117 NE 95 St (5)r,•�111,. �., o� 74
swan's .Name and Address
7:1160 a
MIAMI SHORES VILLAGE AxP °
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
.••; i•, ■ II.•rcby inane for the approval of the detailed statement of the plans and specifications herewith subs v. i for the building or other
n.., :•■rr herein des. riI ed. This application is made in compliance and conformity with the Building Ordinance of Mi: ' Shores Village. Flonda,
... A'! i.I „.i.I ns of the Laws of the State of Florida, all ordinances of Miami Shores Village and all isles and regulate• of the Building Division
.It :I,Un, Shores Villabc shall be complied with, whether herein specified or not. A copy of approved plans and spec fications mist be kept a2
•mildmit during progress of work.
a 111 ... � ►.� �. .— ..._.. __. No. — _.—. Street.. ! E
r,: •t 'red Arehite. and /or Engmwr.... _- _ - - -. __.__ _._- ..._....-- • -._ -. 1 n . 1 ..
I, 1111 ° Plumber's Name e o p l 7 }sue �� a F No... .l °_ 2 .... 3 . 6 l:O \ �� �
/� �� d Leg �L7es °ption Lot � .G.�.. / Rica Mazy' � ga S!bdl v K/ . /.. ��'1.J'
Street . P.
.. E _.. 1 s( • ..._...
Street aiui `umber where work is to be performed No. 1 \ 1,
hate w. k to be performed and purpose of IndWing (By Floor)
1.v• I . ii.ling . . Remodeling . Addition _ ....... Repairs
.Type of Tank. --- ` . : . • . '' .Capacity .alL..
Sc t Septic Tank- -
F'e.:t of Drain Tile ....... ...__ _.._._..Dist. Feet of Tank or Drain Field from Well ..{
Noi.ue of «'aier Supply. City —Well
Date . _ ...
S —2z —d�l
. N•: of Stories
Sire of Soakage Pit
Amo.Int of Permit $ i . U.0 - - - - - -- -- ......- -- ._ ....— (Si ,? C
3 O 14,
Plumbin•i 1nsl.et ter
The umlersil,ln•d applicant for this building permit does hereby certify that he understands and accepts his obligations as an e n,.insri of !elan
r tl.r 1• IIIn.1a Vt'ol kruen's Compensation Act, being Section 5900, Compiled General Laws of Florda Permanent rum !anent, •inl: ha. ro
:.,.! .•.:I. ti r lino %lsl.nl. ti e:r•Irf and will requite similar compliance from all antratirns or orb- tvntsaeturs employd n
1 y him I
1t. ,I:I..1 uwt••r tills permit, and will post or cause to he posted' for inspection on the site of the work nuh pnhl: •sutste
•e•tu'tr.1 by the Act. The undersigned agrees to employ only such sub- contractors, on work to be )rmed ;iemt --•r1 u., al es .
1 ::rnsed by Miami Shores Village.
ST.NTI: t rE 1.1,01111)A,
i';t)I'N - iii OE DADE.
$a.
(Signed)
A Plumber
14.•tl,:r ins, the undersigned authority, a notary public, duly autMrtized to administer oaths and take acknowledgment,. petAn.a, . nvearet.
t . A.il 1,no..•n. and K•h.,, bring by me first duly sworn, upon oath deposes and says that he 11 the . ..
.11 the al,•.lr des( construction, that he has carefully read the foregoing application, and that he did sign the same, and that all acts
theJein by liar, statl.i are true.
My C. uu ,ua lose Expires Notary Public, State of Florida
Nt,'Ii. A re inspection fee of 111.00 will be made when such rs4nipectloo is mods necessary by Improper notice for Ingse^'on. ter butt)
YINl. ex workmanship.
C.1 O {R{
nAT.
{{ tfNOW {R•
T J I
_ —.J
LAVA•
To.,„
iIMK•
SLOP
SINK•
LAUNOR
Tua{
URINALS
CATCH
e A {IN
ILOOR IDR,MRINO
DR
DRAIN ROUNT'Ns
I
To - .t.
R -
1{TI R
- - -- •
Low -•
1. {r I
SI•rIC. '
TANK I
SEWER I
CONM
DRAIN
►IELo
BOAKAOI
PIT
G
TRAP
SOLAR
H
Our
WELL
ePRRLR.
