PLUMBINGLegal Description
Owner/Lessee / Tenant /�2/e <3 e 2 T S/7 4 �/
Owner's Address
Contracting Co. ,4//
Qualifier 2.).41.-/D Ca eit
State # O`
Architect/Engineer P 1 t`f
Bonding Company L.
Mortgagor 1-'
Permit Type (circle one):(BUILDIN
WORK DESCRIPTION
Square Ft.
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 ATTOP.NEY 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 y;, compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work sta
s
er and/
do President
(SD. 32t
l Date /
/ /,
1
ate
Signature
Notary
My C
6e
APPROVED:
Zoning
Mechanical
. ..�
to Owner an or Co '• ' vi4 LL
)! VILLAR
mmission Ex p ir N OTABY P'UBIZC STATE OF FLORIDA
COMMISSION NO. 0710103
Mit COMMISSION EX ?. MAR. 2
g
FEES: PERMIT O RADON
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address / D S /71 C 9s- Sf• Tax Folio
/D Or 5 5-74
Municipal # Competency #
Address
Address
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE
sir/ e ` 4D/ Gu /�igr- c '7
s-7 o 716 r , s
C.C.F.
Historically Designated: Yes No
Master Permit # ' q3 if
Phone 36 717 3 6
Address //2 2 c 1 /-�re
SS# - - , Phone 3� $13 / ®(3f
Ins. Co. +-or
Address
Estimated Cost (value)
Electrical
w
/ /ire s
000 °°
SIGN
uilder
oelC
TOTAL DUE4_61A2
Structural Engineer
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
BATH TUB
BIDET
DISHWASHER
DISPOSAL
DRINKING FOUNTAIN
FLOOR DRAIN
GREASE TRAP
INTERCEPTOR
LAVATORY
LAUNDRY TRAY
CLOTHES WASHER
SHOWER
SINK, POT /3 COMP.
SINK, RESIDENCE
SINK, SLOP
TEMPORARY WATER CLOSET
URINAL
WATER CLOSET
INDIRECT WASTES
WATER SUPPLY TO:
A/C UNIT
FIRE SPRINKLER
HEATER -NEW INST.
HEATER - REPLACE
LAWN SPRINKLER -WELL
SWIMMING POOL
WATER SERVICE
SEWER CONNECTIONS
UTILITY -SEWER
UTILITY -WATER
SEPTIC TANK
RELAY
DRAINFIELO, 4' TILE/RES.
PUMA S ABANDON SEPTIC TANK
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING •
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
3AS PIPING
ELECTRICAL
MECHANICAL
cf
UNIT
a
FEE ITEM
SWITCH OUTLETS
GENERATORS TRANSFORMERS
LIGHT OUTLETS
RECEPTACLES
SERVICE TEMPORARY
SERVICE SIZE IN AM'S
SERVICE REPAIR/METER CHANGE
APPLIANCE OUTLETS
RANGE TOP
OVEN
WATER HEATER
MOTCRS 0- 1 HP
MOTORS OVER 1- 3 HP
MOTORS OVER 3- 5 HP
MOTORS OVER 5- 8 HP
MOTORS OVER 8- 10 HP
MOTORS OVER 10- 25 HP
MOTORS OVER 25-100 HP
MOTORS OVER 100 IP
A/C WINDOW
AIR CONDITIONERS
STRIP HEATER
GENERATORS TRANSFORMERS
GENERATORS TRANSFORMERS
SPECIAL PURPOSE
OUTLETS COMMERCIAL
SIGN TUBES
SIGN TRANSFORMERS
SIGN T I M E CLOCK
FIXTURES
ANTENNA
TELEVISION OUTLETS
VIOLATION
RE INSPECTION
UNIT
FEE
ITEM
SPACE HEATERS
CENTRAL HEATING
A/C (WIND)
A/C (CENTRAL)
DUCTWORK
REFRIGERATION
UNIT
PROCESS AND PRESS PIPING
UNDERGROUND TANKS
ABOVE GROUND TANKS
U.F. PRESSURE VESSELS
STEAM BOILERS
HOT WATER BOILERS
MECHANICAL VENTILATION
TRANSPORTING ASSEMBLIES
ELEVATORS /ESCALATORS
FIRE SPRINKLER SYSTEMS
COOLING TOWERS
VIOLATION
REINSPECTION
FEE
ITEM
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ U
PLUMBING ❑ PERMIT Ne 9701
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Bl.
.v1 12'
Subdi-
vision
Sq. Ft
Value of
Project $
DATE 19
Contractor's
License No.
Amt. of
Permit $ f
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
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
° PERMIT N? 9733
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE,
Bl.
Work to be performed under this Permit -
Subdi-
vision
FLORIDA
DATF
Contractor's
Sc1. Ft
Value of
Project $
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. �.4 v
Signed • - v , , 0 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
17
Permit No. -__
Application is hereby made for the approval of the detailed statement of the plans and specifications he ' ith submitted for the building or,other
structure herein described. This application Is made in compliance and conformity with the Building Or finance 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___ O V f 5 ___
Registered Architect and /or Engineer
Employing Plumber's Name____LZ' to .5.3p `47:
STATE OF FLORIDA,
COUNTY OF DADE. I
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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)
Amount of Permit $______ t____ __------ _ - - -__ ( Signed)
No.__1 D O s _ S treet__. I _ J
C.__ No. Street__ik
Date_
Subdivi
Capacity Gals.
Notary Public, State of Florida
J
Street
N Building Remodeling_ _______ Addition Repairs No. of Stories.
Size Septic Tank Type of Tank__
Feet of Drain Tile______ _____ _.__ ___Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— .___1__ __— ___Size of Soakage Pit
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--p : • ed under this . ennit, as are
licensed by Miami Shores Village.
(Signed)
-
r 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•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
T
SLOP
SINKS
U�ry�D
W'4"yiV p
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
� /t/,
,
VA'
`/- _
TOTAL
FIXTURES
Law
^
•
CHECK
-
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
/
/
CHECK
Permit No. -__
Application is hereby made for the approval of the detailed statement of the plans and specifications he ' ith submitted for the building or,other
structure herein described. This application Is made in compliance and conformity with the Building Or finance 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___ O V f 5 ___
Registered Architect and /or Engineer
Employing Plumber's Name____LZ' to .5.3p `47:
STATE OF FLORIDA,
COUNTY OF DADE. I
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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)
Amount of Permit $______ t____ __------ _ - - -__ ( Signed)
No.__1 D O s _ S treet__. I _ J
C.__ No. Street__ik
Date_
Subdivi
Capacity Gals.
Notary Public, State of Florida
J
Street
N Building Remodeling_ _______ Addition Repairs No. of Stories.
Size Septic Tank Type of Tank__
Feet of Drain Tile______ _____ _.__ ___Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— .___1__ __— ___Size of Soakage Pit
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--p : • ed under this . ennit, as are
licensed by Miami Shores Village.
(Signed)
-
r 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•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
r
C,f
1.4
r
j by
Permit No -__ -1.
New Building
Amount of Permit $
Size Septic Tank ° ® _.._ -_ Type of Tank_
IAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING NkIIT
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)__ .... _.....
_____
(Signed)
(Signed)
Date
/- 9'
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. f -,��
Owner's Name and Address � %�_ -- --- -------- -- - - -- _ No._,C / �`�e 7 � 1 °` — Street__ v ../;
Registered Architect and /or Engineer______-_.__________ ________ —__._— _ _
Employing Plumber's isain __.�` °'-` `-, '' i ''-----:- 4 i_
- -- - : _ - _ _:- No. _ —_/ _ - -- _ 7 _ - -- Street__
and Legal Description Lot._______ Block__ Subdivision
Street
Remodeling_____ Addition ________________________ Repairs No. of Stories
Feet of Drain Tile_ .; ! 42- ' 642 e-÷' _Dist. Feet of Tank or Drain Field from Well
_ -- _ -- --
Capacity Gals 1 a
Nature of Water Supply: City—Well. _______ — ____Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
umbing 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 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.
STATE OF FLORIDA,
COUNTY OF DADE.
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•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
Tues
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINA
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
SWIM'G
POOL
CONTR.
LIOT
.
CHECK
f/
Permit No -__ -1.
New Building
Amount of Permit $
Size Septic Tank ° ® _.._ -_ Type of Tank_
IAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING NkIIT
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)__ .... _.....
_____
(Signed)
(Signed)
Date
/- 9'
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. f -,��
Owner's Name and Address � %�_ -- --- -------- -- - - -- _ No._,C / �`�e 7 � 1 °` — Street__ v ../;
Registered Architect and /or Engineer______-_.__________ ________ —__._— _ _
Employing Plumber's isain __.�` °'-` `-, '' i ''-----:- 4 i_
- -- - : _ - _ _:- No. _ —_/ _ - -- _ 7 _ - -- Street__
and Legal Description Lot._______ Block__ Subdivision
Street
Remodeling_____ Addition ________________________ Repairs No. of Stories
Feet of Drain Tile_ .; ! 42- ' 642 e-÷' _Dist. Feet of Tank or Drain Field from Well
_ -- _ -- --
Capacity Gals 1 a
Nature of Water Supply: City—Well. _______ — ____Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
umbing 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 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.
STATE OF FLORIDA,
COUNTY OF DADE.
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•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 specifie l or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Addre"
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be on:
Lot , �' Block Subdivision
Street and Number where work is to be done__. /.p..Q
State work to b done aan�d/?p pose of building (by floo
be sent to
Permit No
Disapproved
(Signed) _ "_
MIAMI SHORES VILLAGE
Building Inspector
BUILDING INSPECTION DEPARTMENT
�' � /.5
No.__ __ " "f�_ Street__
1
Date cq!
I hereby submit all th lans an sp ifica for id bull g. All not' s y�i re en • Ito the
and for no other purpose.
New Building ' Remocfe ing Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required plan Cubage
Distance to next nearest building._ "_ Size of Building Lot
Maximum live load to be borne by each floor
its construction may
The undersigned applicant for this building pennidoes 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 complied 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 poste_ or inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only f ; .contractors o be formed under this
permit, as are licensed by Miami Shores Village. / �^
Remarks (Signed L. —
STATE OF FLORIDA, I
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
ti 7 Date f 2 / o 60 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chainnan Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
MIAMI SHORES VILAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE
PLUMBING ❑ PERMIT N? 881
ROOFING El
Owner of
Building_
Architect
Contracto
or Builder
Legal
Descriptio
Address
Building
CONTRACTOR OR BUILDER
Work to be perfmed under this Permit
BY
Contractor's f? c
License No
AUTHORITY
195'
This permit is granted to the contractor or builder named above to constrct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with theunderstanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and apprved 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 at 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 )r 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.
e r
a .-
r
n
Lot
Bi.
3ubdi-
vision
f
sg. Ft
Amt. of
Permit
$
Value of
Project
$
MIAMI SHORES VILAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE
PLUMBING ❑ PERMIT N? 881
ROOFING El
Owner of
Building_
Architect
Contracto
or Builder
Legal
Descriptio
Address
Building
CONTRACTOR OR BUILDER
Work to be perfmed under this Permit
BY
Contractor's f? c
License No
AUTHORITY
195'
This permit is granted to the contractor or builder named above to constrct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with theunderstanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and apprved 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 at 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 )r 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.
Permit No .. ...
Dates ) /75
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
Registered Architect and /or Engineer
Emplgying Piranha's Name
Location and Legal Description Lot. Blnc Subdivision
). .
Street and Number where work is to be performed —No /6 t'7 Jam— street `re_ 74\)
State work to be performed and purpose of building (By Floors)_ C c tt .. —
New Building___.._ _ _.. Remodeling_____.._.._. _ __ Addition
Size Septic Tank__
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
la_ •I P) to t). k r_ NeNien. 8 tt��t .> s_
Type of Tank,._
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 )
No.? Q O StreetE ..9. 5 _
Repairs No. of Stories . . .....
Capacity
The undersigned applicant f o r this building permit does hereby certify that he understands and accepts his obligatio s a n employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Perinanen uplement, 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.
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
materNiaOTE: re-inspection fee of $1.00 will be made when such re - inspection is made•neeessary by improper notice for inspection, or faulty
workmanship.
CLOSETS
BATH
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
URINALS
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'O
POOL
CONTR.
LIT
CHECK
Permit No .. ...
Dates ) /75
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
Registered Architect and /or Engineer
Emplgying Piranha's Name
Location and Legal Description Lot. Blnc Subdivision
). .
Street and Number where work is to be performed —No /6 t'7 Jam— street `re_ 74\)
State work to be performed and purpose of building (By Floors)_ C c tt .. —
New Building___.._ _ _.. Remodeling_____.._.._. _ __ Addition
Size Septic Tank__
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
la_ •I P) to t). k r_ NeNien. 8 tt��t .> s_
Type of Tank,._
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 )
No.? Q O StreetE ..9. 5 _
Repairs No. of Stories . . .....
Capacity
The undersigned applicant f o r this building permit does hereby certify that he understands and accepts his obligatio s a n employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Perinanen uplement, 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.
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
materNiaOTE: re-inspection fee of $1.00 will be made when such re - inspection is made•neeessary by improper notice for inspection, or faulty
workmanship.