PLUMBINGPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Pg4=7-/S Job Address /575 7&f Tax Folio /1 g a 4/ /.9 Sib 9
Legal Descriptionle l 7gi /
Owner / Lessee / Tenant Master Permit „35
Owner's Address I ��. � -�"►'� -�-
Signature of own
Date:
4pkier
41 as ti 1 n' and /or Condo President
My Commi.ssipp Expires:
�a %. GLORIA E SWILLAGO
* My Commission CC308759
** * ' I
i � Y t Expires Aug. 16. 199
* *
Bonded gy HAI
- 422 -1555
APPROVED:
FEES: PERMIT
r and /or Condo President
Zoning Buildin
Mechanical Plumbin
nature of Cont
Date: 12/L
Phone
Contracting G). the, Ni ) Mir yrn P1 Address 4 NV\J Ip Oa" K"--/
SS# � Phone
Qualifier L nnis mele,191
State # T=L- Municipal # Competency #(PC ) O Y ins.Co. N( 4relf 1 rG.
Architect/Engineer Address J
Bonding Compar.y Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
— a
WORK DESCRIPTION Qw�o Qr� C'e- \0.C2 ( t.D(Le' )°,`"‘,
Square Ft. Estimated Cost(value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULP 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 st
or or
er- Builder
otary o (�•, tr= •r 1 Owner- Builder
�t � . . • IA E SUV1LLAGC
My Commissfr • �► •1 r Commission CC308759
* '1 A J * Expires Aug. 16, 1997
Bonded by HAI
* 44., 0 4 800 -V2 -1555 *
RADON C.C.F. ,f U NOTARY TOTAL DUE
Fire Other
**
Electrical
Engineering
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH 'OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
- r
CENTRAL HEATING
DISHWASHER
RECEPTAUIS
A/C (WIND)
DISPOSAL
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
EWER
MOTORS JVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS iOVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
HATER 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
;EWER CONNECTIONS
SIGN TRANSFORMERS
JTILITY -SEWER
SIGN TIME CLOCK
JTILITY -WATER
FIXTURES
;EPTIC TANK
ANTENNA'
IELAY
TELEVISION OUTLETS
RAINFIELD, 4' TILE,RES.
VIOLATION
'OAP & ABANDON SEPTIC TANK
REINSPECTION
UAKAGE PIT CU. FT,
:ATCH BASIN
)ISCHARGE WELL
>OMESTIC WELL
REA DRAIN
OOF INLET
OLAR WATER HEATER
IRE STANDPIPE
OOL PIPING
ANN SPRINKLER SYSTEII
AS RANGE
ETER SET (GAS)
AS PIPING
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
I
(AN APPLICAT] FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
MECHANICAL
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building 7,
Architect
Contractor
or Builder_
Legal Lot
Description
Address of
MIAMI SHORES VILLAGE, FLORIDA
E
n PERMIT N? 11160
El Work to be performed under this Permit
Subdi-
vision
DATE
v .
osaNcaa
1954_
Contractor's
License No
Value of Amt. of
Building -- 1 1 ' , ,,44 7 e % ✓i Project $ Permit $ - A .
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 Jone 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 responsibility for work
done by his agents, servants or employees.
r
-4dh
INSPEDTOR r d1
In consideration of the issuance to me of this permit I agree ° tg "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 acceptia$ this permit; I assume responsibility for all work done by either, myself, my agent, servant or employee.
��w it--(41^. - t",'i � �, +het t rjP- t _ �.( � ' f � �1 o ' +i�t. '" �-' '`<`'',7,e. ,;4-P - L
v
� .4CTOR (3tt "BUILDER BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE + ° r 19
PERMIT N° 6421
v : e nrei)
Architect
Contractor
or Builder r '1„
Legal Lot
Description II Bl
CO■TRACTOROR BUILDER r BY
Contractor's
License No. i
Work to be performed under this Permit
Subdi-
vision
!
