PLUMBINGBUILDING
ELECTRICAL
PLUMBING
ROOFING
Ui vr_er c:
Builc�ir,q.
Architec-
Contracto
or Buiic.LL
Legal.
Descrip CIl
Addre
Build :r cl
MIAMI SHORES VILLAGE, FLORID
BATE
rj
PERMIT N9 8343
CONTRACTOR OR BUILD ?R
Work to .Be performed under this Per:nit
Suodi-
5n. Et..
Va1uo of
Project
BY
Contractor's
License Nca.
1 '95`__ _
] mi. of
F errnit
Thi; nc-;:iit is granted to the cantractor or builder named above to const the building or tc install the equipment r device described in the application
Lerefor in aria compliance with all ordinances pertaining thereto and with t understanding that the wo-k will be performed in compliance with any plans,
drawing, .tote -ents or specifications that may have been submitted to and ap, by the proper minicipal authorities. This Permit may be revoked at any
time if the I. is not done in compliance with such ordinances or if the ph.ns sic changed without authorization. A further condition upon which this permit is
,ranted i< fro _rnderstanding that the contractor or builder named above as;ttm_s the responsibility For thorough knowledge of the ordinances and regulations
pertaining( tJ the work covered hereby w1 shown on the plans or drawing: or in the statements or speci and that he assumes responsibility for work
done by his aients, servants or employees.
Signed: — — — BY
INSPECTOR
In r .n-ideration or the i,snance to me of this permit I agree to per=orm the work covered hereunder- in compliance with all ordinances and regulations
pertaining trop° and in strict caeta-mit with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permi. I assume re pon:ibility for all work done by either, myself, my gent, secs ant or employee.
p; a
.AUTHORITY
BUILDING
L-- -4
ELECTRICAL
PLUMBING L
ROOFING
Ovrner
Build:Est
cr
Lo:Tcl
AdIrLa
CON IIIAC;011. (J BUILDEa
MIAMI SHORES VILLAGE. FLORIDA
P E lit 31 1 rr N
8273
'Work to he performed under this Pernit
195
Contractor's
License Nc:
Sc-
Vi.Si Or.
cf V LVt. of
ro-t Pc.rrnit
L7 graTlECC1 t the contr,ctor or builder named above to constri'ct the building crr t install cor.ipmert c)• device described in tl.e c.i)plication
here:ot in -t'ict. corrpliance v•iCi all ordinances pertaining thcrEto and with th understanding that thc work will n,r recfornecl in complianc e. any plans.
rit:r or c;),..cification,-; that may have been suhmitted to Lnd 11)pr:wed hy the proper 1 uiicfral authorities. "l1 Pc:mlit may he N:' 01 at any
time if tklc rot d1171j p!itinco ■ such ordinances or if the plass ay r. changed withol,t ant:Iori:;ation. A turthcr con.lition ton which thi, permit is
granted ta H.2r.•t;or.clirg• that the. connector or builder nam.cd ahovc assl.mes the responsibility fcr a thoroirgl) knowledirc (o the ordinance an,1 7ceulations
pertainirr.: ta t1 covered lirJj 'whethtrr 11own on the plaris or (drawings or in the statement crfccii:rations and that he ume,: responsihnit% for work
done by LOtS sarcvant. or ernooc.;„
Signed: BY
LNSPECTOR
1 :t.]rat of the i:-..wance to no of this permit I agree to perform Ihe work covered hercund.:r 0 corrpliance v•ith all ordinances Inc r , :r.n.ations
pertainir tle..c-Lto and in strict conformity .yid) the plans, drawings, statements or specifications sohnittcc to the pc peeper aiitoritc of :vliano Shore, Village.
In accept 'hi, permit I :lb.:II:TU.11: rosoonsikiiity for all work clone by either, my:trlf, my agent, set or employee.
BY AUTHORITY
MIAMI SHORES VILLAGE
PLUMBNG NSPECTi N DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Apnlicaaion is hereby na • a far the approval of the detailed atatement of the plans and specifications herewith submitted for the building or
lazzein deswileed. T application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all previsions of the Laws of the State of Florida, ail ordinances of Miami Shores Village and all rules and regulaticns of the Building Divls!a...n
Shores Village shall he complied with whether heazin apefied. or not. A copy of approved plans and specifications must be kept ;at
bufaiin3 during proxes of work.
