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61 NE 93 St (11)- -^ CLO[[T• BATH TU•S SHOWERS LAVA- TORIES SINK[ SLOP SINKS LAUNDRY Tuns U RINALS CATCH BASIN IL00R DRAIN DRINKING POUNT'NS TOTAL FIXTURE[ CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR MEATIER Map WELL BPRKLR. SYSTEM SWIM•0 POOL Gown*. LIST .-- CHECK Date... -- -1 8..c..2_......._._ — 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 complied with, whether herein specified or not. A copy of approved plans and specifkations must be kept at building during progress of work. Owner's Name and Address 0 V.-14 No 4;,__1.--_N_&: Street.. ` Registered Architect and /or En ' eer Employing Plutpber's Name - g.--"Z•' Location and Legal Description Lot Block Street and Number where work L to be performed —No Permit No • " LF' 1� Street. _----- ._..._. State work work to be performed and purpose of building (By K New Building- -_..._ _ _.._..........._.. Remodeling Size Septic Tank..- _Type of Tank__ Feet of Drain Tile Dist- Feet of Tank or Drain Field from Well .. - -.__- �— Nature of Water Supply: City —Wells Size of Soakage Pit. Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition..._____ .._ _ Repairs (Signed) Nor....- ,- 4,C.. .3 No. of Stories... (Signed)g_lYic, YY. 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 5966, Compiled General Laws of Florida Permanent Supplement, and IIYT com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the worr to be performed under this permit; and will post or cause to be posted' for inspection on the site of the ork such public notice or notices as are on required by the Act. The undersigned agrees to employ only such sub- etr actors on work to \e perforundder this permit, as are licensed by Miami Shores Village. 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 be did sign the same, and that all facts therein by him stated are true. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Notary Public, State of Florida er Plumber. ... NOTE: A re inspection fee of $1.00 will be made when mei eBispotian Y made by improper notice for Impaction, at faulty materials and /or wod®aas6rP Permit No 1 L1C MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date..._.. ..3,/ ...— .--.— 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 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 J.) -.z ,s 6 1 / // LCt ; ,-, Registered Architect and /or En ineer (J4 2 c, e 2 -- Employing Plumber's Name 1 r/u w /c �s , ,...,. No„ ....... Street. 22: . -- 1. a, : Location and Legal Description Lot- O d' %- 101 / 5 glair ..3 Subdivision .f12 c °'e' c Street and Number where work is to be performed —No 6 / ,12. r 9 3 -.4-7 street Z1 6. ,' ...5 -- e b " .c. State work to be performed and purpose of building (By Floors)-._. w! 4.!.d^.c: _ / S � fd c _4_ A ck- New Building ____--- . - -• -- Remodeling _—.. Addition_-- -_.__. Repairs Size Septic Tank Feet of Drain Tile _Type of Tank__-----_ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. Size of Soakage Pit. Amount of Permit $ 1' STATE OF FLORIDA, } C u. OUNTY OF DADE. My Commission Expires 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 5966, Compiled General Laws of Florida Permanent Supplement, and liar com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed 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 suc publi otice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, ?• work to be perf -ed es this permit, as are licensed by Miami Shores Village. (Signed) No. street :.. P3 . s � .. YI % Ga. ; No. of Stories. .... ...... Capacity Gals..._...__. - _.. __.._.. -- •___ -.. Master Plumber. 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. Notary Public, State of Florida mater OTT: re-inspection fee of $1.00 will be made when such re- inspection is made•neoessary by improper notice for inspection, or faulty CLO![Tf BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUMID URINALS URINAL! CATCH FLOOR DRAIN —_ DRINKING FOUNT•NS TOTAL FIXTURES CONTR. LIST CHICK -T SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•O POOL CONTR. LIST • CHICK Permit No 1 L1C MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date..._.. ..3,/ ...— .--.— 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 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 J.) -.z ,s 6 1 / // LCt ; ,-, Registered Architect and /or En ineer (J4 2 c, e 2 -- Employing Plumber's Name 1 r/u w /c �s , ,...,. No„ ....... Street. 22: . -- 1. a, : Location and Legal Description Lot- O d' %- 101 / 5 glair ..3 Subdivision .f12 c °'e' c Street and Number where work is to be performed —No 6 / ,12. r 9 3 -.4-7 street Z1 6. ,' ...5 -- e b " .c. State work to be performed and purpose of building (By Floors)-._. w! 4.!.d^.c: _ / S � fd c _4_ A ck- New Building ____--- . - -• -- Remodeling _—.. Addition_-- -_.__. Repairs Size Septic Tank Feet of Drain Tile _Type of Tank__-----_ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. Size of Soakage Pit. Amount of Permit $ 1' STATE OF FLORIDA, } C u. OUNTY OF DADE. My Commission Expires 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 5966, Compiled General Laws of Florida Permanent Supplement, and liar com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed 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 suc publi otice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, ?• work to be perf -ed es this permit, as are licensed by Miami Shores Village. (Signed) No. street :.. P3 . s � .. YI % Ga. ; No. of Stories. .... ...... Capacity Gals..._...