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461 NE 93 StPermit No. !!"i MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Repairs Amount o f Permit s Z % ( Signed ) 2 - ' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith dbmltted 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 Dopy of approved plans and specifications must be kept et building during progress of work. � � 1412 /' Owner t' Owner's Name and Address 1 �// 5,1 ( JILL No / Street.. — 93 5r . /4 Registered Architect and /or Engineer -rA) g Employing Plumber's Name f i9-i � �4-c c� Na4 3 & _ (..� .Z..�r.... 1lrMt. �..z.Q. !✓. c✓ ! s � f oi' anS Le al ` sc pt�on Lot-E— / 9 "�' �4 Bk,k snbdl,ldon. � Street and Number where work is to be performed —No 7 A / Street.__.__ f ..._._... .' ...... State work to be performed and purpose of building (By )__._.— New Building.__..__ ------- ..... -.._.. Remodeling - - -- Addition -. _. No. of Stories Size Septic Tank._ Type of Tank_—_ Feet of Drain Tile D1 Feet of Tank or Drain Field from Well .. --•------__ -- Nature of Water Supply: City—Well. Size of Soakage Pit. 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 5988, Compiled General Laws of Florida Permanent Supplement, and h„T com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worm- 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 licensed by Miami Shores Village. - STATE OF FLORIDA, 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 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 $L00 will be made whsa glob re aspeotfau Y oade•aeoan-ry by improper notice for inspection, ar faulty materials and /or workmanship. CLOSETS B TM US� SN [RS LAVA- TORIES / S KS JN SLOP SINKS LAUNDR TUSS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT• NS ,J, / / TOTAL F17TURES --- CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR HEATER DEEP WELL BPRKLR. S SM'IM'O POOL CoNTR. LIST r� CHECK Permit No. !!"i MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Repairs Amount o f Permit s Z % ( Signed ) 2 - ' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith dbmltted 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 Dopy of approved plans and specifications must be kept et building during progress of work. � � 1412 /' Owner t' Owner's Name and Address 1 �// 5,1 ( JILL No / Street.. — 93 5r . /4 Registered Architect and /or Engineer -rA) g Employing Plumber's Name f i9-i � �4-c c� Na4 3 & _ (..� .Z..�r.... 1lrMt. �..z.Q. !✓. c✓ ! s � f oi' anS Le al ` sc pt�on Lot-E— / 9 "�' �4 Bk,k snbdl,ldon. � Street and Number where work is to be performed —No 7 A / Street.__.__ f ..._._... .' ...... State work to be performed and purpose of building (By )__._.— New Building.__..__ ------- ..... -.._.. Remodeling - - -- Addition -. _. No. of Stories Size Septic Tank._ Type of Tank_—_ Feet of Drain Tile D1 Feet of Tank or Drain Field from Well .. --•------__ -- Nature of Water Supply: City—Well. Size of Soakage Pit. 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 5988, Compiled General Laws of Florida Permanent Supplement, and h„T com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worm- 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 licensed by Miami Shores Village. - STATE OF FLORIDA, 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 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 $L00 will be made whsa glob re aspeotfau Y oade•aeoan-ry by improper notice for inspection, ar faulty materials and /or workmanship.