Address of !� Value of Amount of
Building 1�J /f• �� �i Project $ 11 Permit $—
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device de:,cribed in the applica-
tion 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 ths.t he assumes respon-
sibility for work done by his agents, servants or employees.
rr
GRZ o/ n ry;
INSPECTOR
Signed. r- < « �'
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compli e with all ordimmces and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper 4 thorities of Miami Shores Village. In ae
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
1
AUTHOR 411110T
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL El DATE J �^ 195
PLUMBING ❑ PERMIT N? 9249 2 4 9 Contractor's
License No -i
ROOFING ❑
❑ Work to be performed under this Permit
Bl.
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
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 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 .-evoked 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 responsibility for work
done by his agents, servants or employees.
Signed
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work coveted 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 responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
;UILDING ❑
LECTRICAL ❑ PERMIT
'LUMBING ❑ N e o
9306
GOOFING ❑
)caner of
wilding
: ontractor
4' Builder
•egal
)escription
address of
wilding
Lot
lrchitect
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Bl.
DATE
195
Contractor's
License No
Work to be performed under this Permit
Subdi-
vision
Sq. Ft
Value of
Project $ f.'.
Amt. of ,
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 application
lerefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
;rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ime if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon w.iich this permit is
;ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
'ertaining 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
ie
lone 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 her in compliance with all ordinances and regulations
,ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n accepting this permit' I assume re sponsibj,),ity--for -an work done by either, myself, my agent, servant or employee.
BY AUTHORITY
TILD)NG ❑
.ECTRICAL
JMBING
?FJNG
'caner of
Buildin
Architect
or Builder Ilse
Legal
Description
Address of
Building
❑ PERMIT N? 11127
done by his agents, servants or employees.
Signed•
CONIBACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
a
DATE t - ` 7 i gr A rl
Contractor's
License No
performed
I
TARE
this Permit
Subdi-
vision
Value of
Project $
Amt. of
Permit
r
"jaCltO#
BY AUTHORITY
1
5
This permit is g.,•anted to the contractor or builder med above to co ruct the building or to install the equipment or device desc ed in t e application
herefor in strict compliance with all ordinances pertainin thereto and with he understanding the work will be performed in compliance wi ny plans,
drawings, statements or specifications that may have bee submitted to andk approved by the, municipal authorities. This Permit may be revok any
time if the work is not done in compliance with such ordinances or if the plans are changed ith.. authorization. A further condition upon which this pe is
granted is the understanding that the contractor or builder named above at sumes the resp ty for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or dr wings or in th .cements or specifications and that he assumes responsibility for work
\ i' Eetesre
In consideration of the issuance to me of this nerinit I agree to perform the work covered hereunder in compliance with all* ordinances an . regulations
pertaining thereto and in strict conformity with the plans, drawings, staliements or specifications submitted to the roper authori of Miami S res Village.
In accepting this permit I assume tespansibility for all work done b myself, my agent, servant or employee.
l'e.nni. No.
is hereby made for the approval of the detailed statement of the plans and specifications herewith subr for the building or other
structure herein cic This application is made in compliance and conformity with the Building Ordinan f hores Village, Florida,
4. all pros isi0115 of the Laws of the State of Florida, all ordinances of Miami Shores Villa ndTru1es and regulatir- of the Bin • vision
ot Miami Sores Village shall be complied with, whether herein specified or not. A p.ey of approved Owls and spec fIcations most be kep
'minding during progress of work.
2Av E I <
'wner's Name and Address
iegict Ired Arc.hit:,ctiagd/or Eng
Mo Avv1 i YICritleect , --4
:mploying Plumler's Name i2.LG AIL.—se---.7 lc Ad 'No..
t
)1/4/ E
Street and Nuinbu- where work is to be performed—No 1 5 r - Street
State work to be performed and purpose of building (By Floors) ek--/N i WO g
New Building ..... _______.. . Remodeling Addition Repairs 1-----
Location and Legal Description Lot
CLOSETS
CoNTR.
