32 NE 92 St (7)rs•■■
CLOSETS
BATH
TWOS
SHOWERS
""g"
LAVA.
SINKS
SLOP
SINKS
LAUNDRY
Tuve
U RINAL S
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NE
TOTAL
FIXTURES
--
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
8
SWIM'S
FOOL
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No 6 4 WY
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.
(Signed)
Street..! �! E" 72-
Owner's Name and Address
Registered Architect r %N ngiryetr pc s ,vr% __........_ .._ .
Em )0 6 1 Pal � d�a ,016/018 5- �e c!�.. No..—...S7. - .. Itr..eIN . .... 1/ i
�/ Loca and %Legal Description Lot. Bloctr / S ubdi4*ion
Street and Number where work is to be performed —No. . street .. k L 571
State work to be performed and purpose of building (By Floors) C \e •.�►.,_ -_— 30_0 5 '
New Building..----_-- .-- .........._.. Remodeling—__ Addition.. ---- ......__..... Repairs. .6..e." No. of Stories
Size Septic Tank__ _Type of Tank -.. _ --
Feet of Drain Tile Dist Feet of Tank or Drain Field from Well..._-__.._
Nature of Water Supply: City —We1L Size of Soakage Pit
- )4o 9y - ......
....
Amount of Permit (Signed)__4_‹.
�`
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 hav com-
plied with the provisions thereof, and will require similar compllance from all contractors or sub - contractors employed by him in the work to he
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such .:878 notice or notices as arr
required by the Act. The undersigned agrees to employ only such sub - contractors, on to be - � und.. this permit, as are
lionised by Miami Shores Village.
er P umber.
STATE OF FLORIDA, } ss.
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 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 81.00 will be made wham snob ee Is nsede"msosasary by improper notice for inspection, or faulty
materials and /or workmanship.