__. - _.. __.._.. -- •___ -.. Master Plumber. 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. Notary Public, State of Florida mater OTT: re-inspection fee of $1.00 will be made when such re- inspection is made•neoessary by improper notice for inspection, or faulty NO. STRE$ PART OF LOT LOT BL'K SUBDIVISION Sig ns Billboards ...w ` +A s ' � 1 ` Bs �iiu Permit Fee Wit Outlets - Motors Receptacles Generators Stoves Water Heaters Sig ns Billboards ...w ` +A s ' � 1 ` Bs �iiu Permit Fee Wit I 7 et ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during he construction. 4 , Owner of Building �,4 a tractor or Eleetkician "= ` t' - �•_ � �. 7thami Aiores9' llage F L O A ID A OFFICE OF ELECTRICAL DEPARTMENT : r 4 Miami Shores Village, Fla , ' / 19 LOCATION DESCRIPTION OF WORK NUMBER OF N? 286 • This Permit is granted up/ n the express condition that all facts stated in the Application are true and that the construction complies strictly with the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code of Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time upon the violation of any provisions of said laws, ordinances, or rules and regulations or on any, chan e in the plans and specifications unauthorized by t� Department. � 0A , Electrical Inspec or. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the State of Florida, he Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the F ctrical Department of Miami Shores Village. ` �j --)/ Dated / , 19 4 .? (Seal) Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee aoA y1- t;,d Owner of Building CTRICAL PERMIT aia►ni £oreslillage ' Permit must be on display on the premises during F L o a 1 n A the construction. Contractor or Electrician NO. STREET Dated . , 19 Miami Shores Village, Fla , 19 OFFICE OF ELECTRICAL DEPARTMENT PART OF LOT N LO CATION LOT BL'K DESCRIPTION OF WORK SUBDIVISION N° 286 This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code -4 Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time ipon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by his Department. t , Electrical Inspector. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the to of Florida, all the Electrical'Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami res Village.: f y 11 -4' -1I (Seal) UUJDING LECTRICAL PLUMBING 'OOFING weer of ilding Ts„ chitect ntractor Builder .;gal scription. ;dress of ilding Lot MIAMI SHORES VILLAGE, FLORIDA ❑ DATF • / 1954 p1 PERMIT INe 11033 Contractor's License No [l Work to be performed under this Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application efor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any e if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is i ted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations taining to the work covered hereby whether shown on the plans or drawings qr in the statement or specifications and that he assumes responsibility for c+'-' ,e by his agents, servants or employees. r ,r` Signed:. f BY .lr INSPE it "' ' " '�.► In consideration of the issuance to me of this permit I agree- to perform the work covered hereunder in compliance with all ordh taining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of ' a accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. r CONTRACTOR OR BUILDER BY Subdi- vision Value of Project $ Amt. of Permit $ a J 0 4r, ...A •ur+0" 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 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 Registered Architect and /or Engi ee , ► a , Employing Plumber's Name -v �" • t � ,. s ____ w �. _,__ - r ._ : -_t � �" No. _�__/ _ °�_4 Street __7‘. Location and Legal Descr ion Lot Block_— Subdivision Street and Number where work is to be performed— No. _ 4:: -.' ........2.L......-- 7— 7_3 Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs 1/ Size Septic Tank Feet of Drain Tile Nature of Water Supply: City—Well Amount of Permit $__ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No Street 1 _Type of Tank_ Capacity Gals Dist.eet of Tank or Drain Field from Well Size of Soakage Pit (Signed) The undersigned applicant for this building permit does hereby certify that he dl rstands and accepts his obligations as an n oyer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent 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 licensed by Miami Shores Village. ss. (Signed) 1 My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, materials and /or workmanship. Date No. of Stories L Plumbing Inspector. 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 f therein by him stated are true. STATE OF FLORIDA, t COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK - / 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 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 Registered Architect and /or Engi ee , ► a , Employing Plumber's Name -v �" • t � ,. s ____ w �. _,__ - r ._ : -_t � �" No. _�__/ _ °�_4 Street __7‘. Location and Legal Descr ion Lot Block_— Subdivision Street and Number where work is to be performed— No. _ 4:: -.' ........2.L......