Li T
CHECK
cownR
LIST
SEPTIC
TANK
---------- -
Amount of Permit $ . j
BATH
Toes
SINNER DRAIN
CONN. PALO
STATE OF FLORIDA,
sa.
COUNTY OF DADE.
SHOWERS
o
LAVA•
TORIES
SOAKAGE
PIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
SINKS
GREASE
TPA/.
SLOP
SINKS
SOLAR
HEATER
LAUNOR
Tus•
Daum
WILL
URINALS
CHICK
Size Septic Tank_..._..__ ...... __..__._______—__...Type of Tank_
Feet of Drain Tile__ __-.._Dist. Feet of Tank or Drain Field from Well
Nature of Water 5.upply: City—Well Size of Soakage Pit
(Signed)
SPRKLR.
SYSTEM
CATCH
BA•IN
Sw 1 m'
POOL
FLOOR
DRAIN
(Signed).
%OA Date
DRINKING
POuNT•Ne
Nc. of Stones
My Commission Expires Notary Public, State of Florida
Capacity ........... .
... • . • • •
ToT,.L
FixTt RES
lumbin3 Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as en e ndloyet o !alkyl
oniii•r the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent rum lement, and li
with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed 1 y him in ' o rk v ii-
I ,Tionned under ti- Is perrnit; and will post or cause to be posted' for inspection on the site of the work such pnbl: notice no icer is
required by the Act. The undersigned agrees to employ only such sub-contractors, on work to .
rformed this „.> TI Ik
licensed by Miami Shores Village.
Mut a Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, perior-e, ppearet.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the al descr:bed construction, that be has carefully read the foregoing application, and that he did sign the same, and tnat all acts
therein by him statei are true.
NOTE: A re fee of ;1.00 will be made when such re-inspection ia made by improper notice for ingpsy-t.ton, fruit)
materials and/or wa.kmanship
Registered Architect and/or Engineer
ElnPloYing Plumber's Mum E
Amount of Permit $
MCAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
PLICATION FOR PLUMBING PERMIT
Je' 3 - 2--
Permit No Date..._3T ?...
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 ;tad Address -Tala C No ) 5-6— fl e .1.4SIStreet 1,7
Location nd Legal Description Lot. 2-1"- '24 Subdivision
Street and Numixr where work is to be performed—No 153 /7e c32-,1 L .
State work to be performed and purpose of building (By . _S
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank. Type of Tank
Feet of Drain Till _Dist. Feet of Tank or Drain Field from
Nature of Water Supply: City—Well. Size of Soakage Pit.
(Signed)
.11.1
.... • •
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob tions as an employer of labor
under the Florida Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Peri v. ent Supplement, and hal 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.
STATE OF FLORIDA, I
as.
COUNTY OF DA:3E.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, sad who, being by me first duly sworn, upon oath deposes and says that he is the
of the above doses bed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him natal are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when molt redsopoction te arde.ntecosary by improper notice for boopation, at faulty
materials and/or waionansinp•
CLoserra
OATH
TU BS
..,„.......
."
"'""'''' .
LAVA-
TORIES
alP41
SLOP
SINKS
LAUNDRY
Tugs
URINALS
CATCH
BASIN
FLOOR
DRAIN
CRIMPLING
FOUNT•NO
TOTAL
FIXTURES
Corm.
Liar
Cmactt
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
CREASE
TRAP
SOLAR
H CLATIM
DEEP
WILL
ISPRKLR.
SYSTEM
SW IM'CI
POOL
CONTR.
LIST
CHECK
Registered Architect and/or Engineer
ElnPloYing Plumber's Mum E
Amount of Permit $
MCAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
PLICATION FOR PLUMBING PERMIT
Je' 3 - 2--
Permit No Date..._3T ?...