SYSTEM
SWIM 0
POOL
L •
I
i
I
1 — .."'''' -
I --_
I
e"
I
--1
1
h•-•-•••
r,•�111,. �., o� 74
swan's .Name and Address
7:1160 a
MIAMI SHORES VILLAGE AxP °
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
.••; i•, ■ II.•rcby inane for the approval of the detailed statement of the plans and specifications herewith subs v. i for the building or other
n.., :•■rr herein des. riI ed. This application is made in compliance and conformity with the Building Ordinance of Mi: ' Shores Village. Flonda,
... A'! i.I „.i.I ns of the Laws of the State of Florida, all ordinances of Miami Shores Village and all isles and regulate• of the Building Division
.It :I,Un, Shores Villabc shall be complied with, whether herein specified or not. A copy of approved plans and spec fications mist be kept a2
•mildmit during progress of work.
a 111 ... � ►.� �. .— ..._.. __. No. — _.—. Street.. ! E
r,: •t 'red Arehite. and /or Engmwr.... _- _ - - -. __.__ _._- ..._....-- • -._ -. 1 n . 1 ..
I, 1111 ° Plumber's Name e o p l 7 }sue �� a F No... .l °_ 2 .... 3 . 6 l:O \ �� �
/� �� d Leg �L7es °ption Lot � .G.�.. / Rica Mazy' � ga S!bdl v K/ . /.. ��'1.J'
Street . P.
.. E _.. 1 s( • ..._...
Street aiui `umber where work is to be performed No. 1 \ 1,
hate w. k to be performed and purpose of IndWing (By Floor)
1.v• I . ii.ling . . Remodeling . Addition _ ....... Repairs
.Type of Tank. --- ` . : . • . '' .Capacity .alL..
Sc t Septic Tank- -
F'e.:t of Drain Tile ....... ...__ _.._._..Dist. Feet of Tank or Drain Field from Well ..{
Noi.ue of «'aier Supply. City —Well
Date . _ ...
S —2z —d�l
. N•: of Stories
Sire of Soakage Pit
Amo.Int of Permit $ i . U.0 - - - - - -- -- ......- -- ._ ....— (Si ,? C
3 O 14,
Plumbin•i 1nsl.et ter
The umlersil,ln•d applicant for this building permit does hereby certify that he understands and accepts his obligations as an e n,.insri of !elan
r tl.r 1• IIIn.1a Vt'ol kruen's Compensation Act, being Section 5900, Compiled General Laws of Florda Permanent rum !anent, •inl: ha. ro
:.,.! .•.:I. ti r lino %lsl.nl. ti e:r•Irf and will requite similar compliance from all antratirns or orb- tvntsaeturs employd n
1 y him I
1t. ,I:I..1 uwt••r tills permit, and will post or cause to he posted' for inspection on the site of the work nuh pnhl: •sutste
•e•tu'tr.1 by the Act. The undersigned agrees to employ only such sub- contractors, on work to be )rmed ;iemt --•r1 u., al es .
1 ::rnsed by Miami Shores Village.
ST.NTI: t rE 1.1,01111)A,
i';t)I'N - iii OE DADE.
$a.
(Signed)
A Plumber
14.•tl,:r ins, the undersigned authority, a notary public, duly autMrtized to administer oaths and take acknowledgment,. petAn.a, . nvearet.
t . A.il 1,no..•n. and K•h.,, bring by me first duly sworn, upon oath deposes and says that he 11 the . ..
.11 the al,•.lr des( construction, that he has carefully read the foregoing application, and that he did sign the same, and that all acts
theJein by liar, statl.i are true.
My C. uu ,ua lose Expires Notary Public, State of Florida
Nt,'Ii. A re inspection fee of 111.00 will be made when such rs4nipectloo is mods necessary by Improper notice for Ingse^'on. ter butt)
YINl. ex workmanship.
Size Septic Tank _ Type of Tank
Feet of Drain Tile
Amount of Permit $
My Commission Expires
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 subfnitted 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. ��++ I
Owner's Name and Address ........... ___`_' f _____le y_ _ No. _ r Street
Registered Architect and /or Engineer____ -�_ _— _______ _ —_ `� t __
Employing Plumber's Name_(___ t/_'!rfl1_t__i_�B_11d.___ C _L eC No._
Nature of Water Supply: City — Well.-_____— ....... -------------..... _- - - - - -_ -_ -- -Size of Soakage Pit
— - - - - - -- (Signed)_
(Signed).
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 L
Str
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Sup
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed b
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such p
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo
licensed by Miami Shores Village.
q S7
street_ __ a� _S__S
subdivision ..............
3 a ' t /c
No. of Stories. .
Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
Notary Public, State of Florida
P1 bing Ins . - or.
a a employer of labor
ent, and has corn -
m in the work to be
or notices as are
this permit, as are
umber.
i
STATE OF FLORIDA,
as.
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $LOO will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N5
TOTAL
FIXTURES
CONTR.
LIST
_-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
__
CONTR.
