321 NE 93 StPermit No
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 subrait:cd for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of WE ! Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatim of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec_ficatlons must be kept at
building during progress of work.
Owners Name and Address _ P<2 _____�_ _ No. -52 Iv EStreet .__. 3 sr
regi stered Architect and /or Enfineer i9 - -- CR ,/n' f �000 33 ( Z
Employing Plumber's Name -KV-RI D'Abc Ti L TANK_ CO
Location and Legal Description Lot Bloc�ir
Street and Number where work is to be performed —No 4
Subdivision..--.. -_-.
Street 9 3 S%
State work to be performed and purpose of building (By Floors)_. _------ .... - .....
- ...---- __. - -- — �.......
Repairs No. of Stones. .
New Building Remodeling._ _- ___ -_- Addition.
Size Septic Tank_ ----- __ - - -- - __________ . -Type of Tank__ -------- -_ - -
Feet of Drain Tile._ ___ -Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: of Soakage Pit
Amount of Permit $
45s
Plumbing inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an enployer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent ;uP. lement, and has cor-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed 1y him in t'•e wcrk •o b�
performed under this permit; and will post or cause to be posted for inspection on the site of the work such publt notice 72 noicer as as
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed ' . ?cs this wnait, as ar .
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. /s.
( Signed )._- -(
!1
Capacity c',als
My Commission Expires Notary Public, State of Fiaida
/ 44
Pic /rind (
Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personal:;• s ppearea
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 'acts
therein by hire stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re-inspection V mads'neoeuary by improper notice for inspection, of !suit)
materials and /or workmanship.
CLOSITS
BATH
TUBS
SHOWER•
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuaa
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTF.L
FIRTI RES
Co'cm.
LIT
--
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
F
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CoNY .
LIST
/ I[LD
CHECK
r—
-
Permit No
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 subrait:cd for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of WE ! Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatim of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec_ficatlons must be kept at
building during progress of work.
Owners Name and Address _ P<2 _____�_ _ No. -52 Iv EStreet .__. 3 sr
regi stered Architect and /or Enfineer i9 - -- CR ,/n' f �000 33 ( Z
Employing Plumber's Name -KV-RI D'Abc Ti L TANK_ CO
Location and Legal Description Lot Bloc�ir
Street and Number where work is to be performed —No 4
Subdivision..--.. -_-.
Street 9 3 S%
State work to be performed and purpose of building (By Floors)_. _------ .... - .....
- ...---- __. - -- — �.......
Repairs No. of Stones. .
New Building Remodeling._ _- ___ -_- Addition.
Size Septic Tank_ ----- __ - - -- - __________ . -Type of Tank__ -------- -_ - -
Feet of Drain Tile._ ___ -Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: of Soakage Pit
Amount of Permit $
45s
Plumbing inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an enployer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent ;uP. lement, and has cor-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed 1y him in t'•e wcrk •o b�
performed under this permit; and will post or cause to be posted for inspection on the site of the work such publt notice 72 noicer as as
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed ' . ?cs this wnait, as ar .
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. /s.
( Signed )._- -(
!1
Capacity c',als
My Commission Expires Notary Public, State of Fiaida
/ 44
Pic /rind (
Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personal:;• s ppearea
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 'acts
therein by hire stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re-inspection V mads'neoeuary by improper notice for inspection, of !suit)
materials and /or workmanship.