Gcvnefe Name. and AcIdmss .A2/ No. , •
Street
Registaaed Architect and/or :Engineer_
Employing ?lumber's Namea_f_il.?.!./ EV
LOCS5331 and Legal 'Description Lot_
Stato work to be perform:4i and purpose of building (By Floors) ' ''- 4 -' 4 ' Y - • .7.
New BuiWing Remodeling — Addition Repaira Nc. of Stories
06;
AEZMPZ c2 $ ... ....
( i
vixvz ImeamA,
COUNTY 'IF DADE.
.fT4
( Signed )_
St'-5 Sapt!C Type of Tank_
Fut. cl Dacin ................. Feet of Tank or Drain Yield from Well
Water Supply: City—Wail. _Size of Soakage Pit
Date
Street. '
Subdivision . _
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands ar4 accepts his obligations as an employer of lobar
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Sapplement, and hob ca-a-
Flier: walz the arovizions tlaeaeof, and will require similar compliance from all contractors or sub-contractors e proyed by hirn in the work to b
ch public notice or notices as 0.:7.3
performecrAder this permit, i:s
perfanani aaarix ahis permit; and wild post or cause to be posted' for inspection on the site of the w tk
ky tk Act. The undersigned agrees to employ only such sub-contractors, o ri aa/ork)
/
lia- 1.57g l'Atin,i Shores Village. i/
la/
•Z , . ,....,,
_,....,,,..--....._. ,...._.:_ . - -,,,,,
Master Plumbea.
Before aro, the undcrarlgne'L authority, a notary public, &sly authorized to administer oaths and take acknowledgments, personally appears
to me well known, End who, being by me first duly sworn, upon oath deposes and says that he is the_
of the above dezeribed construction, that he has carefully read the fl application, and that he did sign the same, and that all facts
therein by hisr, stated are true.
My SE-4321 Expires Rotary Public, State c Florida
NCTE: A ra-inspectica fee of $1.00 will be made when such re-I:mond= is mado•neeessery by improper notico for inspection, or i'af
rratarials analks workrnsnc'hi,na
e
BATH
TU DS
SKOW'ERS
LAVA-
Tomes
SINKS
SLOP
$INK
LAUNDRY
UBZ3
URINALS
CATCH
BASIN
FLOOR
DRAIN
DAT NK NG
FOUNT' NS
- . .
YOY A L
FIXYL::1:Z5
corral.
UST
i /'.. 7//'
.--,
---
cazax
oaParc
YGC,13
samara
COMM.
BOA I N
FIELD
SOAKAGE
PIT
—
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
---
SPRKLR.
SYSTEM
SW I M • G
POOL
__
• . __
ocanu•
UST
C::SCR
MIAMI SHORES VILLAGE
PLUMBNG NSPECTi N DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Apnlicaaion is hereby na • a far the approval of the detailed atatement of the plans and specifications herewith submitted for the building or
lazzein deswileed. T application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all previsions of the Laws of the State of Florida, ail ordinances of Miami Shores Village and all rules and regulaticns of the Building Divls!a...n
Shores Village shall he complied with whether heazin apefied. or not. A copy of approved plans and specifications must be kept ;at
bufaiin3 during proxes of work.
Gcvnefe Name. and AcIdmss .A2/ No. , •
Street
Registaaed Architect and/or :Engineer_
Employing ?lumber's Namea_f_il.?.!./ EV
LOCS5331 and Legal 'Description Lot_
Stato work to be perform:4i and purpose of building (By Floors) ' ''- 4 -' 4 ' Y - • .7.
New BuiWing Remodeling — Addition Repaira Nc. of Stories
06;
AEZMPZ c2 $ ... ....
( i
vixvz ImeamA,
COUNTY 'IF DADE.
.fT4
( Signed )_
St'-5 Sapt!C Type of Tank_
Fut. cl Dacin ................. Feet of Tank or Drain Yield from Well
Water Supply: City—Wail. _Size of Soakage Pit
Date
Street. '
Subdivision . _
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands ar4 accepts his obligations as an employer of lobar
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Sapplement, and hob ca-a-
Flier: walz the arovizions tlaeaeof, and will require similar compliance from all contractors or sub-contractors e proyed by hirn in the work to b
ch public notice or notices as 0.:7.3
performecrAder this permit, i:s
perfanani aaarix ahis permit; and wild post or cause to be posted' for inspection on the site of the w tk
ky tk Act. The undersigned agrees to employ only such sub-contractors, o ri aa/ork)
/
lia- 1.57g l'Atin,i Shores Village. i/
la/
•Z , . ,....,,
_,....,,,..--....._. ,...._.:_ . - -,,,,,
Master Plumbea.