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 ;tad Address -Tala C No ) 5-6— fl e .1.4SIStreet 1,7
Location nd Legal Description Lot. 2-1"- '24 Subdivision
Street and Numixr where work is to be performed—No 153 /7e c32-,1 L .
State work to be performed and purpose of building (By . _S
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank. Type of Tank
Feet of Drain Till _Dist. Feet of Tank or Drain Field from
Nature of Water Supply: City—Well. Size of Soakage Pit.
(Signed)
.11.1
.... • •
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob tions as an employer of labor
under the Florida Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Peri v. ent Supplement, and hal 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.
STATE OF FLORIDA, I
as.
COUNTY OF DA:3E.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, sad who, being by me first duly sworn, upon oath deposes and says that he is the
of the above doses bed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him natal are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when molt redsopoction te arde.ntecosary by improper notice for boopation, at faulty
materials and/or waionansinp•
Permit No. __--__-- (D _ z _ --
Application is 1 ereby made for the approval of the detailed statement of the plans and specifications herewith submi yf d 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 provisior!s 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 Shore:; 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 f- ' 'J `_ _o W
Registered Archi:ect and /or Engineer _________ — ___
Employing Plum''Der's Name . � n f — 1� f¢�f - 2 G' - - - - -- - -�� . ` - ,J✓
_____ .___ No.__ __.. _ _— Street_ _ -
Location and Legal Description Lot_-_ -_-----___ ___ __--_------ _--_ - -_ _ �_ Block - -_^ — — •__ - Subdivision
Street and Number where work is to be
State work to be performed and purpose of building (By Floors)' _______ _ � -t /v
New Building Remodeling Addition
Amount of Permit $__
STATE OF FLORIDA, 1
J
as.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) __
No.. Street_ _ -_ 2:12 _.._
— Street
Repairs
Date_
Capacity Gals
Size Septic Tank J Type of Tank
Feet of Drain Tile. -3 , �A ' Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City VV Y. _____________Size of Soakage Pit
No. of Stories .
Plumbing Inspector.
The undersignel applicant for this building permit does hereby certify that he understands and accepts,/Jiis obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and Ilas 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 ;ire true.
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 work ianship.
CLOSETS BATH
TUBS
SHOWERS
LAVA •
TORIES
SINK6
SLOP
SINKS
LAUNDRY
TUBS
UR
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
SW IM'G
POOL
CONTR.
LIsT
� ,
__ -- -_
CHECK
Permit No. __--__-- (D _ z _ --
Application is 1 ereby made for the approval of the detailed statement of the plans and specifications herewith submi yf d 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 provisior!s 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 Shore:; 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 f- ' 'J `_ _o W
Registered Archi:ect and /or Engineer _________ — ___
Employing Plum''Der's Name . � n f — 1� f¢�f - 2 G' - - - - -- - -�� . ` - ,J✓
_____ .___ No.__ __.. _ _— Street_ _ -
Location and Legal Description Lot_-_ -_-----___ ___ __--_------ _--_ - -_ _ �_ Block - -_^ — — •__ - Subdivision
Street and Number where work is to be
State work to be performed and purpose of building (By Floors)' _______ _ � -t /v
New Building Remodeling Addition
Amount of Permit $__
STATE OF FLORIDA, 1
J
as.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) __
No.. Street_ _ -_ 2:12 _.._
— Street
Repairs
Date_
Capacity Gals
Size Septic Tank J Type of Tank
Feet of Drain Tile. -3 , �A ' Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City VV Y. _____________Size of Soakage Pit
No. of Stories .
Plumbing Inspector.
The undersignel applicant for this building permit does hereby certify that he understands and accepts,/Jiis obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and Ilas 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 ;ire true.
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 work ianship.
�-c 3 0C=='
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEN\''
APPLICATION FOR PLUMBING
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 provisims 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 Arc:iitect and /or gineer_'_____..—
Employing Plumber's Name' ' `_ "—a
Location and L egal Description Lot._
Street and Nuniber where work is to be performed— No.____ / L _ __
State work to be performed and purpose of building (By Floors)
New Building___. Remodeling Addition
Nature of Water Supply: City —Well
Amount of Permit $
STATE OF FLOF IDA, 1
j ,s.