-- 7— 7_3 Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs 1/ Size Septic Tank Feet of Drain Tile Nature of Water Supply: City—Well Amount of Permit $__ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No Street 1 _Type of Tank_ Capacity Gals Dist.eet of Tank or Drain Field from Well Size of Soakage Pit (Signed) The undersigned applicant for this building permit does hereby certify that he dl rstands and accepts his obligations as an n oyer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent 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 licensed by Miami Shores Village. ss. (Signed) 1 My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, materials and /or workmanship. Date No. of Stories L Plumbing Inspector. 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 f therein by him stated are true. STATE OF FLORIDA, t COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared JILDING ELECTRICAL PLUMBING Owner of Building J4 PeCt4411. Architect ..Contractor p" or Builder Legal Lot Description PERMIT N° 5915 Work tobep RA TO R OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE 1 /4` 77 r rformed under this Permi ■ Bl. Contractor's License No. Subdi- vision Project Permi Address of .Value of Amt. of /� Building This permit is granted to the . .ntractor or buil. er named above to construct the building ding t o install the equipment o dev ice described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the respon ' y for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in th : "s • ements .r sp 'fications and th9he assumes respon- sibility for work done by his agents, servants or employees. By 194 In consideration of the issuance to me of this permit I agree to perform the work covered hereun' 'r in compliance with Offdinances and;egp4afions petaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoritiet of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or er}iployee. AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description / Lot Contractor's License No. Work to be performed under this Permit -- i E L r' t f . v4./ CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE /j PERMIT N? 5915 Bl. Signed: Subdi- vision Value of Project Address of (or , Building This permit is granted to the .ntractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the °statements „el specifications and thaf'}ie assumes respon- sibility for work done by his agents, servants or employees. ray f , ✓ By ) 1` 1f Amt. of Permit .3 , S 194_ 1 In consideration of the issuance to me of this permit I agree to perform the work covered hereurn$r in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. 1 �.. AUTHORITY Registered Architect and /or Engineer IAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No Date 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 complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of k. ,+ Owner's Name and Addr s/! r ' ' " No Street - -- ` '-., Employing Plumber's Name :, , � ' -� �---- �------- --�=-- �- ' - - )�To P Street Location and Legal Description Lot !__r ,, Block_____ ____ Subdivision Street and Number where work is to be performed—No ___ __ F ___ __f___ ____— '___ ____ _ State work to be performed and purpose of building (By Floors) • Repairs No. of Stories New Building Remodeling Addition_ Street Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit Amount of Permit $ - (Signed)__/. ___ • ss. (Signed) 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 5966, Compiled General Laws of Florida Permanent 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 licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, j 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 $1.00 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 SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST - CHECK SEPTIC TANK SEWER CONN. DRAIN FI ELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL. SPRKLR. SYSTEM SWIM'G POOL .. ,< CONTR. LIST 11 CHECK Registered Architect and /or Engineer IAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No Date 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 complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of k. ,+ Owner's Name and Addr s/! r ' ' " No Street - -- ` '-., Employing Plumber's Name :, , � ' -� �---- �------- --�=-- �- ' - - )�To P Street Location and Legal Description Lot !__r ,, Block_____ ____ Subdivision Street and Number where work is to be performed—No ___ __ F ___ __f___ ____— '___ ____ _ State work to be performed and purpose of building (By Floors) • Repairs No. of Stories New Building Remodeling Addition_ Street Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit Amount of Permit $ - (Signed)__/. ___ • ss. (Signed) 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 5966, Compiled General Laws of Florida Permanent 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 licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, j 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. • DATE ISSUED TO MIAMI SHORES VILLAGE PLUMBING PERMIT • N JJ v 7 to install the following described plumbing, in accordance with the laws, statutes and regulations of Miami Shores Village, Florida and the State of Florida, governing_plumbing and drain- age work done in Miami Shores Village, Florida] FOR A / STORY4, BUILDING AT / ' "' C. FIXTURES FIXTURES SEWER / SEPTIC 'TANK TOTAL VILLAGE PLUMBING INSPECTOR `, . / BY 4 NO. 636 aYl✓"���tr'4s • • DA'I'E ISSUED TO MIAMI SHORES VILLAGE PLUMBING PERMIT to install the following described plumbing, in accordance with the laws, statutes and regulations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drain- age work done in Miami Shores Village, Florida. FOR A STORY. BUILDING AT FIXTURES FIXTURES SEWER SEPTIC TANK ' TOTAL VILLAGE PLUMBING INSPECTOR BY NO,, 636