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700 NE 93 St (10)Permit No. 0 Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name_ • II '' Location and Legal Description Lot " i7 Block Street and Number where work is to be performed —No 4_ 1. : State work to be performed and p urpose of building (By Floors) Nature of Water Supply: City —Well Amount of Permit $ ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed) (Signed) No. ---7 7 Date_ _ _ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s ibmitted 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. No Street Street Subdivision Remodeling Aldition Rep rs No. of Stories Ca acity Ga s 1 � Size Septic Tank > 0 0 Type of Tank Feet of Drain Tile aJ Dist. Feet of Tan or Drain Field from Well Y__ll 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 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 n ice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be p led unpl'e this permi (ire licensed by Miami Shores Village. �►L,. / - Notary Public, State of Florida • - 4 Master umber. 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 sane, 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. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR LIST 64._ ___2.,_ i� "( / M V CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD / 71( SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST LIST ' / CHECK Permit No. 0 Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name_ • II '' Location and Legal Description Lot " i7 Block Street and Number where work is to be performed —No 4_ 1. : State work to be performed and p urpose of building (By Floors) Nature of Water Supply: City —Well Amount of Permit $ ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed) (Signed) No. ---7 7 Date_ _ _ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s ibmitted 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. No Street Street Subdivision Remodeling Aldition Rep rs No. of Stories Ca acity Ga s 1 � Size Septic Tank > 0 0 Type of Tank Feet of Drain Tile aJ Dist. Feet of Tan or Drain Field from Well Y__ll 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 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 n ice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be p led unpl'e this permi (ire licensed by Miami Shores Village. �►L,. / - Notary Public, State of Florida • - 4 Master umber. 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 sane, 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. BUILDING ❑ ELECTRICAL ❑ PERMIT IT? 13627 PLUMBING lid ROOFING r .. ❑ Wor be performed under this Permit Owner of Building (' Architect 1 Contractor or Builder �� M)`:'...." Legal Lot I, 11 BL Description. 1 " B ildin of L 1 1 6 0 YN . d 'i/J, MIAMI SHORES VILLAGE, FLORIDA Subdi- vision Value of _ Project $ BY DATE Contractor's License No II 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 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 knowled of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawiggs,or t4s state en or specifications and e assumes responsibility for work done by his agents, servants or employees. S LOU igned • . , 1 twse�✓ �, j �+'� +'Z+C BY INSPECTOR `1' ' �►�'7..i�s Amt. of Permit I o, sideration of issuance this permit I agree to perfo e work covered hereunder in compliance with all ordinances and regulations pertai, K t reto and i ct confo with the plans, drawings, statements r specifications submitted to the proper authorities of Miami Shores Village. In a ptin 'this permi ssu, re o- sibility for all work done by either, myself, my agent, servant or employee. AUTHORITY OP— /?/ Permit No -- 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 u./e720 � ,- � No. 7c Registered Architect and /or Engineer -,Gz .5—A7 Employing Plumber's Name D w /1//F / Location and Legal Description Lot- O' Street and Number where work is to be performed -No 7 4//1 Street 3 S� - State work to be performed and purpose of building (By loors)_-_-- f2..c<..._ _29- e2 .. - - -- / %.:�.2............ . New Building Remodeling____ __...___ Addition.- ._...__ Repairs No. of Stories Size Septic Tank_ -- ____.____-- -- -- - ---- ...Type of Talc —_ 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 $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Bloc3t (Signed)- (Si No .....— .,..,....mmism,...m.,,...,_ Slreet..us..sT Capacity Gals. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an finployer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and bar com- plied with the provisions thereof, and will require similar compliance from all contractors or - b- 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 i. . . work such public notice or notices as are required by the Act. The undersigned agrees to employ only such stab- contractors, . work to - • performed,er this permit, as are licensed by Miami Shores Village. Muter um . STATE OF FLORIDA, 1 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 dep 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 hire stated are true. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such ro.inspect m is madelneoesary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH -r SHOWERS LAVA• Tomo SINKS SLOP SINKS LAUNDRY TUP• URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURES Comm. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR II DEEP WELL SPRKLR. SYSTEM SWIM'O POOL CONTR. LIST CHECK OP— /?/ Permit No -- 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 u./e720 � ,- � No. 7c Registered Architect and /or Engineer -,Gz .5—A7 Employing Plumber's Name D w /1//F / Location and Legal Description Lot- O' Street and Number where work is to be performed -No 7 4//1 Street 3 S� - State work to be performed and purpose of building (By loors)_-_-- f2..c<..._ _29- e2 .. - - -- / %.:�.2............ . New Building Remodeling____ __...___ Addition.- ._...__ Repairs No. of Stories Size Septic Tank_ -- ____.____-- -- -- - ---- ...Type of Talc —_ 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 $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Bloc3t (Signed)- (Si No .....— .,..,....mmism,...m.,,...,_ Slreet..us..sT Capacity Gals. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an finployer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and bar com- plied with the provisions thereof, and will require similar compliance from all contractors or - b- 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 i. . . work such public notice or notices as are required by the Act. The undersigned agrees to employ only such stab- contractors, . work to - • performed,er this permit, as are licensed by Miami Shores Village. Muter um . STATE OF FLORIDA, 1 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 dep 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 hire stated are true. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such ro.inspect m is madelneoesary by improper notice for inspection, or faulty materials and /or workmanship. ;UILDING LECTRICAL 'LUMBING )weer of .adding rchitec tr}t Lot contractor r Builder ,ega1 )escription .ddress of : uilding 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 appli- ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance'twith any Tans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked t 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 ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and 3gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- :bility for work done by his agents, servants or employees. t t h INSPECTOR In consideration of the issuance to me of tiiis permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations ertaining thereto and in strict conformity; with he M . , drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. ,i accepting this per 't I ass .. r= = L . bility for ;I rk done by either myself, my agent, servant or employee. MIAMI SHORES VILLAGE, FLORIDA RM BL IT N? . 4706 Work to be performed under this Permit 3 cog Signed. Subdi- vision Value of Project Contractors License No DATE �� 3 194 Amt. of Permit By /1 3 I 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 work. � .__(1...51......._. Owner's Name and Address r 1.1 No. 7 NE Street Registered Architect and /or Engineer 1A) IA1 • S x � ' /1 J &PUL ,A A i h c ,Q, Employing Plumber's Name /k. .[ QJL �— NO. / , 1 � �, �.,s »....m.,,...., 8.. �t{(. freet i1�!�� �`...p. mo t•... ,. -, Location and Legal Description Lot x_ Block 1 Subdl .01A - Street and Number where work is to be performed —No 700 1V E Street. .9.3 _ _ _ - - - -- State work to be performed and purpose of building (By Floors)___ Gi _ - -•- ,Lt1✓�2 _ N Building -_- Remodeling_ -- _ .____ Addition Repairs No. of Stories Size Septic Tank_ --- _---------- - - - - -- - -Type of Tank___ 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 $ 7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as n employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supp ement, and Isar 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 - contractor, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Azree 1,7- - : = - --7' — Plurgl� Inspector. Muter Plumber. 