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960 NE 92 St (3)Owner/Lessee / Tenant Owner's Address APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address ?6() P5-1-- Tax Folio '360 Ai s (.; Contracting Co. 1..07/"T Q cm TR il-c I o ie Qualifier /Wc .. , �/1 P M9A0,e/:s State #( 'a(/ 7 Municipal # Architect/Engineer Bonding Company Building Plumbing Hist 'cally Designated: Yes No Master Pt # (7 0 g i.J Phone r3C ermi (73 70 Address63a /$ O /J/Z c y 1-7 &tai SS #, / Phon . J77 Competency # Address Address L Mortgagor Address Permit Type (circle one): BUILDING ELECTRIC _/ / WORK D SCRIPTION e# o t ` d t/A l �' /� - (, `/ � & f L PLUMBING 1VIECHANICAL ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost (value) WARNING 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 permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named . ntractor to do the work stated. as to on y Commission Exp FEES: PERI .. RADON C.C.F. L" ° NOTARY Electrical 5C ,, eta Structural Engineer BOND Ins. Co. 6 ,Ziof TOTAL DUE I'tHIVIl I API L1LAI lUN FUH MUN1LlNAL1I ltJ ur UAUt IUUvI I Date - Job Address Legal Description Owner Owner's Address Contracti Qualifier i� , SS�� / / . - Phone/ - 64" 4-70S- State lfr b Architect /Engineer Bonding Company Mortgagor Permit Type: ROOFING BUILDING ELECTRICAL WORK DESCRI PTION 0 Square Ft. L d 'fL L k d 3 (' M Per t# 0 Tenant CCnn _l Day -Time Phone I j ' - 2 5 4 ' I ec /7 ompetency# WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILUkt 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 permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing information is ur e and that all work will don compliance with all applicable laws -:ulat construction zoning. Furth o w on a the above -named contractor o d• e w Signature of Property Owner or Condo Pres. Sworn to & s bsc ibed before me this day of �r :.`/ _ AP z 19 / _ . Affiliffff / Signature (Prin Personally TYPE OF I.D. PRODUCED FEE - gel/ aigliCtigiOPOAttiCondo President My (Omm..Exp. 7/30/96 8 ed 8 `Servlc or e.• . 490 ioned Name) wn I Ifvww4R 1)oireduced Zoning Building Mechanical 'lumbing 96 U A /2/ Tax Folio 1/ Sao/ ,ia# /bf Address / /02Y pt Ck ( / 4/ 52�› )r Address Address Address Estimated Cost 3gna ure o TYPE OF I.D. PRODUCED Ins. Co. ?4 PLUMBIN_ MECHANICAL PAVING FENCE SIGN ntrac Sworn to & sub cribed before me this day of 1 e Electrical Signature of Notary to Contractor [i[r;:1' ['51'),c :»P A „l:d. •rjhu [ i (Print, Type, or Stamp Commissioned Name) Personally Known F OR Produced I.D. 7 / r Engineering I fr — ..MorildliniA....mill.10111111.mall r -w4 bt BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ,_ Date 19 —_ f ELECTRICAL ❑ PLUMBING Q PERMIT NU 8305 Contractor's •-• �- ROOFING ❑ License No. ❑ Work to be performed under this Permit Owner of Building " c i ?. -' 14 .. r ■ _ • F•; r, Architect Contractor or Builder r' t. ' Legal Lot i l Description ii Bl Address of 7 Cr_' 1 i - C t Building - C . ..› sibility for work done by his agents, servants or employoles. / t '. s` ■ Signed CONTRACTOR or BUILDER 1 t t Subdi- vision Sq Ft. C 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 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- (INSPECTOR) BY In consideration of the issuance to me of this permit I agree,? o perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings; Atatements 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 BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA Date 1 - 1 ) ELECTRICAL ❑ PLUMBING PERMIT N9 8303 Contractor's License No. ROOFING ❑ Owner of Building '- L t f / ❑ Work to be performed under this Permit Architect (. L Contractor it or Builder " t' " + .) 1 Y Legal Lot 4r Description "4 I" C CI Bl 1 Address of # toy Building 1 1 Subdi- ( kk ' vision 1, _. A • E; ;: 4 _ii ''''';- e Sq. Ft. Value of 1 1 Amount of Project $ 2,:`- -t'3 11 Permit $ ,CONTRACTOR or BUIdDER BY AUTHORITY 19 e7 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. Signed• ) . ' -4. -ow _.y __. (INSPECTOR) BY In consideration of the issuance to me of this permit I agr' to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawina, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting ,this permit I assume responsibility f all work dole by either, myself, my agent, servant or employee. I l v 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 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 (Chh' q_____ Registered Architect and /or Engineer Jy Amount of Permit $ ---- -------------- - - - - -- My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date S No. � �� Street_ 9 Z Employing Plumber's Name_ __ ______.__.__ No..___._______ _ Street_- ---- - - --- — / - Location and Legal Description L t_LQ/!.... / Y F _ 6 . 1 ...... t L !_— Block / Subdivision 04 —(/ Street and Number where work is to be performed— No.-__ 76° �`�1' _._Z __ ..... ___. Street State work to be performed _ ed and purpose of building (By Floors)___ 2QJ _ - _i� _i/ j._ N Building Remodeling _.__________ Addition Repairs 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 (Signed)._ — (Signed) --- - L 7" ...... - umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio .: s an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent S :.lement, 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, o1p work to b performed under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida s/` No. of Stories. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. j 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. NOTE: A ro-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 Tues SH LAVA- TORIES SINKS SLOP SINKS LAUNDRY TU88 URINALS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS 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 CNECK 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 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 (Chh' q_____ Registered Architect and /or Engineer Jy Amount of Permit $ ---- -------------- - - - - -- My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date S No. � �� Street_ 9 Z Employing Plumber's Name_ __ ______.__.__ No..___._______ _ Street_- ---- - - --- — / - Location and Legal Description L t_LQ/!.... / Y F _ 6 . 1 ...... t L !