Before aro, the undcrarlgne'L authority, a notary public, &sly authorized to administer oaths and take acknowledgments, personally appears
to me well known, End who, being by me first duly sworn, upon oath deposes and says that he is the_
of the above dezeribed construction, that he has carefully read the fl application, and that he did sign the same, and that all facts
therein by hisr, stated are true.
My SE-4321 Expires Rotary Public, State c Florida
NCTE: A ra-inspectica fee of $1.00 will be made when such re-I:mond= is mado•neeessery by improper notico for inspection, or i'af
rratarials analks workrnsnc'hi,na
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewth submitted for the buil
ing or other structure herein described. This application is made in compliance and conformity with the Bui.ding Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances ol 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 prggress of the work.
Date.
Owner's Name and Address , ,-, - 7- - ,e!-- 7. , - ,2 ,3 , No •----.' e street_ r- ' - '
llcgiatercd Axchitect and/or Engineer
- • -
Name and address of licensed contractor X
••
Location and legal description of lot to be built on:
Lot V 6 : ' , e7 ----' Block
i
'/- ' Subdivision ,,,,,..,-, , /<, ,-,"/? /.
/
Street and Number where work is to be done 7 (, "V. 7,;: --' • r
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Lloof ., vering
Estimated Total cost of improvements $...-.4./e). •.`-'-- Amount of Permit $. - i °
,---,,,
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to ---•','% ,-,-..,,, cr...it -,, - ": • -.-=t:*
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employe::
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 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 subcontractors, on work to be performed under fris
permit, as are licensed by Miami Shores Village.
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. ss..
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally el,-
ceased
and who, being by me first duly sworn, upon oath deposes and says that he is the.
cf the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fats
therein by him stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
'17,1J :Q. V: n rr,2;
Building Inspector
.t>
Choir
Member
Member
Council Approved Date
NOTE: A charge of $1.00 will
the f.anning Board.
A re-inspection fee of 51.00
materials and/or workmanship.
UILDFNCA INSra*C:TION DEPAR7MENT
F:La
IC
,
.to me well know,
Notary Public, State ot Florida
My Commission Expires
PLANNING BOARD .DATE
Member
Member
Member
Disapproved Date
be made for making corrections or changes to this application after approval has been obtained from
will be charged when such ra-inspection is made necessary by improper notice for inspection or fauL'y
Date
Metz^ 8.:..4 _ - U y
Building and Zoning Department
Attention: Building Official
Gv� ew<':'
123.03-92
D
SWIMMING POOL OWNER'S CERTIFICATION
7:
I certify that I am the legal owner of the property described asi�- --4/1 °
located at JC 4, S -
In accordance with Section 33- 12(f), Code of Metropolitan Dace County, 1 certify that 1
understand and agree that the swimming pool to be constructed at the above address cannot be
used or filled with water until a separate permit has been obtained for an approved safety bar-
rier, and such barrier erected, inspected and approved.
11 further understand that this certification, however, does not eliminate the need for ob-
taining a permit and erecting an approved barrier prior to final inspection and use of, the pool.
Legal Owner `,7
Note: This certification is to be submitted with a swimming pool permit application in duplicate.
F r
• "V
-- --
CLOOEYC
BATH
TUDS
�. -- - —"
.MOW MC'
LAVA- -
TORIEO
GINKO
SLOP
F
LAUNDRY
TL•JS
�_- —�-
URINALO
CAVE
DAUIN
FLOOR
DRAIN
DRINKING
FOUNT' NO
TOTAL
F IIYUr'2CI.6
Como.
Cx3CK
SEPYIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
.ems
D IL' EP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL.
- --
-
N -• —_J --
-- --'
CGrNv:1.
LIEV
OM 3E
//
- - -
Pxnrnit No
Stato Wei: to he performed and purpose of b iblag (3y IF/lears)
Now Iauildimmr3 __ Remmnodeling____ -- — _ -- --•
Sac 'II anPs ._._ -- --
Fest of IIDaain Tile_
—_-- -
Nature of Water Supply: City — Well.__
Arsat of Permit 3
S'li'A'IP.e. ®F FL ®RMA,
COUNT7 ®F DADIE.
