557 NE 92 St (2)MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. _____ -- -- 4
Application is hereby ma a 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 . _./. of 1 Z5 No. _ Jrd _ 7- - -.,l, Street.. - -9�
Registered Architect and /or Engineer. —._ ___— _ - - - -_ _ -- ___ - - - - - -- _- - - - -_
--
Employing Plumber's Name / �/- � .Q� - - - ✓ G617 — /e /� L_
4(J( No. -_9 c%
- --- ��> �
Street__—_ L-- � --- --- -- •--- ••- •- -•-- ......
Location and Legal Description Lot____.__ __.________ _ — Block Subdivision
Street and Number where work is to be performed —No `�. 5 7 �� street
State work to be performed and purpose of building (By Floors)______
New Building _ _ _ ___ Remodeling___._ — ______ Addition____ Repairs No. of Stories.
Size Septic Tank Type of Tank —
Feet of Drain Tile___ / _0 ___________ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.__ - _ —.._ Size of Soakage Pit
0
Amount of Permit $---- - - - - -- z - -- — - -- — -- (Signed)_
Capacity Gals
STATE OF FLORIDA, 1
COUNTY OF DADE. j
(Sign
Date._
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 ' im in the work to be
performed under this permit; and will post or cause to be posted' for inspection on t si e of the or su • publi. ni .+ or notices as are
required by tlie Act. The undersigned agrees to employ only such sub- contracto , o , work - rfo ; f d un r this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
My Commission Expires Notary Public, State of Florida
U��- '�- - - - / --
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.
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.
CLOSRS
BATH
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
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
SWIM'G
POOL
COMM.
LIST
i
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. _____ -- -- 4
Application is hereby ma a 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 . _./. of 1 Z5 No. _ Jrd _ 7- - -.,l, Street.. - -9�
Registered Architect and /or Engineer. —._ ___— _ - - - -_ _ -- ___ - - - - - -- _- - - - -_
--
Employing Plumber's Name / �/- � .Q� - - - ✓ G617 — /e /� L_
4(J( No. -_9 c%
- --- ��> �
Street__—_ L-- � --- --- -- •--- ••- •- -•-- ......
Location and Legal Description Lot____.__ __.________ _ — Block Subdivision
Street and Number where work is to be performed —No `�. 5 7 �� street
State work to be performed and purpose of building (By Floors)______
New Building _ _ _ ___ Remodeling___._ — ______ Addition____ Repairs No. of Stories.
Size Septic Tank Type of Tank —
Feet of Drain Tile___ / _0 ___________ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.__ - _ —.._ Size of Soakage Pit
0
Amount of Permit $---- - - - - -- z - -- — - -- — -- (Signed)_
Capacity Gals
STATE OF FLORIDA, 1
COUNTY OF DADE. j
(Sign
Date._
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 ' im in the work to be
performed under this permit; and will post or cause to be posted' for inspection on t si e of the or su • publi. ni .+ or notices as are
required by tlie Act. The undersigned agrees to employ only such sub- contracto , o , work - rfo ; f d un r this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
My Commission Expires Notary Public, State of Florida
U��- '�- - - - / --
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.
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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
C -1 2S Date L��`S�
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
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 4 0. Tkorn N ST
Street..._.__.._..._._.._... - -- - -___ --
Registered Architect and /or E eer
Employing Plumber's Name �� �� �Q
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City-Well.
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
Location and Legal Description Lot_. Bloeir . Subdivision
Street and Number where work is to be performed -No S A S ' ? 4/4_7- Street.. Z S I
_.._...__.._..
State work to be performed and purpose of building (By Floors) - ....
...._
New Building _ _.. Remodeling_ _ _ Addition.
to IVY eeem.reve .� ..ose.......— ....... Street .._.e..._..— ....._..m.._........,._.. ••.
Type of Tads —_
Feet of Tank or Drain Field from Well ______
Size of of Soakage Pit.
(Signed)-
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Su lement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed y 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 ynder th)s permit, as are
licensed by Miami Shores Village.
(Signed
Repairs No. of Stories
Capacity Gals..._..
........ • ••••
Plu g Inspecto .
kir:4
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.
My Commission Expires Notary Public, State of Florida
materials re-inspection fee of 61.00 will be made when such re is made•neoessary by improper notice for inspection, or faulty
D
CCLOUTS
BATH
TUDS
SNGW[RE
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CoNTR.
LIST
CNECK
---
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL.
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
C -1 2S Date L��`S�
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
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 4 0. Tkorn N ST
Street..._.__.._..._._.._... - -- - -___ --
Registered Architect and /or E eer
Employing Plumber's Name �� �� �Q
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City-Well.
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
Location and Legal Description Lot_. Bloeir . Subdivision
Street and Number where work is to be performed -No S A S ' ? 4/4_7- Street.. Z S I
_.._...__.._..
State work to be performed and purpose of building (By Floors) - ....
...._
New Building _ _.. Remodeling_ _ _ Addition.
to IVY eeem.reve .� ..ose.......— ....... Street .._.e..._..— ....._..m.._........,._.. ••.
Type of Tads —_
Feet of Tank or Drain Field from Well ______
Size of of Soakage Pit.
(Signed)-
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Su lement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed y 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 ynder th)s permit, as are
licensed by Miami Shores Village.
(Signed
Repairs No. of Stories
Capacity Gals..._..
........ • ••••
Plu g Inspecto .
kir:4
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.
My Commission Expires Notary Public, State of Florida
materials re-inspection fee of 61.00 will be made when such re is made•neoessary by improper notice for inspection, or faulty
D