PLUMBING PERMIT•
Date
Legal - ption Historically Designated:
x0.1c.Q hee
?754 L- X2 ar
1.9-s bkrr (Lit, GrRls
Qualifier m AO_ -
State 1( , �.G/ 7 S7 Municipal #
Owner/Lessee / Tenant
Owner's Address
Contracting Co.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Addressq 7 , //
9 2 Tax Folio
Architect/Engineer Address
Bonding Company Address
Mortgagor —Address
Permit Type (circle one): BUILDING ELECTRIC ' PLUM ING M ' HA CAL ,ROOFING
/--.
WORK DESCRIPTI
/i ' 0 6
Square Ft. Estimated Cost (value)
Competency #
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 contractor to do the work stated.
d ef
Signature ofbwner and/or Condo President
Date
Notary as to Owner and/or Condo President Date
My Co t�iissrq ptres: :" = ti.A►., Y
„,i.v ' g P'`s�[ialIDA
FEES: PERMIT RADON
APPROVED:
Zoning
Mechanical Plumbing
C.C.F.
757 11 L5
r-
Ins. Co.
No
PAVIN G FENCE SIGN
/07
Signature of Contractor or Owner- Builder Date
Notary as to Contracto
AR
My Commission Expir s: DAVE LANHAM
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION N. CC3 3
ii, p:70N EXP
NOTARY
TOTAL DUE
.
D
Building (� Electrical
Engineering
BUILDING ❑
ELECTRICAL ❑
PLUMBING
ROOFING ❑
Owner of "-' : f
Building [.
Architect
Contractor
or Builder i 7H
Legal Lot
Description
Address of
Building
CONTRACTOR OR;BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE - 1 f' /9
PERMIT N9 5073
Work to be performed under this Permit.
Bl.
BY
Subdi-
vision
Value of
Project $
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 �` •�i -- IySPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances theeregulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
4 J ",
Contractor's ) r ,
License No. t / �`
4'1 ,
Amount
Permit $
of «-
AUTHORITY
fy _
AB »x'R
.....o
C!_OlSHT3
DATN
TUBS
SHOWERS
LAVA•
TO
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOU NT' NS
W M
TOTAL
FIXTURES
oNTl
G 1.137
J
I
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
11 .6 6
LIST
+
-
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit. Na._. `� . Date. _. r i__ -. /— /?61-
Application is hereby mane 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,
acid LB 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.
Cw is s Name and Address No._..-
Registered Architect and /or Engineer . -- -- - ___ -.—
Employing Plumber's Name Q. J4
P Y�g ' G � "" - ' ` No.--- �., �_ �..�� -- .- - - -.__ Street. .l!.`�rq,l_ — b _�___ : .�`
Location and Legal Description Lot.__ -- - - __- _- ____- _— ____._ Block.. Subdi
Street and Number where work is to be performed —No C 7-7.5 Street 7a.
State work to be � per rf forrmed and purpose of building (By Floors)
, ---- -- __- --_
New Building -.__ Remodeling----- .•-- _-- ----- -. - - -- Addition
Amount of Permit . _ ,
Repairs No. of Stories.
Size Septic Tank ..... _------ - -____ _ -_ Type of Tank
Feet of Drain Tile_--_-_------------- ..... Feet of Tank or Drain Field from Well
Nature of Water Supply:. CityyWell._______ _ ____Size of Soakage Pit
Capacity Gals
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 5968, 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
Street.-_ .....
—
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.
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.
\c,
3
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
0
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Bl
N9 5080
Work to be performed under this Permit
Value of
Project $
DATE__ _ - .',19
Contractor's
License No.
- WINO
Subdi-
vision
Amount 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 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. , k- alSPECTOR
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 ao
cepting this permit I assume fat all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER ✓ BY AUTHORITY All SOT ..1€7,".f..
Permit No
Feet of Drain Tile.
Owners Name and Address
Registered Architect and /or En
Employing Plumber's Name
Location and Legal Description Lot Bl
Street and Number where work is to be performed —No 5
State work to be performed and purpose of building (By Floors) _
Size Septic Tank_ -_ _ —
Ansount of Permit $
Nature of Water Supply: City—Well.
STATE OF FLORIDA,
COUNTY OF DADE. J
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
_Type of Tank
Street_
41Q�Ti it S e
P
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 b specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Street
New Building__________ ...... Remodeling—______- ___._.___ Addition________ -_-_ Repairs.__ No. of Stories
Capacity Gals
t. Feet of Tank or Drain Field from Well
_ _Size of Soakage Pit
(Signed)_ =��r
(Signed)*
P1 bing 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 5968, 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 tlie 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 acimowledgments, 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.
My Commission Expires Notary Public, State of Florida
Master 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
TueS
S
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
U
CATCH
BASIN
FLOOR
DRAIN
ORINKI NG
FOUNT' NS
TOTAL
FIXTURES
CoNTR.
LIST
-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW I PA' G
POOL
CONTR.
LIST
_
CHECK
Permit No
Feet of Drain Tile.
Owners Name and Address
Registered Architect and /or En
Employing Plumber's Name
Location and Legal Description Lot Bl
Street and Number where work is to be performed —No 5
State work to be performed and purpose of building (By Floors) _
Size Septic Tank_ -_ _ —
Ansount of Permit $
Nature of Water Supply: City—Well.
STATE OF FLORIDA,
COUNTY OF DADE. J
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
_Type of Tank
Street_
41Q�Ti it S e
P
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 b specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Street
New Building__________ ...... Remodeling—______- ___._.___ Addition________ -_-_ Repairs.__ No. of Stories
Capacity Gals
t. Feet of Tank or Drain Field from Well
_ _Size of Soakage Pit
(Signed)_ =��r
(Signed)*
P1 bing 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 5968, 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 tlie 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 acimowledgments, 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.
My Commission Expires Notary Public, State of Florida
Master 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.