LIST
CHECK
Size Septic Tank _ Type of Tank
Feet of Drain Tile
Amount of Permit $
My Commission Expires
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 subfnitted 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. ��++ I
Owner's Name and Address ........... ___`_' f _____le y_ _ No. _ r Street
Registered Architect and /or Engineer____ -�_ _— _______ _ —_ `� t __
Employing Plumber's Name_(___ t/_'!rfl1_t__i_�B_11d.___ C _L eC No._
Nature of Water Supply: City — Well.-_____— ....... -------------..... _- - - - - -_ -_ -- -Size of Soakage Pit
— - - - - - -- (Signed)_
(Signed).
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 L
Str
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Sup
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed b
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such p
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo
licensed by Miami Shores Village.
q S7
street_ __ a� _S__S
subdivision ..............
3 a ' t /c
No. of Stories. .
Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
Notary Public, State of Florida
P1 bing Ins . - or.
a a employer of labor
ent, and has corn -
m in the work to be
or notices as are
this permit, as are
umber.
i
STATE OF FLORIDA,
as.
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $LOO will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Date: 7 /
I herewith submit the following application for a permit covering the installation
Y /
of a Septic Tank
For a (Store:
(Garage wash floor: Waste water from a:
—
Building has: r St es; Offices; Apts.; Hotel Rms; ZBedrm.s
Owner or Agent:
LOT N01/7 BLOCK NO. ZO STJBDIVISION
Address of
No. of Plumbing Fixtures:
Nature of water supply:
Type of tank installed:
Size of Soakage Pit:
Additional information:
Ready for Inspection:
APPROVED BY:
Remarks:
PERMIT NO. /
DADE COUNTY ZONING •CE
Form #11
Old: Story: 7- Addition: Remodeled:
Garage: AA t.: V Hotel: Office Bldg: Res:
DIVISION OF PLUMBING INSPECTION
� Address: y� �n
7Lt- L 41._ .tom �v / « // •� f !/ 7/ ✓
Laundry Tubs: Floor Drains:
Well: Feet distant from all wells:
Soakage Pit:
New: V Feet of drain the :7S
Tank capacity in gallons: c3
Purpose of same:
CONDEMNED BY:
/) 4/A
•
OWNER
LOT
BLOCK
SUBDIVISION
Issued to
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing a
drainage work done in Miami Sho - . Village, Florida.
For astory
Fixtures
Fixtures
Sewer
•tic Tank
PLUMBING PERMIT
= //'-
aiami chor
J $
Total $
F L 0 H I D A
uilding at
Village Plumbing Inspector
Received Payment by
/ / % 7l
■9 1260
r
•
OWNER
t
LOT
BLOCK
SUBDIVISION .
, l ',;.! e` L- "
'.. •
i � if LIT'
' 1 Nil r
4De
Issued to
to install the following described plumbing, in accordance
lations of Miami Shors Village, Florida and the State of
drainage work done in Miami Shores Village, Florida.
`,l`' �, "e:I � x ; f` / ` /
For a story { � � building at �
f r 1 f
Fixtures
Fixtures $
Sewer
aiami cJbores9' llage
F L O R ID A
PLUMBING PERMIT ■9 1248
14;
$
lipic Tan .) $
(' Total $
N... ,,L� AA it ` s '
A
fi Village Plumbing Inspector "" 1� f
Q1 , .
Received Payment by
with the laws, statutes and regu-
Florida, governing plumbing and
'
rr
�ttt�trd�
Et��itt PERMIT A N° 258
PLUMBING
Owner of Building
Architect
Proposed Location
NAmg - ADDRESS
and /or Engineer-a_ y `" ,
LOT
BLOCK SUB -DI
I 27
the building above described, b a era hcation s p pp Plan and Spec p ec cations heretofore filed in ts office
that all facts stated in the application are true and that the construction complies strictly with the
and compliance with the building laws of the State of Florida and with the building ordinances
regulations of the building department of Miami S1 res Vill This permit may be revoked at
/
laws, ordinance &Qr rules and regulations, or upot any,than in the plans and specifications
•
s - r
AMOUNT - R PAY ENT ACCT. DEPT.
Dated____________ '"'
, 19 _
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
_//7
NAME " ADIORIES f �`
Contractor or. �'f_.� =�-� � - --s-- ` � = � =- � - -- --=- - - - - --
NAME / _ ADDRESS
NO.,
.w-
LICENSE NO.
LICENSE NO.
1 9 Y
.
STREET
L `
This permit is issued to 1 L -!< /mow "_r ( h f To
. This permit is granted upon the express condition
plans and specifications submitted, and in accordance
and zoning laws of Miami Shores Village, and rules and
time upon the violation of any provisions of said
ttze by thvtuildilg inspector.
INSPECTOR
In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and
plans and specifications thereof heretofore by me submitted, and in compliance 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.
(SEAL)
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has teen obtained from the Planning Board.
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.
BUILDING
ELECTRICAL
PLUMBING
ri
Architect
Contractor
or Builder '
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA 1
DATE.. 195
PERMIT N° 10033
Work to be performed under this Permit
Owner of t' II
Building
BI.
