402 NE 93 St (10)Permit No C I C)
Owner's Name and Address
OS
Registered Architect and /or Engineer .
Zimplay ng Plumber's
Location and Legal Description Lot
Bloc Subdivision
Street and Number where work is to be performed —No 4 74 ell✓ .4
Street.
State work to be performed and purpose of building (By Floors)__.__ _ .__ ______
New Building _ -- Remodeling_____. - -___ _ -_ Addition
Size Septic Tank
Feat of Drain Tile__._IC
Nature of Water Supply: City—Well
STATE OF FLORIDA, }
COUNTY OF DADE. •
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PUJMBING PERMIT
No._
_Type of Tanis
t. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Street.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submittec(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.
.e.. _ ssases ......_ veal Na..IIIM,..12C7.0q21131.,.....062..6830 Street.,.2..2..65.a..... ..:.. r...I e•
Repairs No. of Stories..... ..........
_... .Capacity Gals._._._ _.__._. __. - -. -- •___ --
Amount of Permit $ (Sigted)- I - 624 '). -- — -------------•-- - - - - --
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 Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
liorynscd by Miami Shores Village.
(Signed)
Master PI ber.
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 avid says that he is the
of the above described construction, that he has carefully read the foregoin3 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 it made•neoessary by improper notice for inspection, or faulty
materials and /or worJrmrrnchip.
CLOSSara
BATH
Tuas
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBA
URINAL{
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•Ne
TOTAL.
FIXTURE'
CONTR.
LICIT
CHECK
—_
•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIDT
caaricut
Permit No C I C)
Owner's Name and Address
OS
Registered Architect and /or Engineer .
Zimplay ng Plumber's
Location and Legal Description Lot
Bloc Subdivision
Street and Number where work is to be performed —No 4 74 ell✓ .4
Street.
State work to be performed and purpose of building (By Floors)__.__ _ .__ ______
New Building _ -- Remodeling_____. - -___ _ -_ Addition
Size Septic Tank
Feat of Drain Tile__._IC
Nature of Water Supply: City—Well
STATE OF FLORIDA, }
COUNTY OF DADE. •
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PUJMBING PERMIT
No._
_Type of Tanis
t. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Street.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submittec(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.
.e.. _ ssases ......_ veal Na..IIIM,..12C7.0q21131.,.....062..6830 Street.,.2..2..65.a..... ..:.. r...I e•
Repairs No. of Stories..... ..........
_... .Capacity Gals._._._ _.__._. __. - -. -- •___ --
Amount of Permit $ (Sigted)- I - 624 '). -- — -------------•-- - - - - --
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 Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
liorynscd by Miami Shores Village.
(Signed)
Master PI ber.
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 avid says that he is the
of the above described construction, that he has carefully read the foregoin3 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 it made•neoessary by improper notice for inspection, or faulty
materials and /or worJrmrrnchip.