COUNTY OF DADE.
____ __ Block__
—
No._.
- --- - - - - - -- (S��) - --
Aru
Street 1.0414 )--
Street
Date_
Subdivision
. 7.
Repairs
plied with the provisions thereof, and will require similar compliance from all contractors or sub -con
performed under this permit; and will post or cause to be posted' for inspection on the site of the
required by the Act. The undersigned agrees to employ only such sub - contractors, � 6�t work
licensed by Miami Shores Village.
(Signed)
Street_
My Commission Expires Notary Public, State of Florida
7- Y
No. of Stories.
Size Septic Tank. Type of Tank Capacity Gals
Feet of Drain Tire Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbin: nspector.
The undersig>ed applicant for this building permit does hereby certify that he understands and accepts his obligations as an a ployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppleme t, and has c'om-
•tors employed by him Wthe work to be
ork such public notice or notices as
be performed under this permit, as
Master Plumber.
are
are
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acicnowledgments, personally appeared
to me well known, tnd 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
TUBE
TUBS
W
SHOER
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
-rue,
URINALS
CATCH
FLOOR
DRAIN
DRINKING DRINK
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
itSW
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
-
/
`/
CHECK
�-c 3 0C=='
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEN\''
APPLICATION FOR PLUMBING
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 provisims 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 Arc:iitect and /or gineer_'_____..—
Employing Plumber's Name' ' `_ "—a
Location and L egal Description Lot._
Street and Nuniber where work is to be performed— No.____ / L _ __
State work to be performed and purpose of building (By Floors)
New Building___. Remodeling Addition
Nature of Water Supply: City —Well
Amount of Permit $
STATE OF FLOF IDA, 1
j ,s.
COUNTY OF DADE.
____ __ Block__
—
No._.
- --- - - - - - -- (S��) - --
Aru
Street 1.0414 )--
Street
Date_
Subdivision
. 7.
Repairs
plied with the provisions thereof, and will require similar compliance from all contractors or sub -con
performed under this permit; and will post or cause to be posted' for inspection on the site of the
required by the Act. The undersigned agrees to employ only such sub - contractors, � 6�t work
licensed by Miami Shores Village.
(Signed)
Street_
My Commission Expires Notary Public, State of Florida
7- Y
No. of Stories.
Size Septic Tank. Type of Tank Capacity Gals
Feet of Drain Tire Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbin: nspector.
The undersig>ed applicant for this building permit does hereby certify that he understands and accepts his obligations as an a ployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppleme t, and has c'om-
•tors employed by him Wthe work to be
ork such public notice or notices as
be performed under this permit, as
Master Plumber.
are
are
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acicnowledgments, personally appeared
to me well known, tnd 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
Owner's Name and Address
Size Septic Tank
Feet of Drain Tile
Nature of 'Water Supp
� IQ/rount of Permit $
STATE OF FLORIDA, 1
• COUNTY OF DADE.
Applic..tion 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 ■iarni 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. -
Register;d Architect and /or Engineer__ :- _ _4
Employing Plumber's Name 4L___ G__
Location and Legal Description Lot__ ---------- _,..____ A ______ Block
Street acd Number where work is to be performed —No
State wo.rk•to be perfo ed
and purpose of building ii]__ Floors \
/ �1
New Building Remodeling Addition Repairs No. of Stories
ss
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No L �, Street -- 'i
I No
Date , ..� a
Street_(
Subdivision
Street ��
Type of Tank Capacity Gals.
