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75 NE 92 St(70 Permit No Nature of Water Supply. City—Well. Amount of Permit $ _ STATE OF FLORIDA, } ss. COUNTY OF DADE. 4, 00 MIAMI SHORES VBILLGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Am: 'cation i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village Florida, and ill provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of th Building 131. sion of M iami 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. N , 1 40 __ tuo 4 . sth _ 109th Stree Ownor's Name and Address. R. Nar Registered Architect and/or Engineer _ _ Employing Plumber's Name 0 'Neal Septic Tank Co. No. P.O. Box 6_2,9_ streetAi am i 9 -- Talifiam i S F-i0 FIR. 3-3-144 Location and Legal Description Loa+ _.....Lat____ _________ 21._ Block_ _2 ____ __ s e dD 431 at Street and Number where work is to be performed—No ___ 75 IA . -', . Street_ 92 State work to be performed and purpose of building ( By Floors) _ . _ New lkilding ____ X Remodeling _____ ____ __. _ __ . . Addition__ _ .... ___ _ Repairs_ .. . _ _.. No. of Stories . . 1 Size Septic Tank._ Type of Tank . cast _ _ Feet oi Drain Tile. ____ 32 _ __Dist. Feet of Tank or Drain Field from Well.. _ Si of Soakage Pit - (Signed)_ (Signed)___. e-1 Date oct.25th ,68. .. Capacity Gals. 9 2 0 _ Plumbing In :pea°. Ths 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, nnd I -om- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be perform sd under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or no' Ices as are required' by the Act. The undersigned agrees to employ only such sub-contractors, on work to be perfo. , ed under this per nit, as are licensed by Miami Shores Village. Master Plumber Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgu.ents, personall 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 apphcation, and that he did sign the same, and that all .acts therein by him stated are true. My Commission Expires Notary Public, State of Florida _ NOTE: A re-inspection fee of BMX) will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and/or worlmianship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tues URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL F %TURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW I M • G POOL CONTR. LNIT X x clime( (70 Permit No Nature of Water Supply. City—Well. Amount of Permit $ _ STATE OF FLORIDA, } ss. COUNTY OF DADE. 4, 00 MIAMI SHORES VBILLGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Am: 'cation i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village Florida, and ill provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of th Building 131. sion of M iami 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. N , 1 40 __ tuo 4 . sth _ 109th Stree Ownor's Name and Address. R. Nar Registered Architect and/or Engineer _ _ Employing Plumber's Name 0 'Neal Septic Tank Co. No. P.O. Box 6_2,9_ streetAi am i 9 -- Talifiam i S F-i0 FIR. 3-3-144 Location and Legal Description Loa+ _.....Lat____ _________ 21._ Block_ _2 ____ __ s e dD 431 at Street and Number where work is to be performed—No ___ 75 IA . -', . Street_ 92 State work to be performed and purpose of building ( By Floors) _ . _ New lkilding ____ X Remodeling _____ ____ __. _ __ . . Addition__ _ .... ___ _ Repairs_ .. . _ _.. No. of Stories . . 1 Size Septic Tank._ Type of Tank . cast _ _ Feet oi Drain Tile. ____ 32 _ __Dist. Feet of Tank or Drain Field from Well.. _ Si of Soakage Pit - (Signed)_ (Signed)___. e-1 Date oct.25th ,68. .. Capacity Gals. 9 2 0 _ Plumbing In :pea°. Ths 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, nnd I -om- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be perform sd under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or no' Ices as are required' by the Act. The undersigned agrees to employ only such sub-contractors, on work to be perfo. , ed under this per nit, as are licensed by Miami Shores Village. Master Plumber Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgu.ents, personall 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 apphcation, and that he did sign the same, and that all .acts therein by him stated are true. My Commission Expires Notary Public, State of Florida _ NOTE: A re-inspection fee of BMX) will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and/or worlmianship. Date -Type Insp' Permit No. Name Address Company Phone # For Inspecttorr: Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Ti e `j-1 '.'e & C BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ PLUMBING ❑ PERMIT N 10377 ROOFING ❑ 0 Owner of Building �`�'% Arch itect Contractor or Builder a Legz1 Lot II Description II B1 Address of �'' Building 4s. u CONTRACTOR or BUILDER r -- Date'' 19'" Contractor's No. Work to be performed under this Permit - 7., G 3t ; ate Subdi- vision Sq Ft Value of (I Amount of r Project $ (I 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 applica- tion Iierefor 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 empl6yees. • Signed t " ' ' _ "7 ' t` (INSPECTOR) BY In consideration of the issuance to me of this permit I ogee 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 ao :epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY BUILDING ❑ MIAMI SHORES VILLAGE FLORIDA . -,,, . ELECTRICAL ❑ Date 19" PLUMBING ❑ PERMIT N? 10675 Contractor's ,in +` -,, n ROOFING ❑ License No `= ` ❑ Owner of Building Arch itect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR or BUILDER Work to be performed under this Permit 11 Bl. n r • Subdi- vision Sq Ft Value of 11 Amount of Project $ 11 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 applica- tion lierefor 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, ser ants or employees.