PLUMBINGPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address /095 /1/eL' . 95 sr Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant 1 O Pat/ UC Z— 2- G! ZA Master Permit # 1/5
,96
Phone
Date /x/7/99
Owner's Address /0 95 9 a gr.
Contracting Co. 1 4.- OW ' ft.C.Cela /A) 6- /,.j Address F e 6'7 S . W . /a 9 Ter r
Qualifier I) 8/7/7J S D. 01 cel o c /(' 3 - o?5 - 9 -5 373
State # ere 0 05/813 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICA PLUMBING 'MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 1Ze,,e_ 3 6, fl wt. / s e'-' / f C?ci /cL
Square Ft. Estimated Cost (value)
gnature of owner and/or Condo President Date
1,411,1 (kA,Lfw— 47/95'
N9 as to Own d/or Condo Presi Date
wily Commission E fires:
SUSAN J. NESENMAN
MY COMMISSION # CC 860763
iigg F XYIRES: Aug 4, 2003
• 70t-i
�r.�',1 ?AftY Fin Notary Service & gordnp Co' D
n,� �• ADO C.C.F. / L NOTARY
FEES: PE
APPROVED:
Zoning
Mechanical
My Commission E
Electrical
19S ?IO
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
constructio - . d zoning. Furthermore, I authorize the above -named contractor to do the work s
n
� /21
Signature of, ontractor or Owner - Builder Date
Ns ry as to Contrac j ; : :. .,- Date
� �' 860763
Y MMISSION CC 860763
to, OF EXPIRES: Aug 4, 2003
I4004NOTARY Fla. Notary Service &Bonding Co.
Structural Engineer
-BUILDING
ELECTRICAL } PERMIT A N? 847
PLUMBING
Owner of Building
NAME
Architect and /or Engineer_,
NAME
Proposed Location =
LOT
NAME
.r'
Contractor .a1-114tdfr_'
r
BLOC$ BUS DIVISION
ADDRESS
ADDRESS
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
NO .
LICENSE NO.
STREET
4 ,
This permit is issued to _ r _ �__ — —_'_ —_ To
the building above described, as per applicatig�, Puns and Specifications heretoforr'filed in this gllice. This permit is granted upon the express con ion
that all facts stated in the application are tree ask) that the construction complis§ strictly with / a plans and specifications submitted, and in accordance
and compliance with the building laws oif` the $tate of Florida and with the building,brdiMances and zoning laws of Miami Shores Village, and rules and
regulations of the building department of Miami' Shores Village. This permit may be. revoked at any time upglt the violation of any'provisiort of said
laws, ordinances (Pr rules and regulations, or upgit any change in the plans and specifications unauthorized by the building inspector. . `'
r /
$ – -- — __ .....__ j 1_ � y —
AMOUNT RECD. PAYM OMIT ACCT y /DEPT. f 744...-
+F SPEC
y INSPECTOR
In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity ti4th the application and
plans and specifications thereof heretofore by me submitted, and in ydmpliance with all provisions of all building laws of the State of Florida, all the
building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Miami Shores Village.
1 9 - - -
NOTE: A charge of $ 1.00 will be made for making corrections or changes to this application after am/rot/al ISae ten obtained rom the Plalgntng Board, r,
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 worts tanship.
or
r
Lot BI. Subdi-
vision
Dn
,f — Value of Amt. of
— -__ - Project Permit
BUILDING
ELECTRICAL
PLUMBING
Owner o
Building
Architect
Contract
or Builde
Legal
Descripti
Address
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 1060
DATE
Work to be performed under this Permit
194—
Contractor's
License No.
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 drawingp 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 regula-
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
n
Village. In accep g this permit I assume responsibility for all work done by either myself, r agent, servant or employee.
4 � _
COACTOIVOR BUILDER BY - 4^^- AUTHORITY 41
BUILDING
ELECTRICAL
PLUMBING
Owner o
Building
Architect
Contract
or Builde
Legal
Descripti
Address
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 1060
DATE
Work to be performed under this Permit
194—
Contractor's
License No.