My Commission Expires
KUM :W.9 NOPi CTEON ®EPARYWRNT
Application is hereby made far the approval ¢s the drtailldl stctemrnt of the plans and specifications herewith submitted for the building or other
structure herein describ d. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Villcge,
arzd all provisions of the Laws of the State of Florida, aHE ordimmammc00 of Miami Shores Village end all rules and regulations of the Building Division
Miami Shores Village shall be complied with, whetaer herein specified or not. A copy of approved plans and specifications must be kept et
( nilrting during prouress of work.
afro Name and Address
Registered Architect and /or IEngineer_—__- __` --1
}Employlig Plumbers Name A;% °;'=}RSr'_ -47
l e.= and Legal Description Lot. �° t - 9 ' ' Bier lr Subdivision_--- - .... — _.-........
Strr s end Numlz�r wham work to l perfe rWdl�No � °` 1 � Street_ 4
Addition Repairs
_--- __Type of Tank_
__Dist. Feet of Tank or Drain Field from Well
_ Size of Soakage Pit
(Signed) -
:Plu ins IInspecto .?
The undersigned applicant for this building permit does hweby certify that he understands and accepts his obligations employer of labs
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent S plement, and I:as co7:-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed y him in the work tc be
performed under this permit; caul will post or cause to be postal for inspection on the site of the work such public notice or notices as a,.�.
req',afrr by tine Act. The undersigned agrees to employ only such sub - contractors, on wore to be performed under this permit, as ere
lifeenzscd Mimll Oksma VilLege.
Master Plumber.
Date__. `1
eat..
Capacity Gals.
No. of Stories. -
s
Mary Public, State of Florida
i
P7,! .P ° _ Street —_/ �zn
Before ma, the undersigned authority, a notary pubErc, duly authorized to administer oaths and take acknowledgments, personally apper ee
to me well !mown, and who, being by me first duly sworn, anpon oath deposes and says that he is 'the
of the above described construction, that he has carefully mead the foregoing application, and that he did sign the sante, and that all facts
thece;n by him stated are true.
NOTE: A rr weesei n fee of 01.40 wiiR lla Enci3 wihco uzza F. inspcction 1.0 MO&•n ay by improper notic. for k s 1, or falLy
materials aadl /e2 cyu3 nas'rnp.
-.. . ....._
— —
CLOSETS
. -. _. .,-
OATH
TUBS
. -
C
LAVA.
TORIES
SINKS
SLor
SINKS
LAUNDRY
TUBS
URINALS
CATCH
imam
...............
FLOOR
DRAIN
DRINKING
FOUNT' NS
....mom.
...............
TOTAL
P:KTUREE
CONTR.
LiBT
•
.,
CHECK
_ L . .
-, ,
SEPTIC
TANK
SEWER
CONK.
..e■g
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
..s...e■ww.. ,_
DEEP SPRKLR.
WELL SYSTEM
ISWCM•G
POOL
.
CONTR.
Liorr
1
/
CHECK
... ......
.. ..
•
..
,
Pearr_it No
ApAcation is hereby made for the approval of the detailed statement of
structure herein described. his application Is made in compliance and conie:
and a provisions of the Laws cf the State of Florida, all ordinances of
of Lei Shores Village shall be cii..^.plied with, whether heroin spe';....
bur.din.g dusting progress of 'Jerk.
Owner's Nanze and Address..
Reretl and/ar Engineer
? 7,7, ‘ 77
Employlmg nirc'ear's Name.. No. Street.— _
,
Location and Legal Description Lot. Blook.. Subdivision..._______ ... __...
Street and Number where work is is. he performed—No SNeet-
State work to he performed and purpose of building (By Floon)______ _
New Building._ Remodeling Addition_ Repairs No. of Stories.
Size Serie Tank ____ Typo of Tank__
Feet of Drain Tile._ _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Sins of Soakage Pit
Amount of Permit $
efcrso
WE'ATE O:Y FLO' 'DA,
se,
::,'OUNTIF CY DADE.
My Co;;;Tsion Expires
LAAMI StiirlitrIZ VI: .
INSPECTIOM DFPARTM.7.V.
