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PLUMBINGB{ E R O B1 01 Ld A B1 hl di til go pa di pl 'It MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEb - APPLICATION FOR PLUMBING ;►, dFli� Permit No Application is hereby made for the approval of the detailed statement of the structure herein described. This application is made in compliance and confo r and all provisions of the Laws of the State of Florida, all ordinances of Miami of Miami Shores Village shall be complied with, whether herein specified or building during progress of work. Employing Plumber's Name. y Location and Legal Description Lot________ State work to be performed and purpose of building (By Floors) - _S New Building Remodeling Addition Date 1'1- -c plans and specifications herewith submitted for the building or other m ity with the Building Ordinance of Miami Shores Village, Florida, Shores Village and all rules and regulations of the Building Division nnt. A copy of approved plans and specifications must be kept at Owner's Name and Address T.1 } P No � N L Street _{__ S re- Registered Architect and /or Engineer..__ ��t - - - -- ____ No ' - 1 —rt Subdivision Street and Number where work is to be performed -No._ Street ? s 7 so c_7 i Repairs No. of Stories .... 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 t - -' tt t n3 Amount of Permit $ 2 c• zs (Signed) _ ___4h.� (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ..li:ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per - anent Supplement, and has cam- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors nployed 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 lioensed by Miami Shores Village. Master 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 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 UR URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' N6 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK B{ E R O B1 01 Ld A B1 hl di til go pa di pl 'It MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEb - APPLICATION FOR PLUMBING ;►, dFli� Permit No Application is hereby made for the approval of the detailed statement of the structure herein described. This application is made in compliance and confo r and all provisions of the Laws of the State of Florida, all ordinances of Miami of Miami Shores Village shall be complied with, whether herein specified or building during progress of work. Employing Plumber's Name. y Location and Legal Description Lot________ State work to be performed and purpose of building (By Floors) - _S New Building Remodeling Addition Date 1'1- -c plans and specifications herewith submitted for the building or other m ity with the Building Ordinance of Miami Shores Village, Florida, Shores Village and all rules and regulations of the Building Division nnt. A copy of approved plans and specifications must be kept at Owner's Name and Address T.1 } P No � N L Street _{__ S re- Registered Architect and /or Engineer..__ ��t - - - -- ____ No ' - 1 —rt Subdivision Street and Number where work is to be performed -No._ Street ? s 7 so c_7 i Repairs No. of Stories .... 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 t - -' tt t n3 Amount of Permit $ 2 c• zs (Signed) _ ___4h.� (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ..li:ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per - anent Supplement, and has cam- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors nployed 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 lioensed by Miami Shores Village. Master 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 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. CITY OF MIAMI SHORES FIRE INSPECTION NAME: Tropp ADDRESS: 58 NE 92 St FEE: 2.00 QUANTITY: meter t DATE: 12/16 MATERIAL: Propane TYPE OF EQUIPPaNT PREVIOUS INSTALLATION: y central heating yes INSTALLED BY ADDRESS Public Gas Co. 7200 NW 7 Ave MIAMI SHORES VILLAGE, BUILDING ❑ ELECTRICAL ❑ PERMIT PLUMBING ❑ ITT. 9653 ROOFING ❑ Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot BI. FLORIDA DATE t 2 Contractor's License No 195 Work to be performed under this Permit Subdi- vision Sq. Ft Value of Project $ Amt. of 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 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 or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • :.« BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder 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. CONTRACTOR OR BUILDER BY AUTHORITY I 7 BUILDING ❑ ELECTRICAL PLUMBING ROOFING Owner of Building ❑ PERMIT N? 14913 ❑ Work to be performed under this Permit Architect Contractor or Builder Legal Lot II 31. Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Subdi- vision Value of Project $ , DATE 195 Contractor's License No Amt. of 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 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 or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder 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. BY AUTHORITY 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 tructure herein described. This application is made in compliance and conformity °with the Building Ordinance of Miami Shores Village, Florida, nd 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 4) No _ __ ' L_ Street Registered Architect and /or Enginer ';'--------- - - --4- Employing Plumber's Name 4� '' n _ _____ A F - , _ Location and Legal Description L A____(FJ W y Bl Subdivision Street and Number where work is to be performed —No S , e IV ar- Street e2 State work to be performed •and purpose of building (By Floors) U! " 4 4- 1 Feet of Drain Tile Amount of Permit ss. Nature of Water Supply: City — Cr The undersigned applicant for this buildi permit under the Florida Workmen's Compensati Jing plied with the provisions thereof, and will require simil performed under this permit; anc will required by the Act. The undersig licensed by Miami Shores Village. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT New Building Remodeling Addition Repairs No. of Stories Size Septic Tank .Type of Tank Capacity Gals Dist. Feet of Tank or Drain Field from Well Date- - - - - -a % a ° d Size of Soakage Pit I� ( Signed) Plumbing Inspector. es hereby certify that he understands and accepts his obligations as au employer of labor ction 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plianee=fren all contractors or sub - contractors employed by him in the work to be sted for inspection on the site of "the work such public notice or notices as are my such sub - contractors, s on -, work` ao be performed under this permit, as are ( Signed) Mas Notary Public, State of Florida Plumber. 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 to me well known, and who, being by nee 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. CLOSETS BATH TUBS SHOWERS LAVA TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS � ♦ /f '. - -- TOTAL FIXTURES CONTR. LIST �) ! / / 1 / � N CHECK 02 i / N � ! -� 4 � s- � +/ '1 SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL : ' C ,_ CONTR.. LIST CHECK c e / 6 G f\ O O 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 tructure herein described. This application is made in compliance and conformity °with the Building Ordinance of Miami Shores Village, Florida, nd 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 4) No _ __ ' L_ Street Registered Architect and /or Enginer ';'--------- - - --4- Employing Plumber's Name 4� '' n _ _____ A F - , _ Location and Legal Description L A____(FJ W y Bl Subdivision Street and Number where work is to be performed —No S , e IV ar- Street e2 State work to be performed •and purpose of building (By Floors) U! " 4 4- 1 Feet of Drain Tile Amount of Permit ss. Nature of Water Supply: City — Cr The undersigned applicant for this buildi permit under the Florida Workmen's Compensati Jing plied with the provisions thereof, and will require simil performed under this permit; anc will required by the Act. The undersig licensed by Miami Shores Village. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT New Building Remodeling Addition Repairs No. of Stories Size Septic Tank .Type of Tank Capacity Gals Dist. Feet of Tank or Drain Field from Well Date- - - - - -a % a ° d Size of Soakage Pit I� ( Signed) Plumbing Inspector. es hereby certify that he understands and accepts his obligations as au employer of labor ction 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plianee=fren all contractors or sub - contractors employed by him in the work to be sted for inspection on the site of "the work such public notice or notices as are my such sub - contractors, s on -, work` ao be performed under this permit, as are ( Signed) Mas Notary Public, State of Florida Plumber. 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 to me well known, and who, being by nee 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. BUILDING ELECTRICAL PLUMBING ROOFING Address of Building Owner of - Building Architect Contractor 1 or Builder ti Legal Lot Description o r 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 applica- tion 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 or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. c r Signed. : ` ' ^ - - ' INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder 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 as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE - " ' � ' 19 I PERMIT Work to be performed under this Permit i N° 7315 Subdi- vision Value of Project $ r. Contractor's License No. Amount of , Permit $ - -' BY AUTHORITY *SOOT ' Permit No t �/ 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. ®Q� Owner's Name and Address ______ — No.______ Street Registered Architect and /or Engineer_____ Employing Plumber's Name._ 14.tfi41_l___ �� No.