580 NE 92 St (2)2- / L)
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submit(ed for the building or other
structure herein described. This application is made in compliance and confzi - t,I.y 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. i( � '
Owner's Name and Address ......... ms ,
Registered Architect and /or Engineer.
. Block_
Street and Number where work is to be performed —No rla% . �. t et '
i:.mployIng Plumber's Name
Location and Legal Description Lot_
State work to be performed and purpose of building (By Floors)._
New Building
Feet of Drain Tile._1
Size Septic Tank
Nature of Water Supply: City —Well.
Amount of Permit $
STATE v' OF FLORIDA, i
88.
i3NT71" OF DADE.
MIAMI SHORES VIL .AGE
PLUMBING INSPECTION DEPARTME<' :
APPLICATION FOR PLUMBING
AE
( Signed) _
Date
Street.
Street__
Remodeling __ Addition Repairs No. of Stories.
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ermanent 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 otipe or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on . or to be performed • , er) th mit, as are
linersed by Miami Shores Village.
(Signed -- - -_ ,- - =- 2d_
Master P umber.
'.efo a me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
t one wJ! known, and who, being by me first duly sworn, upon oath deposes and says that he is the
cf above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
'Yr.. rtr ted 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
TUBE
SHOWERS
S
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING DRINK
FOUNT' NS
TOTAL
FI %TORES
CONTE:.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWI PA' G
POOL
I - --
CONTR
LIST
CHECK
_.
2- / L)
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submit(ed for the building or other
structure herein described. This application is made in compliance and confzi - t,I.y 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. i( � '
Owner's Name and Address ......... ms ,
Registered Architect and /or Engineer.
. Block_
Street and Number where work is to be performed —No rla% . �. t et '
i:.mployIng Plumber's Name
Location and Legal Description Lot_
State work to be performed and purpose of building (By Floors)._
New Building
Feet of Drain Tile._1
Size Septic Tank
Nature of Water Supply: City —Well.
Amount of Permit $
STATE v' OF FLORIDA, i
88.
i3NT71" OF DADE.
MIAMI SHORES VIL .AGE
PLUMBING INSPECTION DEPARTME<' :
APPLICATION FOR PLUMBING
AE
( Signed) _
Date
Street.
Street__
Remodeling __ Addition Repairs No. of Stories.
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ermanent 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 otipe or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on . or to be performed • , er) th mit, as are
linersed by Miami Shores Village.
(Signed -- - -_ ,- - =- 2d_
Master P umber.
'.efo a me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
t one wJ! known, and who, being by me first duly sworn, upon oath deposes and says that he is the
cf above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
'Yr.. rtr ted 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.