's
License No
Am
Permit
AUTHORITY
194.
4 f
BUILDING
ELECTRICAL
PLUMBING
Owner of i t
Building
CONTRACTOR OR BUILDER
7�vMIAMI SHORES VILLAGE, FLORIDA
tt DATE 194
PERMIT N. 4165
Work to be performed under this Permit
1
Subdi-
vision
g t f a
Si ned INSPECTOR By
Contractor's
License No.
Architect
Contractor
or Builder
Legal Lot BI.
Description
Address of / r7 ` ' Value of Amt. of
Building r r Project Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device 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 are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
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
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting,tiris perwit I assyn]e resp sibilityi all work done by either myself, my agent, servant or employee.
r r
BY AUTHORITY
Permit No
1 -k ,
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.
Name and Address___ T_
Registered Architect and /or Engineer_
Employing Plumber's Name !4E L e
Location and Legal Description Lot Block / Subdivis }on
Street and Number where work is to be performed —No �� Street !
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
Amount of Perrnit $ __�
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)
No /it 9
No.__ street_ _A'i__ e 7
Dist. Feet of Tank or Drain Field from Well
(Signed)
�/� f Street /�`A -.
Type of Tank �1�C����� Capacity Gals } ® O
No. of Stories
Size Septic Tank O
Feet of Drain Tile__ r
^!
Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing Inspector
The undersigned a plicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Wor en'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.
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
vials 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
FIED
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
_
� /0
CHECK
Permit No
1 -k ,
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.
Name and Address___ T_
Registered Architect and /or Engineer_
Employing Plumber's Name !4E L e
Location and Legal Description Lot Block / Subdivis }on
Street and Number where work is to be performed —No �� Street !
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
Amount of Perrnit $ __�
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)
No /it 9
No.__ street_ _A'i__ e 7
Dist. Feet of Tank or Drain Field from Well
(Signed)
�/� f Street /�`A -.
Type of Tank �1�C����� Capacity Gals } ® O
No. of Stories
Size Septic Tank O
Feet of Drain Tile__ r
^!
Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing Inspector
The undersigned a plicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Wor en'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.
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
vials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
Contractor's � 00 1,
License No.
PERMIT N9 3008
Work to be performed under this Permi
>' 3 (
Architect _.
sx
Contractor
or Builder
Legal Lot . t /17 Bl.
Description "' ' "
Address of / c. •
Building
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 authorization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibilit er a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on th2 plaus.ac- slrawingc...os. iw atements ,ox s and
that he assumes responsibility for work done by his agents, servants or employees.
Signed. ' " ` t { By ,., „ir
g
e INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto atpd in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In a9ceppng this permit 1 asetlme responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
t
Subdi-
vision
Value of
Project
BY
Amt. off (
Permit
AUTHORITY
e
Permit qp
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
Owner's Name and Address building during progress of work.
.... 51.1_, S ‘14°
_____ — ___ -- No / . Street_ J_ --__-•
Registered Architect and /or Engi _
Employing Plumber's Name _ _ __ No.___ Street, �"
Location and Legal Description Lot_ *_` _ ^"1_ _' ��" Bl ' ��__ Subdivision__— S
Street and Number where work is to be performed —No at _________S.!' - ____ Street ! '_�_____
State work to be performed and purpose of building (By Floors)
New Building_ �! _ Remodeling Addition Repairs No. of Stories
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-- -_�
Date___ __ _ /2 _
(Signed)
Size Septic Tank________ Type of Tank .
Feet of Drain 'file_________ ____ ___ —_ ____ Dist., Feet of Tank or Drain Field from Well__
Nature of Water Supply: City — Well. Size of Soakage Pit
Capacity Gals._ e>
Amount of Permit $_ /# 0 0 _(Signed) ______________________________________________________________
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 under signed agrees to employ only such sub - contractors, on w. or _ t9 be . ed" nder this permis,,,,..as are
licensed by Miami Shores Village. -
My Commission Expires Notary Public. State of Florida
Master PI ' ber.
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
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
e
Permit qp
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
Owner's Name and Address building during progress of work.
.... 51.1_, S ‘14°
_____ — ___ -- No / . Street_ J_ --__-•
Registered Architect and /or Engi _
Employing Plumber's Name _ _ __ No.___ Street, �"
Location and Legal Description Lot_ *_` _ ^"1_ _' ��" Bl ' ��__ Subdivision__— S
Street and Number where work is to be performed —No at _________S.!' - ____ Street ! '_�_____
State work to be performed and purpose of building (By Floors)
New Building_ �! _ Remodeling Addition Repairs No. of Stories
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-- -_�
Date___ __ _ /2 _
(Signed)
Size Septic Tank________ Type of Tank .
Feet of Drain 'file_________ ____ ___ —_ ____ Dist., Feet of Tank or Drain Field from Well__
Nature of Water Supply: City — Well. Size of Soakage Pit
Capacity Gals._ e>
Amount of Permit $_ /# 0 0 _(Signed) ______________________________________________________________
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 under signed agrees to employ only such sub - contractors, on w. or _ t9 be . ed" nder this permis,,,,..as are
licensed by Miami Shores Village. -
My Commission Expires Notary Public. State of Florida
Master PI ' ber.
