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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.