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PLUMBINGMIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION F R 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 work. I Owner's Name and Address _- - - i -- ----- _. - -. - -- _ - •---- -_ - -.- No. Street_ Registered Architect and /or Engineer___ _ Employing Plumber's Name _:_4/ _ __ __ No._ Street,_ —.. Location and Legal Description Lot_-___�i BI Subdivision Street and Number where work is to be performed —No fa 9 Streak State work to be performed and purpose of building (By Floors) New Building Remodeling - Addition Repairs No. of Stories. _ .._._ 1 Size Septic Tank_ Feet of Drain Tile Nature of Water Supply: City —Well. Amount of Permit $- STATE OF FLORIDA, as. COUNTY OF DADE. (Signed)_ (Signed). My Commission Expires Notary Public, State of Florida _Type of Tank__ Capacity Gals ___Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit 1 1 aster Plumber. mbing . pector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatian employer If labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent - .plement, and Ilai 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. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally appeared to me well known, and who, being by me first duly swoni, 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 insp " m or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•N6 I TOTAL TOTAL CONTR. LIST CNZCK I I --- I - -- 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 F R 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 work. I Owner's Name and Address _- - - i -- ----- _. - -. - -- _ - •---- -_ - -.- No. Street_ Registered Architect and /or Engineer___ _ Employing Plumber's Name _:_4/ _ __ __ No._ Street,_ —.. Location and Legal Description Lot_-___�i BI Subdivision Street and Number where work is to be performed —No fa 9 Streak State work to be performed and purpose of building (By Floors) New Building Remodeling - Addition Repairs No. of Stories. _ .._._ 1 Size Septic Tank_ Feet of Drain Tile Nature of Water Supply: City —Well. Amount of Permit $- STATE OF FLORIDA, as. COUNTY OF DADE. (Signed)_ (Signed). My Commission Expires Notary Public, State of Florida _Type of Tank__ Capacity Gals ___Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit 1 1 aster Plumber. mbing . pector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatian employer If labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent - .plement, and Ilai 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. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally appeared to me well known, and who, being by me first duly swoni, 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 insp " m or faulty materials and /or workmanship.