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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
MIAMI SHORES VI LLAG E
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
‘
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
Employing Plumber's Name _ 1_ _« 'r
•
Location and Legal Description LotA.L.0_ l
Street and Number where work is to be performed—No./'� �•/ /
State work to be performed and purpose of building (By Floors)
New Building____..
- - - - - -- — –f.' —mo
No. ../_/.•c_444 Street- r 4- a=' f
r Subdivision _g_wra$__,7��r
t . 44.2
Remodeling Addition
Size Septic Tank ___.
Feet of Drain Tile_
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $___
STATE OF FLORIDA, ?
COUNTY OF DADE.
Before me, the undersigned
ss.
Date_ te_Cr
No Street
Repairs ____ No. of Stories____
Type of Tank . Capacity
Dist. Feet of Tank or Drain Field from Well
(Signed)
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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
r
(Signed) r 44!.2
My Commission Expires Notary Public. State of Florida
Master Plumber.
authority, a notary public, duly authorized to administer oaths and take acknowledgments, personail}I
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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
-
/
CHECK
.
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
MIAMI SHORES VI LLAG E
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
‘
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
Employing Plumber's Name _ 1_ _« 'r
•
Location and Legal Description LotA.L.0_ l
Street and Number where work is to be performed—No./'� �•/ /
State work to be performed and purpose of building (By Floors)
New Building____..
- - - - - -- — –f.' —mo
No. ../_/.•c_444 Street- r 4- a=' f
r Subdivision _g_wra$__,7��r
t . 44.2
Remodeling Addition
Size Septic Tank ___.
Feet of Drain Tile_
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $___
STATE OF FLORIDA, ?
COUNTY OF DADE.
Before me, the undersigned
ss.
Date_ te_Cr
No Street
Repairs ____ No. of Stories____
Type of Tank . Capacity
Dist. Feet of Tank or Drain Field from Well
(Signed)
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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
r
(Signed) r 44!.2
My Commission Expires Notary Public. State of Florida
Master Plumber.
authority, a notary public, duly authorized to administer oaths and take acknowledgments, personail}I
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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Legal Lot
Description
Address of
Building
PERMIT N9 2964
Work to be performed under this Permit
Architect
Contractor r` ,
or Builder
MIAMI SHORES VILLAGE, FLORIDA
CONTRACTOR OR ILDER
Subdi-
vision
Value of
Project
DATE
Amt. of
Permit j
This permit is granted to the contractor or bu Tder 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 authorization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assuttntt.e� the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed. By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinar
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorir'
Village. I accepting this perpit I assume responsibility for all work done by either myself, my agent, servant or employee.
BY AL'
194L
Contractor's
License No.
Permit No..
Registered Architect and /or Engineer
Employing Plumber's Name
Size Septic Tank
Feet of Drain Tile___
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date_lAtee 14& . 1,y/
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 461.414 _24 11 4 11041 C0 04 0 No Street
Location and Legal Description Cote —__1hf _.k_W f2Jr lock X lumn Subdivision_ '.ti Sigili . dial
Street and Number where work is to be performed— No._i* 7 Street__ __f ___,-3___ _ ___
State work to be performed and purpose of building (By Floors)
New Building_ ___.___X Remodeling
Addition
2, y -- Street_ _E+ AE_ "
Repairs No. of Stories ......
___.___.
Type of Tank . Capacity
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit.
Amount of Permit $ r" (Signed)
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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
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.
ss.
My Commission Expires
(Signed) .,.T °a__
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.
Pr
CLOSETS
BATH
TUB
SHOWERS
LAVA-
TORI
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR. LIST
j
/
/
J
/
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..
Registered Architect and /or Engineer
Employing Plumber's Name
Size Septic Tank
Feet of Drain Tile___
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date_lAtee 14& . 1,y/
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 461.414 _24 11 4 11041 C0 04 0 No Street
Location and Legal Description Cote —__1hf _.k_W f2Jr lock X lumn Subdivision_ '.ti Sigili . dial
Street and Number where work is to be performed— No._i* 7 Street__ __f ___,-3___ _ ___
State work to be performed and purpose of building (By Floors)
New Building_ ___.___X Remodeling
Addition
2, y -- Street_ _E+ AE_ "
Repairs No. of Stories ......
___.___.
Type of Tank . Capacity
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit.
Amount of Permit $ r" (Signed)
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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
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.
ss.
My Commission Expires
(Signed) .,.T °a__
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.
Pr
JOB :
BUILDING
ELECTRICAL
PLUMBING ,iy,e
41.4 :VIA= ADD
The • Following is ready for inspection:-
Inspector's Report :
WORK
DONE BY:
REQUESTED : WILL BE READY
`• 1 7 ( ( O MAP
BUILDING
ELECTRICAL
PLUMBING
Inspectorts Report: -
• WORK
DONE BY:
• • REQUESTED
•
The Following is ready for inspection:-
A:DD : ) • L- 9 --=
: WILL BE READY
;1 NA4