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 drawingp 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 regula-
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
n
Village. In accep g this permit I assume responsibility for all work done by either myself, r agent, servant or employee.
4 � _
COACTOIVOR BUILDER BY - 4^^- AUTHORITY 41
Permit No. 7
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 No . Street
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot Block V -__, Subdivision
Street and Number where work is to be performed—No. ______.__ Street
State work to be performed and purpose of building (By Floors)
New Building ' Remodeling Addition Repairs No. of Stories
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. r .Size of Soakage Pit
No
Date z
Street
Amount of Permit $_ (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 under signed 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,
ss.
(Signed)
My Commission Expires Notary Public, State of Florida
Master Plumber.
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
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
.7
CHECK
Permit No. 7
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 No . Street
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot Block V -__, Subdivision
Street and Number where work is to be performed—No. ______.__ Street
State work to be performed and purpose of building (By Floors)
New Building ' Remodeling Addition Repairs No. of Stories
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. r .Size of Soakage Pit
No
Date z
Street
Amount of Permit $_ (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 under signed 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,
ss.
(Signed)
My Commission Expires Notary Public, State of Florida
Master Plumber.
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.
4
Permit No. -- -- — — ______
' MIAMI SHORES VILLAGE
APPLICATION FOR PLUMBING PERMIT
Date___ ei)
—__
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.
. y �
Owner's Name and Address
PLUMBING INSPECTION DEPARTMENT
No
Registered Architect and /or Engi r /
Employing Plumber's Name _ y _t
Street
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)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $_
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
appeared
ss.
My Commission Expires
(Signed)
authorized to administer
Subdivision
Type of Tank Capacity Gals
Size Septic Tank
Feet of Drain Tile________ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, op syork to be performed under this permit, as are
(Signed)
Master Plumber.
; ' r' ' .
oaths and take ackdiowledgments, personally
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
therein by him stated are true.
Notary Public, State of Florida
all facts
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
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
4
Permit No. -- -- — — ______
' MIAMI SHORES VILLAGE
APPLICATION FOR PLUMBING PERMIT
Date___ ei)
—__
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.
. y �
Owner's Name and Address
PLUMBING INSPECTION DEPARTMENT
No
Registered Architect and /or Engi r /
Employing Plumber's Name _ y _t
Street
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)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $_
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
appeared
ss.
My Commission Expires
(Signed)
authorized to administer
Subdivision
Type of Tank Capacity Gals
Size Septic Tank
Feet of Drain Tile________ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, op syork to be performed under this permit, as are
(Signed)
Master Plumber.
; ' r' ' .
oaths and take ackdiowledgments, personally
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
therein by him stated are true.
Notary Public, State of Florida
all facts
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.
. ' MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No ____._______ Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address __. No / Street /7
Registered Architect and /or Engineer
Employing Plumber's Name No
Location and Legal Description Lot.. Block Subdivision
Street and Number where work is to be performed—No ._________
State work to be performed and purpose of building (By Floors)
New Building Remodeling_____ Addition Repairs No. of Stories /
Amount of Permit $___
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
SS.
My Commission Expires
(Signed)
(Signed)
STATE OF FLORIDA, k
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized
Street__
Street
Type of Tank Capacity Gals
Size Septic Tank
Feet of Drain Tile — Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City Well. Size of Soakage Pit.
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
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
therein by him stated are true.
Notary Public, State of Florida
Master Plumber.
that all facts
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
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
. ' MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No ____._______ Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address __. No / Street /7
Registered Architect and /or Engineer
Employing Plumber's Name No
Location and Legal Description Lot.. Block Subdivision
Street and Number where work is to be performed—No ._________
State work to be performed and purpose of building (By Floors)
New Building Remodeling_____ Addition Repairs No. of Stories /
Amount of Permit $___
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
SS.