- 1( - y Signed ('INSPECTOR) BY 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 Date - 02 Job Address 7 -2- 5 Tax Folio Legal Dcscription Historically Designated: Yes No Owner/I essee / Tenant Wen d & I ` ( G h a m Master Permit # � ' -P r P cvZ • /3 L Owner's Address 2,5" 6 9 2 5 r WORK: DESCRIPTION c �ET (i TD 2/2" 6 - E Notary as/to Owner and/or Condo Presi s ent Date OFF4CMNOTARY SEAL FLEAA..LONZO C DANO My Co mmission Expire ( FEES: PERMIT 70 RADON PERMIT APPLICATION FOR MIAMI SHORES VILLAGE „ '-'d;,44.t1S' ICNd4ri01+lBER `A 3D39a022 tE` nc� ,EXPIRES OF f.P A AR.6,2006 APPROVED: Zoning Building Mechanical Plumbing C.C.F. j-3)-� Olga Notary as to Contractor or Owner - Builder My Commiss Electrical 4 Phone , �' 2 $ - ,.r( 7--. 2 -5 - / c� Contracting Co. (/1/ C /< S 6A 5 Address .3 "0 Q /v 4/ S s Y Qualifier ✓A AI CS ,Y aAl SS# . ?Phone /o ' - 63,c ”- y State # r L /1 LP ° l 17 Municipal # Competency # Ins. Co. Architec t/Engineer Address Bonding; Company Address Mortgal;or Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FE CE SIGN Lf 14NK a llN 6 LINE O O Square � Estimated Cost (value) "—RV �J WARMING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permit: are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNE;WS [DAVIT: r ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable cons jjd a g c zo �. Furthermore, I authorize the above -named contractor to do the work stated. laws r ! WO Signati a -afz ier ani1 Co l do President Date Si a of Contractor 1r Owner- Builder // J. O PL e <i REA A L �ZO{EDAldo 1 0% Q AI I COMMISSIOBER Q DD098022 OF f 1 ,,c\ M Y COMMISSION EXPIRES MAR. 6,2006 -o2., Date Date NOTARY BOND TOTAL DUE 90 ^ (_.(2 Engineering 7o7- i? vim/ •3 • WEEKS GAS 3800 N.W. 59TH STREET MIAMI FL 33142 -2032 (305) 635 -1395 (305) 635 -4GAS 1 72- c APPS LL 7 .' n/t z s7 W IM®.e*" GL C/ZA WEED S 3800 kW. 59TH SIR MIAMI FL 331424032 (305) 6354395 (305) 635m4GAS lu '1 02- 5 7 J Miami mores viiiage 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/7/2002 Applicant: MAGDA Owner: LOVINSKY JOB ADDRESS: 75 Permit Status: Approved Permit Expiration: 12/4/2002 Work: 2 ET (1) 200 # LP TANK & RUN G /LINE NE 92 Plumbing Permit Permit Number: PL2002 -134 LOVINSKY MAGDA ST Contractor WEEKS GAS Contractor's Address: 3800 NW 59 ST Local Phone: 305 - 635 -4427 Parcel # 1132060130270 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 21 & E 1/2 LOT 20 BLK 2 LOT SIZE Construction Value: $465.00 Page 1 of 1 Total Fees: $0.00 Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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: (INSPECTOR) BY: 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: ,non. ..cau+muZa S PY /J( a n, TO ...IIVJJ���� c( ORDER Og UNION BANK Where Your Business Is Big Business." 954- 916 -4444 www.udoubk.00m FOR V `+V THE PERMIT PROFESSIONALS P.O. BOX 8205 CORAL SPRINGS, FL 33075 ran\ eh-J 11'00457511' I:06 700 7 70 3i: i I y en li a c r d A n a rn r1 1 F n r l f ,1 I n i I DATE 00 L LO L40401I' 0(0/D 4-008- C00 I0 Permit No (c J Amou nt of Permit $ 4 ' My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date Z Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structu :e 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 Registered Architect and /or En 'neer _____________ Employing Plumber's Name .__ _. __ _L'__ _S__ r (Vif 4 -- -tNo.___ Street Location and Legal Description Lot________ —__ Block__ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Emilding Remodeling Addition.___ Repairs No. of Stories. . . ... No 7 ` Street_ /_,l_: -t: 9 Z S (Signed) (Signed) Subdivision Street Size Septic Tank Type of Tani Capacity Gals. Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well s % a, o- Nature of Water Supply: City —Well F -- -Size of Soakage Pit 3 Notary Public, State of Florida mbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatipsiis 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 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 be formed under is permit, as are licensed by Miami Shores Village. ter Plumber. STATE OF FLORIDA, COUNTY OF DADE. 1 3efore 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 tie above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by hin, 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 Twits B URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT 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 ✓ Q/ CHQCP Permit No (c J Amou nt of Permit $ 4 ' My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date Z Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structu :e 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 Registered Architect and /or En 'neer _____________ Employing Plumber's Name .