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930 NE 92 St (4)MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR 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. Owner's Name and Address . � ER �� �_._____.____ 93 Street__ Registered Architect and /or Engineer ..... - - - -_ -- Employing Plumber's Name S.I.A. _4_ j0_0_ No.------ - - --- Location and Legal Description Lot_-_ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling — -- --_ -- Size Septic Tank Feet of Drain Tile ..... _____ Nature of Water Supply: City —Well Amount of Permit $ Bl Addition Repairs _Type of Tank__ _Dist. Feet of Tank or Drain Field from Well _Size of Soakage Pit ( 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 plied with the provisions thereof, and will require similar compliance from all contractors or sub -con performed under this permit; and will post or cause to be posted' for inspection on the site of work required by tlie Act. The undersigned agrees to employ only such sub- contractors, ork to b licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires Before me, the undersigned authority, a notary public, duly authorized to administ 3 ® Street_ Street___ k d `€ Capacity Gals. Subdivision 91 92 7: No. of Stories. i spector. tions as an ebployer of labor anent Supplement, and has com- ed by him in the work to be p blic notice or notices as are ed under this permit, as are 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. Notary Public, State of Florida ® / _ fez aster Plumber. 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 INAS 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 SWIM'G POOL CONTR. LIST _ CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR 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. Owner's Name and Address . � ER �� �_._____.____ 93 Street__ Registered Architect and /or Engineer ..... - - - -_ -- Employing Plumber's Name S.I.A. _4_ j0_0_ No.------ - - --- Location and Legal Description Lot_-_ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling — -- --_ -- Size Septic Tank Feet of Drain Tile ..... _____ Nature of Water Supply: City —Well Amount of Permit $ Bl Addition Repairs _Type of Tank__ _Dist. Feet of Tank or Drain Field from Well _Size of Soakage Pit ( 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 plied with the provisions thereof, and will require similar compliance from all contractors or sub -con performed under this permit; and will post or cause to be posted' for inspection on the site of work required by tlie Act. The undersigned agrees to employ only such sub- contractors, ork to b licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires Before me, the undersigned authority, a notary public, duly authorized to administ 3 ® Street_ Street___ k d `€ Capacity Gals. Subdivision 91 92 7: No. of Stories. i spector. tions as an ebployer of labor anent Supplement, and has com- ed by him in the work to be p blic notice or notices as are ed under this permit, as are 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. Notary Public, State of Florida ® / _ fez aster Plumber. 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. Ready: Condemned Relay drainfield • Cross connections Gas service or house piping repairs MIS LLA,:EOL"S IT.rS EC'IONS Installed by x„ Owner's s name k%). ?ate / Address of ;^cork 3 e) o AM PM Ap' by Sewer repairs Cas appli-.nces Waste, building drain, - Vent Water pinin` Hot water, safe wastes, pit privies, water supply wells