My Commission Expires
(Signed)
(Signed)
STATE OF FLORIDA, k
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized
Street__
Street
Type of Tank Capacity Gals
Size Septic Tank
Feet of Drain Tile — Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City Well. Size of Soakage Pit.
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
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
therein by him stated are true.
Notary Public, State of Florida
Master Plumber.
that all facts
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.
Registered Architect and /or Engine
Employing Plumber's Name
Street and Number where work is to be performed— No.___ -��;
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
"511/ t 6
Date
Application is hereby ntb 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. +ti
r
Owner's Name and Address _ ,� �} '{� �__� r ! k; "�It No. it � hg Street 'J
No i` �I 7 Street __/ t17
O Block ! Subdivision ?'" '
Location and Legal Description Lot __� r
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition. Repairs No. of Stories. /
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...
Size Septic Tank t__.("
Amount of Permit $_ 7
(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 under signed agrees to employ only such sub - contractors, on work to - be performed under this permit, as are
. -.
licensed by Miami Shores Village. / . ,
(Signed)
Master Plumber.
STATE OF FLORIDA,
j ss.
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.
My Commission Expires Notary Public. State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
_._
LAVA-
T O$I ES
SINKS
/
SLOP
SINKS
LAUNDRY
Tt aS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIX/ T
CONTR.
LIST
' p
J
.....*
uy!
r�il�
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.
Registered Architect and /or Engine
Employing Plumber's Name
Street and Number where work is to be performed— No.___ -��;
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
"511/ t 6
Date
Application is hereby ntb 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. +ti
r
Owner's Name and Address _ ,� �} '{� �__� r ! k; "�It No. it � hg Street 'J
No i` �I 7 Street __/ t17
O Block ! Subdivision ?'" '
Location and Legal Description Lot __� r
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition. Repairs No. of Stories. /
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...
Size Septic Tank t__.("
Amount of Permit $_ 7
(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 under signed agrees to employ only such sub - contractors, on work to - be performed under this permit, as are
. -.
licensed by Miami Shores Village. / . ,
(Signed)
Master Plumber.
STATE OF FLORIDA,
j ss.
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.
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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
A PPLICATION FOR PLUMBING PERMIT
Permit No..__ Date___
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitte or the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mia i 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 woe.-
Owner's Name and Address
Registered Architect and /or Engi r .
Employing Plumber's Name
Location and Legal Description Lot
State work to be performed and purpose of building (By Floors)
- -- - - - - - -- -
Amount of Permit $ • - --
STATE OF FLORIDA.
j ss.
COUNTY OF DADE.
My Commission Expires
eV2. 6'� No. //
/ v Street
(Signed)
No.../_
(Signed)
Bloc ____
Street and Number where work is to be performed— No._ _.1.+1. -� !! t Street
X / G �'�+ T - ��'� _j_ . » z /R iv IN
New Building Remodeling Addition Repairs No. of Stories
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.
Plumbing Inspector.
• The undersigned applicant for this building permit does hereby certify that he understands and accepts his o ttons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per neat 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 under signed agrees to employ only such sub - contractors, on ork to be this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac . owledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
aster Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
Tuns
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
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.
LIST
Ir
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
A PPLICATION FOR PLUMBING PERMIT
Permit No..__ Date___
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitte or the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mia i 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 woe.-
Owner's Name and Address
Registered Architect and /or Engi r .
Employing Plumber's Name
Location and Legal Description Lot
State work to be performed and purpose of building (By Floors)
- -- - - - - - -- -
Amount of Permit $ • - --
STATE OF FLORIDA.
j ss.
COUNTY OF DADE.
My Commission Expires
eV2. 6'� No. //
/ v Street
(Signed)
No.../_
(Signed)
Bloc ____
Street and Number where work is to be performed— No._ _.1.+1. -� !! t Street
X / G �'�+ T - ��'� _j_ . » z /R iv IN
New Building Remodeling Addition Repairs No. of Stories
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.
