10777Permit No /0 7 7 Date et
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 c mPlied 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,
Registered Architect and/or Engineer V
Employing Plumber's Name_
Location and Legal Description Lot "
No. j StredN� rE D1�. tti ° i.
Subdivision
Streets $ T •
State work to be performed and purpose of building (By Floors) r 1 .. 4 .. 5 ✓ 1 . ) Q e ijo Afr 0l £.
Street and Number where work is to be performed —No
New Building Remodeling Addition
Size Septic Tank Type of Tank
Feet of Drain Tile i]tat- Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well. Size of Soakage Pit
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
lac
( Signed)
No.
X 77 .
Repairs No. of S
Plumbing Inspector.
The undersigned' applicant for thus building permit does hereby certify that 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 Supple3nent, 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
licensed by Miami Shores Village.
Str 1�-4►�
Capacity Gals
(Signed) e '
0
STATE OF FLORIDA, i , , i
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 'personally appeared
Master Plumber.
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 $ .00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship. '
CLOSETS
BATH
TUBS
SHOWERS
�, .LAVA.
TORIES
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
BAS IN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
-
-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL.
SPRKLR.
SYSTEM
SW IM'O
POOL
CONTR.
LIST
CHECK
Permit No /0 7 7 Date et
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 c mPlied 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,
Registered Architect and/or Engineer V
Employing Plumber's Name_
Location and Legal Description Lot "
No. j StredN� rE D1�. tti ° i.
Subdivision
Streets $ T •
State work to be performed and purpose of building (By Floors) r 1 .. 4 .. 5 ✓ 1 . ) Q e ijo Afr 0l £.
Street and Number where work is to be performed —No
New Building Remodeling Addition
Size Septic Tank Type of Tank
Feet of Drain Tile i]tat- Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well. Size of Soakage Pit
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
lac
( Signed)
No.
X 77 .
Repairs No. of S
Plumbing Inspector.
The undersigned' applicant for thus building permit does hereby certify that 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 Supple3nent, 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
licensed by Miami Shores Village.
Str 1�-4►�
Capacity Gals
(Signed) e '
0
STATE OF FLORIDA, i , , i
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 'personally appeared
Master Plumber.
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 $ .00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship. '