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 be has carefully read the foregoing application, and that be 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 $1.00 will be made when such re-inspection is mede•neoessary by improper notice for inspection, or faulty materials and /or workmanship. CLO[[T$ BATH T UB[ SHOWERS LAVA- TORIES 6161". SLOP SINKS LAUNDRY Tuna URINAL[ CATCH DAMN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK — SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE GREASE PIT TRAP SOLAR HEATER our WELL SPRKLR. SYSTEM SWIM'G POOL ken CONTR. LIST f t I c 7 • JJ r-C,D CHECK I 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 work. � .__(1...51......._. Owner's Name and Address r 1.1 No. 7 NE Street Registered Architect and /or Engineer 1A) IA1 • S x � ' /1 J &PUL ,A A i h c ,Q, Employing Plumber's Name /k. .[ QJL �— NO. / , 1 � �, �.,s »....m.,,...., 8.. �t{(. freet i1�!�� �`...p. mo t•... ,. -, Location and Legal Description Lot x_ Block 1 Subdl .01A - Street and Number where work is to be performed —No 700 1V E Street. .9.3 _ _ _ - - - -- State work to be performed and purpose of building (By Floors)___ Gi _ - -•- ,Lt1✓�2 _ N Building -_- Remodeling_ -- _ .____ Addition Repairs No. of Stories Size Septic Tank_ --- _---------- - - - - -- - -Type of Tank___ 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 $ 7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as n employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supp ement, and Isar 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 - contractor, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Azree 1,7- - : = - --7' — Plurgl� Inspector. Muter Plumber. 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 be has carefully read the foregoing application, and that be 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 mede•neoessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No... _ 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 Location and Legal Description Lot Amount of Permit $ SubdivWon.._..._.-..— ._ -._ —. Street and Number where work is to be performed —No - Street `f State work to be performed and purpose of building (By Floors) 1 \ -- 5 -• - -- "+" =— r-- - 4 1 1 -- � � New Building -- Remodeling____ — .. -_ -- Addition..._ -. -- Repairs No. of Stories MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT , l Z c v t c - / 2 Q - ( ' ' !VI/ Registered Architect and /or Engineer �A e ee Employing Plumber's Name. O a.� �Ce( Block (Signed) No. 76 Street.__ A No ,, .,_ ..�,_., .e...,...m.,....., $treet..sa .,.. ......�,,... Size Septic Teak_ -- •------- - - - - -- —_ -- T ype of Tank.__ Feet of Drain Tile._ _ _ ____ -- -Dist. Feet of Tank or Drain Field from Well -_._ Nature of Water Supply: City —Well. __._____- -.Size of Soakage Pit The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanen 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. ( Signed) — — Date..._ Capacity Gals • Plumbi Inspector. Muter Plumber. STATE OF FLORIDA, µ COUNTY OF DADE. l 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 be 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•inspecdon is mede'neoessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH TUBE SHOWERS LAVA- TORIES 61NKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKI NO FOUNT'N. TOTAL FIXTURE• CONTR. LIST CHECK i SW IM 'O POOL /_ 1 • r Ae " ( IJV,.� SEPTIC SEWER DRAIN FIELD SOAKAGE PIT G TRAP SOLAR H DEEP WELL SPRKLR. S CONTR. LIST TANK CONN. 2 • c`- CHECK Permit No... _ 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 Location and Legal Description Lot Amount of Permit $ SubdivWon.._..._.-..— ._ -._ —. Street and Number where work is to be performed —No - Street `f State work to be performed and purpose of building (By Floors) 1 \ -- 5 -• - -- "+" =— r-- - 4 1 1 -- � � New Building -- Remodeling____ — .. -_ -- Addition..._ -. -- Repairs No. of Stories MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT , l Z c v t c - / 2 Q - ( ' ' !VI/ Registered Architect and /or Engineer �A e ee Employing Plumber's Name. O a.� �Ce( Block (Signed) No. 76 Street.__ A No ,, .,_ ..�,_., .e...,...m.,....., $treet..sa .,.. ......�,,... Size Septic Teak_ -- •------- - - - - -- —_ -- T ype of Tank.__ Feet of Drain Tile._ _ _ ____ -- -Dist. Feet of Tank or Drain Field from Well -_._ Nature of Water Supply: City —Well. __._____- -.Size of Soakage Pit The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanen 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. ( Signed) — — Date..._ Capacity Gals • Plumbi Inspector. Muter Plumber. STATE OF FLORIDA, µ COUNTY OF DADE. l 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 be 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•inspecdon is mede'neoessary by improper notice for inspection, or faulty materials and/or workmanship.