PLUMBINGPermit No
I
13
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
1_,IN _ ... 14.1_17a A No._1Y ? Al i;': afeet_?.? s 7 .
building during progress of work.
Owner's Name and Address 64
Registered Architect and /or En ineer 5:1"40-1-6_-
Employing Plumber's Name___ _o__ � �/ _ / Street__ —
Location and Legal Description Lot____________ _ —____________— __, �j Block_ _ Subdivision _ ___________
Street and Number where work is to be performed—No --/-q------,A1--/-q------,A--/-q------,A1.4 7 3 Street
State work to be performed and purpose of building (By Floors)
N Building ______ ___ Remodeling_ _______ Addition____ Repairs No. of Stories.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Tank e a� Type of Tank_ Capacity Gals.
Feet of Drain e -- v� sf . Feet of Tank or Drain Field from Well
Nature of Water Supply: City — ell.________ _ ___ -_Size of Soakage Pit
Amount of Permit $
My Commission Expires
(Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi':. ions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin. t Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractor o ub- contractors : , , oyed b _ him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site f the wo •s public no 'ce or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, on ork to • e , e r ed nd this perinit, as are
licensed by Miami Shores Village.
Notary Public, State of Florida
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.
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.
CSETS
LO
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
-
Permit No
I
13
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
1_,IN _ ... 14.1_17a A No._1Y ? Al i;': afeet_?.? s 7 .
building during progress of work.
Owner's Name and Address 64
Registered Architect and /or En ineer 5:1"40-1-6_-
Employing Plumber's Name___ _o__ � �/ _ / Street__ —
Location and Legal Description Lot____________ _ —____________— __, �j Block_ _ Subdivision _ ___________
Street and Number where work is to be performed—No --/-q------,A1--/-q------,A--/-q------,A1.4 7 3 Street
State work to be performed and purpose of building (By Floors)
N Building ______ ___ Remodeling_ _______ Addition____ Repairs No. of Stories.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Tank e a� Type of Tank_ Capacity Gals.
Feet of Drain e -- v� sf . Feet of Tank or Drain Field from Well
Nature of Water Supply: City — ell.________ _ ___ -_Size of Soakage Pit
Amount of Permit $
My Commission Expires
(Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi':. ions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin. t Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractor o ub- contractors : , , oyed b _ him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site f the wo •s public no 'ce or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, on ork to • e , e r ed nd this perinit, as are
licensed by Miami Shores Village.
Notary Public, State of Florida
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.
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 No.
Size Septic Tank_.
Feet of Drain Tile
Amount of Permit S-
r
.a 1
STATE OF FLORIDA,
COUNTY OF DADE. ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date___.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. / /
Owner's Name and Address No
Registered Architect and /or Engint¢r
Employing Plumber's Name --_ -- - -- - - - -_— __- �____ -- L -- `�h No._. -.___ L - - ".
Location and Legal Description Lots �l—
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs —___ No. of Stories______________
Type of Tank .
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well.
_Block
Street
Size of Soakage Pit
(Signed)
(Signed)
Street
Stree
Subdivision_ '"?
_Capacity
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.
Notary Public. State of Florida
T
Plumbing Inspector.
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.