APPLKATION FCL FLumpimn
Date /
,•, and speLi.. r .11s herewith submitted for the building or other
y with the Ordinance of Miami Shores Village, 51oricla,
Viiilap;,: and all tales and regulations of the BuiltLrk;
ved pans and bpeClications must be kept a.
S treet— c-
-1,1■11•HOlal
Capacity Gals.
Plumbing Inspectzr.
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 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
recoire by tie Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as ate
Ii=ased by Miand Shores Village. , - ,-9
(SiSnea) `'
•atr...S.•••••■•• .
,/
nude a... authority, a notary public, duly authorised to administer oaths and tako ackncrwledgmnuts, personally appeared
Notary Public, State of Florida
Muter Plumber.
to me well kowz, and W being by me first duly swons, upon oath deposes and says that he is the.
c.fr j above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
stated are true.
N3773: A ir'brApezt.L.. rze of $1.00 will be made when such re-inspection is made'necessary by improper notice fcr inspection, or faulty
matesia::; anti/or workmanship.
Jk
7,0
OATH
CLOSETS TUa6
SHOWERS
LAVA-
TORIES
RINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DR:NKI NG
FO:JNY'NS
TOTAL
IIIETURES
CO:L'Y.7.
LIG?
C: <aC L
SEWER
CONN.
_
SEPTIC
TANK
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWING
POOL.
LIG4
-
CX:ICK
;Paennt No 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
cf y,iami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans cnd specifications must ua '_ccpt at
btlding during pro:a:ess of work.
Ia 4,0
C ref o Name and Address ° r rt t_'t
ae Architect and/or Fng .r �
Plumber's Name --d ',�
St:set „ N:rrbea where work is to be performed —No.
Stc..e work to be performed and purpose of building (By Floors) _.._.-- - - - - --
Ner Building ------- - - - - -- - - - - - -- Remodeling------- - - - - -- ----- - - - - -- Addition
C ,ptic Tank_ L T 9 f Tdtrk_— Capacity Gals
e of °1 ile--- ___ - -- r / (
�, e . f I l min ___ —Dist. Fee t of Tank or Drain Field from Well
I`�_,t�.sro of Water Supply: City —Well
A :eu�t of Perrrnit 6
9ii A°�°U+ OF FLORIDA, . 3 R'' C OF '. >ADE.
My Commission Expires
L' 8At i SNORES VIL`f4GE
PLUMBING INSPECTION DEPARTMEi�7
APFLICATION FOR PLUMBING
No.
(Signed)_
Street_
= 'L - ��_� e �PJ ®. �.'_. �___
Employing Street__
Location and Legal Description Lot- __...— _�lgcl� � Subdivision
'.v ' z . : J StSeet_
Notary Publiz, State of Florida
Repairs No. of Stories
_Size of Soakage Pit
Plumbing lr-spector.
The undersi_ ry ed applicant for this building permit does hereby certify that he understands and accepts his oj'ligations as an emp:oycr of labor
wader the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pen anent Supplement, and I :as corn-
:Peel with ::he 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
rcz. r, rd by die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed •arnder this permi?, as are
Tio E i . , Miami Shores Village. r
__ — =— - - -' —` =
(Signed) � , -
r
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally u-:peared
°°:e v.reil known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ _ --
c£ Q.be above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that a:. facts
t"_cein by him stated are true.
N0 E: A rreinspection fee of X1.00 will be made w:kee such re- inspection is made'nececssary by improper notice for inspections, faulty
> cteriais and /or workmanship.
BUILDING
ad" RICAL
PLUM3ING
Owner of
Building
Contractor
or Builder
Legal
Description
Lot
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N: 4770
Work to be performed under this Permit _.4 Ira.
Architect
BI.
r
Subdi-
vision
DATE 194,:x__
Contrac'tor's
License No._
Address of Value of Amt. of -
Building _ '-- ,. , +— ' f ; /`;,*` c Project Permit
This permit is granted to the contractor or builder named above to ccnstruct the building or to install the equiut tent or device descrf ;ed :n tli,' appli-
cation herder in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in complier in with ;ni
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit n, 1:: n 1 o'.cn
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 Upn 1 NcLkli ilti-
permit is granted is the understanding that the contractor or builder named above assumes the responsib'lity for a thorough knowledge of the orciii i en;•s said
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that be lie ni :'v rr'spon-
sibili y for work done by his agents, servants or employees. r Af
H • , `
S igne :3: � r ar By - ---
L \�SPE, T
In consideration of the issuance to me of this permit I agree to perform the work covered Ihereundar tif with al .prd_nances an.1yi m
pertaining '1-creto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami SI ion s V ihTr,c.