Plumbing Inspector.
• The undersigned applicant for this building permit does hereby certify that he understands and accepts his o ttons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per neat 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 under signed agrees to employ only such sub - contractors, on ork to be this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac . owledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
aster Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
1
Permit No._ I)
- -4d
Street and Number where work is to be performed —No.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
• w •
APPLICATION FOR PLUMBING PERMIT
Owner's Name and Address ___ — _4- - • . • ..,,e,, ,,... No 7 ' Street
Registered Architect and /or Engineer
Employing Plumber's Name _.t " ., ' r__ No f A:1 ' Street l r -_,
Location and Legal Description Lot_____'_______ i Block Subdivision
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
x-- Street
State work to be performed and purpose of building (By Floors)
,SP f /1 _L1 MI `-_ S 1 GP'
New Building Y Remodeling Addition Repairs No. of Stories _
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well r
Nature of Water Supply: City —Well. L.— -t...., Size of Soakage Pit
Amount of Permit $ '�` ! =!/ -k (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 under signed agrees to employ only such sub - contractors, on wor( to be performed ulide. this rmit, as are
licensed by Miami Shores Village. f ati
(Signed
STATE OF FLORIDA,
ss.
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.
Notary Public, State of Florida
lumber.
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
SINK
SLOP
SINKS
LAUNDRY
TUBS
URINAL
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.
LIST
V
CHECK
1
Permit No._ I)
- -4d
Street and Number where work is to be performed —No.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
• w •
APPLICATION FOR PLUMBING PERMIT
Owner's Name and Address ___ — _4- - • . • ..,,e,, ,,... No 7 ' Street
Registered Architect and /or Engineer
Employing Plumber's Name _.t " ., ' r__ No f A:1 ' Street l r -_,
Location and Legal Description Lot_____'_______ i Block Subdivision
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
x-- Street
State work to be performed and purpose of building (By Floors)
,SP f /1 _L1 MI `-_ S 1 GP'
New Building Y Remodeling Addition Repairs No. of Stories _
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well r
Nature of Water Supply: City —Well. L.— -t...., Size of Soakage Pit
Amount of Permit $ '�` ! =!/ -k (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 under signed agrees to employ only such sub - contractors, on wor( to be performed ulide. this rmit, as are
licensed by Miami Shores Village. f ati
(Signed
STATE OF FLORIDA,
ss.
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.
Notary Public, State of Florida
lumber.
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 f 7
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 b 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 No. _,___
Registered Architect and /or En
Employing Plumber's Name C o�� _ - No._ 0_ Street `i
Location and Legal Description Lot o` 0 - Y Block Subdivision
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) ._
New Building
Nature of Water Supply: City—Well.
Amount of Permit $ °?
STATE OF FLORIDA, I &I.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Task ---- ----- -------- --- -- - - - - -- --Type of Tank
C 0-
(Si
( Signed)_
Date __� °. `?
Street
Remodeling____________ __ Addition_,___.._ Repairs No. of Stories.
Capacity Gals
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
tz 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.
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.
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.
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
NKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
L18T
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
L18T
CHECK
Permit No f 7
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 b 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 No. _,___
Registered Architect and /or En
Employing Plumber's Name C o�� _ - No._ 0_ Street `i
Location and Legal Description Lot o` 0 - Y Block Subdivision
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) ._
New Building
Nature of Water Supply: City—Well.
Amount of Permit $ °?
STATE OF FLORIDA, I &I.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Task ---- ----- -------- --- -- - - - - -- --Type of Tank
C 0-
(Si
( Signed)_
Date __� °. `?
Street
Remodeling____________ __ Addition_,___.._ Repairs No. of Stories.
Capacity Gals
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
tz 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.
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.
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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Date__________
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engin
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed -No
Size Septic Tank_ __
Feet of Drain Tile_ __ - -- Nature of Water Supply: City-Well.
