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373 NE 92 St (6)MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 'ar-ei4 T+to. / ` Date q 6/' Application is hereby .nade fos 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. Owner's Name and Address E - -. :E- /_i4_2-- _— ___..____ -_ No. _------ '_ 7.:3 Street-- 9 Registered Architect and /or Engincer.______�.. ____ ___ _ Employing Plumber's Name__f..t _l. cFi_I _iU-�_t _e14- 1 c it No.-__.-___._ Location and Legal Description Lot.--__ _---- _ __�______, Street and Number where work is to be performed —No { S late work to be performed and purpose of building (By Floors) __ -- - - :1L1 -_� - - -- 1_!? .Ls i New Building ___ -.__ Remodeling__ -__ Addition_-- _ -.__. Repairs Amount of Permit $ The undersigned applicant for this building permit does hereby certify that he understands and accepts under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori plied with the provisions thereof, and will require similar compliance from all contractors or sub -contj performed under this permit; and will post or cause to be posted' for inspection on the site of the requ.red by the Act The undersigned agrees to employ only such sub- contractors, ork t licensed by Miami Shores Village. ( Signed) ( Signed )_. c - - Street_ ___ Block Subdivision_ 3 Street �. _. My Commission Expires Notary Public, State of Florida J T No. of Stories...., Size Septic Tank. ___ -_— Type of Tank__ Capacity Gals Feet of Drain Til e ................. -_- -----__Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._____ ___________________Size of Soakage Pit Plumbing Inspector. bligations as an employer of labor ennan Supplement, and has com- er employed by him in the work to be such public notice or notices as are perfo ed under this permit, as are Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. f Before me, the undersigned authority, a notary public, duly authorized to administ 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 he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. Cl!atS ?Ti5 BATH TUSG SHOW CRS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URIL URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 TOTAL FIXTURES Cowro. LIST C1T.CK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL —•— Ceaarta. LIST — CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 'ar-ei4 T+to. / ` Date q 6/' Application is hereby .nade fos 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. Owner's Name and Address E - -. :E- /_i4_2-- _— ___..____ -_ No. _------ '_ 7.:3 Street-- 9 Registered Architect and /or Engincer.______�.. ____ ___ _ Employing Plumber's Name__f..t _l. cFi_I _iU-�_t _e14- 1 c it No.-__.-___._ Location and Legal Description Lot.--__ _---- _ __�______, Street and Number where work is to be performed —No { S late work to be performed and purpose of building (By Floors) __ -- - - :1L1 -_� - - -- 1_!? .Ls i New Building ___ -.__ Remodeling__ -__ Addition_-- _ -.__. Repairs Amount of Permit $ The undersigned applicant for this building permit does hereby certify that he understands and accepts under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori plied with the provisions thereof, and will require similar compliance from all contractors or sub -contj performed under this permit; and will post or cause to be posted' for inspection on the site of the requ.red by the Act The undersigned agrees to employ only such sub- contractors, ork t licensed by Miami Shores Village. ( Signed) ( Signed )_. c - - Street_ ___ Block Subdivision_ 3 Street �. _. My Commission Expires Notary Public, State of Florida J T No. of Stories...., Size Septic Tank. ___ -_— Type of Tank__ Capacity Gals Feet of Drain Til e ................. -_- -----__Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._____ ___________________Size of Soakage Pit Plumbing Inspector. bligations as an employer of labor ennan Supplement, and has com- er employed by him in the work to be such public notice or notices as are perfo ed under this permit, as are Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. f Before me, the undersigned authority, a notary public, duly authorized to administ 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 he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship.