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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.