Amount of
State work to be performed and purpose of building (By Floors)-____ ________
New Building------ _--- _- _____--- ._ - -__ -- Remodeling____ .... _____._ Addition_______-____________ -_ Repairs No. of Stories
t. Feet of Tank or Drain Field from Well
Permit $ - - -- - - - - - -- - -- ( Signed)_ -
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.
STATE OF FLORIDA, as.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly anthorized 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
oftthe `above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by , • . : ted are true.
My Commission Expires
NOT • A I e- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper
materials and / workmanship.
(Signed).
Street__
No. _ —/ 0. 9-5- -- /14
Subdivision
Street
Capacity Gals
__ _Size of Soakage7 r r
Notary Public, State of Florida
umbing Inspector.
Master Plumber.
notice for inspection, or faulty
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
RINALS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL.
FIXTURES
CoNTR.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL.
COHTR.
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Date__________
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engin
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed -No
Size Septic Tank_ __
Feet of Drain Tile_ __ - -- Nature of Water Supply: City-Well.
Amount of
State work to be performed and purpose of building (By Floors)-____ ________
New Building------ _--- _- _____--- ._ - -__ -- Remodeling____ .... _____._ Addition_______-____________ -_ Repairs No. of Stories
t. Feet of Tank or Drain Field from Well
Permit $ - - -- - - - - - -- - -- ( Signed)_ -
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.
STATE OF FLORIDA, as.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly anthorized 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
oftthe `above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by , • . : ted are true.
My Commission Expires
NOT • A I e- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper
materials and / workmanship.
(Signed).
Street__
No. _ —/ 0. 9-5- -- /14
Subdivision
Street
Capacity Gals
__ _Size of Soakage7 r r
Notary Public, State of Florida
umbing Inspector.
Master Plumber.
notice for inspection, or faulty
Date
,r4„ey
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
Address
1/ X75:204
Owner / Lessee / Tenant ' /— Q A/i ( P
Legal DescriptionA94
Owner's Address
Contracting Co iii 0 ft v @ IA) d` Ter ,.97rGZ Address
Qualifier ( t
State #
Architect /Engineer
Bonding Company
Mortgagor
/6 c
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGZ:
WORK DESCRIPTION
Square Ft.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT /ND 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.
Further e. I authorize the above -named contractor to do he wo " stated.
Sign
Date:
lotary a: to Owner and /or Cando Pre T '
'i Com s Expires: O 7 c v *
* . * . * * er
'ERMIT FEE: APPROVED:
(OWNER TO RETAIN COPY)
/74/5 c Tax Folio, .3..W /i 3430y
Competency � �F 1 ins. Co. '✓ / e
do President
*
Fire
1 Zoning Building
Mechanical Plurobinv
Address
Address
Address
Estimated Cos
Signature
Date:
Master Permit it L f /acLrb
Phone
SS¢ Ph QJ -23 ,) ‘
Electrical
1 ` rnciree.l
O 0
Notary Or to Contractor or Owner- Builder
My Com * ssion pixes* / 7 7' 9y *
Other
*
.w •
JOB:
BUILDING
: : WORK
ELECTRICAL : :
DONE BY:
PLUMBING :
. : REQUESTED
The following is ready for Inspection: -
Inspector's Report: -
AD: //or 2) 6r
27 c. w
READY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of 1
Building
Address of
Building r'
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
°
DATE - 19
° PERMIT N? 4987 Contractor's
License No.
❑ Work to be performed under this Permit__
Architect
Contractor
or Builder
Legal Lot
Description II BI
Signed.
Subdi-
vision
Value of 1 Amount of
Project $ II 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.
•. ' • '� 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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
ABBOT al.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building '
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
BI
N9 4989
Work to be performed under this Permit
DATE_ __ 19
Contractor's
License No.
Subdi-
vision
Value of II Amount of :.
Project $ II 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. - 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 ac•
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY ABBOT