__ 12 S Street 4 STS S Location and Legal Description Lot_----- ---________ _______ _____ _____ _____ Subdivision Street and Number where work is to be performed— No._____—_ State work to be performed and purpose of building (By Floors) Re' f - 611 _0QQ4t6_ New Building Remodeling Addition Repairs Nature of Water Supply: City —Well Amount of Permit $ I -EMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accepts his under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Peri plied with the provisions thereof, and will require similar compliance from all contractors or sub - contract performed under this permit; and will post or cause to be posted' for inspection on the site of the w required by the Act. The undersigned agrees to employ only such sub- contractors, on to licensed by Miami Shores Village. Date___- A t C I • / , / No. of Stories. Size Septic Tank Type of Tank Capacity Gals .__.___ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit 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 / / v � F 2 2 67 Plumbing Inspector. obligations as an employer of labor t Supplement, and has corn - d by him in the work to be is notice or notices as are under this permit, as are i; 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 worlananship. CLOSERS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKI FOUNT' NS TOTAL FIXTURE6 CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No t �/ 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. ®Q� Owner's Name and Address ______ — No.______ Street Registered Architect and /or Engineer_____ Employing Plumber's Name._ 14.tfi41_l___ �� No.__ 12 S Street 4 STS S Location and Legal Description Lot_----- ---________ _______ _____ _____ _____ Subdivision Street and Number where work is to be performed— No._____—_ State work to be performed and purpose of building (By Floors) Re' f - 611 _0QQ4t6_ New Building Remodeling Addition Repairs Nature of Water Supply: City —Well Amount of Permit $ I -EMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) The undersigned applicant for this building permit does hereby certify that he understands and accepts his under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Peri plied with the provisions thereof, and will require similar compliance from all contractors or sub - contract performed under this permit; and will post or cause to be posted' for inspection on the site of the w required by the Act. The undersigned agrees to employ only such sub- contractors, on to licensed by Miami Shores Village. Date___- A t C I • / , / No. of Stories. Size Septic Tank Type of Tank Capacity Gals .__.___ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit 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 / / v � F 2 2 67 Plumbing Inspector. obligations as an employer of labor t Supplement, and has corn - d by him in the work to be is notice or notices as are under this permit, as are i; 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 worlananship. Permit No. .._/ 49 / Owner's Name and Address Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. J.W. Stan ley N 58 N of 0 9 Registered Architect and /or Engineer 18r Hurst Drillin & EquiRmentN 2 _Q!� Ste Employing P um er s Name �i _..__ _. 7th Ave Location and Legal Description Lot_._ _____.__ _ Block______ _ ____ Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition _____ .......... ..__._. -. Repairs. 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 2 ©].* Wells f Q ____ (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 Pennanent Supplement, and bus u n- 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 an licensed by Miami Shores Village. (Signed) Date July 6, 19 5.3 Street__ Capacity Gals. __. No. of Stories Master Plumber. STATE OF FLORIDA, } ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally dppeare 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 lac 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 fool materials and /or workmanship. CLO6ETB BATH TU08 SHOWERS LAVA- TORIES SIN SLOP SINKO LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT NS TOTAL FIKTUREI CONTR. LIST - " SEPTIC TANK SEWER CONN.• DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIMG POOL CONTR. LIST CHECK Permit No. .._/ 49 / Owner's Name and Address Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. J.W. Stan ley N 58 N of 0 9 Registered Architect and /or Engineer 18r Hurst Drillin & EquiRmentN 2 _Q!� Ste Employing P um er s Name �i _..__ _. 7th Ave Location and Legal Description Lot_._ _____.__ _ Block______ _ ____ Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition _____ .......... ..__._. -. Repairs. 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 2 ©].* Wells f Q ____ (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 Pennanent Supplement, and bus u n- 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 an licensed by Miami Shores Village. (Signed) Date July 6, 19 5.3 Street__ Capacity Gals. __. No. of Stories Master Plumber. STATE OF FLORIDA, } ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally dppeare 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 lac 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 fool materials and /or workmanship.