In accepting this permit I assume respcnsibility for all work done by either myself, my agent, servant or enployoe.
CO:\TRACTOR OR BUILDER BY AUTHORII Y
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect _ _-
Contractor
or Builder ._
Legal
Description
Lot
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 4770
W ork to be performed under this Permit
Building*
Subdi-
vision
DATE
Contractor "s
License No.
194
Address of dalue of Amt. of
Project Permit
j
This permit is granted to the contractor or builder named above to constr the building or to install t equipment or device described in the appli-
cation herefor i strict compliance with all ordinances pertaining thereto and with the understanding that the y ork will be peiformied in compliance with any
plans, drawings. statements or specifications that may have loin submitted to <<nd approved by the proper num,icipal authorities. Thi.; 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 aotaroritation. A further c )edition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibili't ha a thorough knowled;e 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.
Signed- ____c....._10:'
� z' By _ ,.. ",
g � IN fe C OR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder im compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authu rities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either myself, _my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
New Bu lding Remodeling
CONTR.
LIST
CHECK
SEPTIC
TANK
CONTR.
LIST I_
CHECK
BATH
CLOSETS TUBS SHOWERS] TORIES
SEWER
CONN.
STATE JF FLORIDA,
COUNTY OF DADE, 1
DRAIN
FIELD
SS.
SOAKAGE
PIT
MIAMI SHORES VILLAGE;
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. ])ate
AppliLat ion is ' itchy made for the approval of the detailed statement of t'lie plans and specifications herewith submitted for the building or otht r
structure herein des,:rihed. This application is made in compliance and conformity with the Building Or.iinlmce of Miami Shores Village, Flortca.
and all provisions of the Laws of the State of Florida, all ordinances of ,Sarni Shores Village and all rules and rrgnlatiu Is of the Building I)iv ision
nt MianIi Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spel •ifica.tions most be kept at
building during progress of work.
Owner's N,.me and Address No. -
Registered Architect andior Engineer.
Employing Plumber's Name . No.__
Location and Legal Description Lot Block ____._____
Street and Number where work i; to be performed —No.
State ',s Lrk to he performed and purpose of building (By Floors)
SLOP
SINKS SINKS
GREASE
TRAP
SOLAR
H EATER
Additior
LAUNDRY
TUBS
DEEP
WELL
URINALS
SPRKLR.
SYSTEM
Size Septic Tank Type of Tank ____
Feet of Drain Tile Dist, Feet of Tank or Drain Field from Well _
Nature c f Water Supply; City—Well. Sine of Soakage Pit
Amount. of Permit tS ( Signed)
(Signed)
Repairs
SWIM•G
POOL.
St:eet
Shoot
Street
Subdivision
CATCH F_OCR - DRINKING
BASIN DRAIN FOL NT NE
No of Stories
C ipacity Cals.
Plumbing Inspector.
lie undersigned applicant for this building permit does hereby certify drat he understands and accepts his obligations employer of labor
under t11r2 Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of 'Horn .t Permanent Supplement. and has com-
plied with the provisions thereof, and will require similar compliance from ill contractors or sub-contractors enlp1 Ity hint in the work to be
pertoraed under this permit; and will post or cause to be posted for inspect on on the site of the work such public notice or notices as arc
required by the :Act. The undersigned agrees to employ only such srh- contractors, on work to he performed under this permit, as ale
licensed by Miami Shores Village.
My Commission Expires Notary Public, State o Florida
Master Plumber.
TOTAL
FIXTURES
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknawleclim ls. personally ,tppear
to ale well known, and who. being by •ne first duly sworn, upon oath depose; and says that 1-e is the
of the .tboce described construction, that lie has carefully read the foregoing application, and that be did :.ign ( sate, and that all laci
therein by hint stated are true.
NOTE: A rc- inspection tee of $1.00 will be made when such re- inspection is made necessary 1)) improper notice for inspection, or faults
luaterials and/or workmanship.
1'. S. FORBES JILE3ER7 C. FORBE,8
J. E. FDRBE:E
PLUMBING AND HEATING
PHONE 2 -4872
216 S. W. 12TH AVENU
MIAMI 36, FLORIDA
2.`'