ist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed)
(Signed)
My Commission Expires Notary Public, State of Florida
/
P1umliing Inspect
The undersigned applic t for this building permit does hereby cerkify that he derstands and accepts his obligations as an employer f labor
der the Florida Workmel's Compensation Act, being Section 5966, C kpile. general Laws of Florida Permanent Supplement, a as com-
ed with the provisions t ereof, and will require similar compliance from -a contractors or sub- contractors employed by him in the work to be
onned 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
ed by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
ensed*lSy 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
TOTAL
FIXTURES
CONTR. -
LIST
p
CHECK
`�
6 " *
�j
1 ,
��
`��) f�
1 "" l_i
c-
, �u�
•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
D EEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
_
V
/
•
C HECK
- if Ul
Permit
Owner's Name and Address
Size Septic Tank
Feet of Drain Tile
Nature of 'Water Supp
� IQ/rount of Permit $
STATE OF FLORIDA, 1
• COUNTY OF DADE.
Applic..tion 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 ■iarni 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. -
Register;d Architect and /or Engineer__ :- _ _4
Employing Plumber's Name 4L___ G__
Location and Legal Description Lot__ ---------- _,..____ A ______ Block
Street acd Number where work is to be performed —No
State wo.rk•to be perfo ed
and purpose of building ii]__ Floors \
/ �1
New Building Remodeling Addition Repairs No. of Stories
ss
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No L �, Street -- 'i
I No
Date , ..� a
Street_(
Subdivision
Street ��
Type of Tank Capacity Gals.
ist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed)
(Signed)
My Commission Expires Notary Public, State of Florida
/
P1umliing Inspect
The undersigned applic t for this building permit does hereby cerkify that he derstands and accepts his obligations as an employer f labor
der the Florida Workmel's Compensation Act, being Section 5966, C kpile. general Laws of Florida Permanent Supplement, a as com-
ed with the provisions t ereof, and will require similar compliance from -a contractors or sub- contractors employed by him in the work to be
onned 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
ed by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
ensed*lSy 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
( /%
Owner's Nam and Address _______
� _� % ^:
Size Septic Tani f�'
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application i; hereby made for the approval of the detailed statement of the plans and specifications herewith sub fitted for the buil r'ig or other
stricture herein described. This application is made in compliance and conformity with the Building Ordinance o , Tiami 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 worke-
i
Registered Arl:hitect and /or gineer
Employing Plumber's Name No Street
Location and :Legal Description Lot 2 B v ( Block__ 2 Subdivision_ .7
Street and Number where work is to be performed —No.._ AYS — Street
No � %•
Date
Street
State work to ')e performed and purpose of building (By Floors)
New Building � Remodeling Addition Repairs No. of Stories .�
Type of Tank
Capacity Gals 6_0_0
Feet of Drain Tile , �Ql- -L Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply:
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
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 .:his 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. /
(Signed) �1���' f i ^� L' ' / t
Master Plumber.
ss.
Well. Size of Soakage Pit
(Signed)
Before me, tho 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
NKS
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
SW IM•G
POOL
CONTR.
LIST
_
,
CHECK
a
L/
Permit
( /%
Owner's Nam and Address _______
� _� % ^:
Size Septic Tani f�'
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application i; hereby made for the approval of the detailed statement of the plans and specifications herewith sub fitted for the buil r'ig or other
stricture herein described. This application is made in compliance and conformity with the Building Ordinance o , Tiami 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 worke-
i
Registered Arl:hitect and /or gineer
Employing Plumber's Name No Street
Location and :Legal Description Lot 2 B v ( Block__ 2 Subdivision_ .7
Street and Number where work is to be performed —No.._ AYS — Street
No � %•
Date
Street
State work to ')e performed and purpose of building (By Floors)
New Building � Remodeling Addition Repairs No. of Stories .�
Type of Tank
Capacity Gals 6_0_0
Feet of Drain Tile , �Ql- -L Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply:
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
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 .:his 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. /
(Signed) �1���' f i ^� L' ' / t
Master Plumber.
ss.
Well. Size of Soakage Pit
(Signed)
Before me, tho 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.