_— Block / Subdivision 04 —(/ Street and Number where work is to be performed— No.-__ 76° �`�1' _._Z __ ..... ___. Street State work to be performed _ ed and purpose of building (By Floors)___ 2QJ _ - _i� _i/ j._ N Building Remodeling _.__________ Addition Repairs 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 (Signed)._ — (Signed) --- - L 7" ...... - umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio .: s an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent S :.lement, 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, o1p work to b performed under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida s/` No. of Stories. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. j 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. NOTE: A ro-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. 1 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description. Address of Building Lot I I CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA yERMIT N? 13041 Work to be performed under this Permit BL Subdi- vision Value of Project $ DATF 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 BUILDING ELECTRICAL PLUMBING ROOFING Owner of r t Building ‘,1 Architect Contractor or Builder Legal Description Address of Building f 1 . Lot MIAMI SHORES VILLAGE. FLORIDA PERMIT X? 12495 ❑ Work to be performed under this Permit .. t • Subdi- vision Value of to( i Project $ f DATE Contractor's License No Amt. of Permit $ I,G J r �J 195 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 patements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed . - v ''k 1 _ �} .�•' . 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. CONTRACTOW OR BUILDI BY AUTHORITY j c • • s,----, r ,, y' V ,1 ,---' Z ' Permit No. -' • t f+ Registered Architect and /or Engineer ti New Building Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. 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 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 . 1' Y1. • r I Employing Plumber's Name i . t i 2 No d to. Street— F Location and Legal Description Lot_: �` h1 i ` c Block Subdivisio ( Street and Number where work is to be performed —No r Street _ __ _ i. - • �> < State work to be performed and purpose of building (By Floors) Remodeling Addition. Repairs 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 —'li�i 1 <' Size of Soakage Pit (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 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 under this permit, as are licensed by Miami Shores Village. (Signed) No Street . Date My Commission Expires Notary Public, State of Florida t- ek No. of Stories ._./ Master Plumber. 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. 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 /V u� r' TOTAL FIXTURES CONTR. LIST I f I --) ••••• % CHECK '. r . I .._.� SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL r I + d 1 111 ��` {.,I 111 7 S ..� i� i i T ! : ) I CONTR. LIST /1 CHECK Permit No. -' • t f+ Registered Architect and /or Engineer ti New Building Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. 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 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 . 1' Y1. • r I Employing Plumber's Name i . t i 2 No d to. Street— F Location and Legal Description Lot_: �` h1 i ` c Block Subdivisio ( Street and Number where work is to be performed —No r Street _ __ _ i. - • �> < State work to be performed and purpose of building (By Floors) Remodeling Addition. Repairs 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 —'li�i 1 <' Size of Soakage Pit (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 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 under this permit, as are licensed by Miami Shores Village. (Signed) No Street . Date My Commission Expires Notary Public, State of Florida t- ek No. of Stories ._./ Master Plumber. 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. 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 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. Owner's Name and Address No. Street Employing Plumber's Name Nature of Water Supply: City—Well Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and/or Engineer tgo Street._ Block-- Subdivision Location and Legal Description Lot. Street and Number where work is to be performed—No (4 6 _a_ n- Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition__ Repairs Date No. of Stories Size Septic Tank Type of Tank__ Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Dram Field from WelL Size of Soakage Pit ( 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 5988, 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 under this perniit, as art licensed by Miami Shores Village. (Signed). 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 appeare 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 fac 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 fatal materials and/or workmanship. CLOSET BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU NT • NS TOTAL FIXTURES CONTR. LIST - CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW I M•G POOL D §,. -"C ,r ) -t-C- , -) comm. LIST CHECK 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 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. Owner's Name and Address No. Street Employing Plumber's Name Nature of Water Supply: City—Well Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and/or Engineer tgo Street._ Block-- Subdivision Location and Legal Description Lot. Street and Number where work is to be performed—No (4 6 _a_ n- Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition__ Repairs Date No. of Stories Size Septic Tank Type of Tank__ Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Dram Field from WelL Size of Soakage Pit ( 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 5988, 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 under this perniit, as art licensed by Miami Shores Village. (Signed). 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 appeare 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 fac 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 fatal materials and/or workmanship.