__ _. __ _L'__ _S__ r (Vif 4 -- -tNo.___ Street Location and Legal Description Lot________ —__ Block__ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Emilding Remodeling Addition.___ Repairs No. of Stories. . . ... No 7 ` Street_ /_,l_: -t: 9 Z S (Signed) (Signed) Subdivision Street Size Septic Tank Type of Tani Capacity Gals. Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well s % a, o- Nature of Water Supply: City —Well F -- -Size of Soakage Pit 3 Notary Public, State of Florida mbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatipsiis 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 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 be formed under is permit, as are licensed by Miami Shores Village. ter Plumber. STATE OF FLORIDA, COUNTY OF DADE. 1 3efore 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 tie above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by hin, 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. 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 M iami Shores Village shall be complied with herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Ownisr's Name and Address mAyo et) ksi s No. Street 7S q.G. 92 ry STIEg - r Reghtered Architect and/or Engineer Employing Plumber's Name. No. Street C07 2 S. V). STPLET Location and Legal Description Lot2.13.!_g_Z2- Block_ Subdivision Strei:t and Number where work is to be Street 7 NI.C. 9.2--Y■ci• Stato work to be performed and purpose of building (By Floors) Nev. Building ' Remodeling_ Addition Repairs No. of Stories Sias Septic Tank Type of Tank_ Feist of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City—Well Arsount of Permit $ STATE OF FLORIDA, } ss. COUNTY OF DADE. Before me, the undersign MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN APPLICATION FOR PLUMBING rMIT Capacity Gals (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 ur der 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 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 und this permit, as are licensed by Miami Shores Village. (Signed)._ Date Aiia 9 4 I • 7--77— authority, a not •ubli , duly authorized administer oaths and take acknowledgments, personally appeared rrte well known, and wh, .eing by me first duly sworn, upon oath deposes and says that he is the c.f the above described nstruction, that he has carefully read the foregoing ap ctin, and that he did sign the same, and that all facts therein by hin. stated are true. ala's f. OF F LIA-A4-4-e - my_Lommi-spiale‘t :•,, . 24, 1972 W. sONDED DIES TELHORST Notary Public, State of Florida Master Plum 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 materiels and/ouworlcman.ship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES siteas SLOP striae LAUNDRY Turm URINALS CATCH BASIN FLOOR DRAIN - DRINKING FOUNT'NS j)/S /-kildkraell TOTAL FIXTURES - CONTR. LIIIT 2 c I a, I / __/___ CHI CK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW I M '0 POOL v AfFTL anZ.. 4 4 ATe .se 1-■11Ce 4 / col ITR. LI GT CH MK f / _z____ 1 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 M iami Shores Village shall be complied with herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Ownisr's Name and Address mAyo et) ksi s No. Street 7S q.G. 92 ry STIEg - r Reghtered Architect and/or Engineer Employing Plumber's Name. No. Street C07 2 S. V). STPLET Location and Legal Description Lot2.13.!_g_Z2- Block_ Subdivision Strei:t and Number where work is to be Street 7 NI.C. 9.2--Y■ci• Stato work to be performed and purpose of building (By Floors) Nev. Building ' Remodeling_ Addition Repairs No. of Stories Sias Septic Tank Type of Tank_ Feist of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City—Well Arsount of Permit $ STATE OF FLORIDA, } ss. COUNTY OF DADE. Before me, the undersign MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN APPLICATION FOR PLUMBING rMIT Capacity Gals (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 ur der 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 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 und this permit, as are licensed by Miami Shores Village. (Signed)._ Date Aiia 9 4 I • 7--77— authority, a not •ubli , duly authorized administer oaths and take acknowledgments, personally appeared rrte well known, and wh, .eing by me first duly sworn, upon oath deposes and says that he is the c.f the above described nstruction, that he has carefully read the foregoing ap ctin, and that he did sign the same, and that all facts therein by hin. stated are true. ala's f. OF F LIA-A4-4-e - my_Lommi-spiale‘t :•,, . 24, 1972 W. sONDED DIES TELHORST Notary Public, State of Florida Master Plum 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 materiels and/ouworlcman.ship.