Subdi-
vision
Value of
Project $
Contractor's
License No
Amt. of
Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge' of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drewiikgs or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
f 4
(......00 BY ) , 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 .6f Miami Shores Village.
In accepts thi permit I assume responsibility fo 4811 work done by either, myself, my agent, servant or employee.
BY AUTHORITY
..-
V `
OWNER
LOT
BLOCK
SUBDIVISION
Date k,
Fixtures
aiami Shores9llage
F L O R 1 D
• PLUMBING PERMIT
Issued to i T
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
For a story building at / /7
Fixtures $
Sewer $ ,Lf ,,
J
Septic Tank $ ,_ �'
Total $
N9 750
Village Plumbing Inspector
Received Payment by
Le l ^'' s
Issued to �� . tea; t�. t { (it
.it A
OWNER
dd iami Aorer d
F L O
PLUMBING PERMIT N9 750
LOT I BLOCK
17 `f��,t
Total $ f e ��
Village Plumbing Inspector 1
Received Payment by
'l -l)
t 1 G' t.
SUBDIVISION
4 I LL.0,I.I4.
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
For a ± story t 11 .t e it( building at ii )/, t , ( f4 .. /(1..f'
Fixtures 1 t �Lt C . t o t 4 1) ` t , t 0 ¢ 1' . ti tr A / lt t. a t i th Y.ii o tit) - t r
Fixtures "V $ (.., ' Ve y
Sewer 1 $ I ' U U
i ltic Tank 1 $ 1 a G pi
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Lot
Work to be pe
Architect
Contractor
or Builder
Legal
Description
Address of
Building
This permit is gran to the contractor or builder named above to cons ct the building or • install the equipment or device described in the appli-
cation 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.
R
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 6119
med under this Permit
1
Bl.
Subdi-
vision
f
Contractor's
License No
Value of
Project
DATE . - t.
/4/
BY AUTHORITY
194-J
AMY
f r j •
A of J f
Pmt. ermit t:11 _"
Signed • By
INSPECTOR
In consideration of the issuance t me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict confo with le plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume r rise all work done by either myself, my agent, servant or employee.
R R OR BUILDS
Date
Issued to
qiiEnni cShores 9' llage
R I D A
PLUMBING PERMIT ■9 1260
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing ansi
• drainage work done in Miami Shore Village, Florida.
For a story
Fixtures
Sewer
Septic Tank
Fixtures
Total
Received Payment by
•
Village Plumbing Inspector
OWNER
LOT
BLOCK
SUBDIVISION
., x
, • f
r .,
"/
fi
/I
it r
r
f
: ',/ 1
Date
Issued to
qiiEnni cShores 9' llage
R I D A
PLUMBING PERMIT ■9 1260
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing ansi
• drainage work done in Miami Shore Village, Florida.
For a story
Fixtures
Sewer
Septic Tank
Fixtures
Total
Received Payment by
•
Village Plumbing Inspector
Permit No.
6 - 6 4
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer ___.___.
Employing Plumber' s Name (_ � ���' �_ 1�JoO - Lv.t._- Street___
Location and Legal Description Lo -__ _--_-- -_......... _. ... __ -___- _Block _... -- __ -_ -_- - _ -_- .._ Subdivision
Street and Number where work is to be performed -No. —__1! x_ 720 2 - ..24° ,,. Street_
State work to be performed and purpose of building (By Floors
New Building Remodeling
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.__------ •- - - -. -- Street
Addition________.____________. Repairs
Size Septic Tank 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 . -.___.
Amount of Permit $ - - - -_- - - - - - -- (Signed)_
Capacity Gals.
Date
No. of Stories
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as all employer of labor
under the Florida Workmen's Compensation Act, being Section 5888, Compiled General Laws of Florida Permanent Supplement, and has c i n-
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 an
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
STATE OF FLORIDA, u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
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 tar
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 foul
materials and /or workmanship.
BATH
TUBE
SHOWERS
LAVA.
TORIES
K
SIKS
SIN
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT NS
TOTAL
FIXTUR[I
'_
CONTR.
LIST
CHECK
_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
NEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No.
6 - 6 4
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer ___.___.
Employing Plumber' s Name (_ � ���' �_ 1�JoO - Lv.t._- Street___
Location and Legal Description Lo -__ _--_-- -_......... _. ... __ -___- _Block _... -- __ -_ -_- - _ -_- .._ Subdivision
Street and Number where work is to be performed -No. —__1! x_ 720 2 - ..24° ,,. Street_
State work to be performed and purpose of building (By Floors
New Building Remodeling
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.__------ •- - - -. -- Street
Addition________.____________. Repairs
Size Septic Tank 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 . -.___.
Amount of Permit $ - - - -_- - - - - - -- (Signed)_
Capacity Gals.
Date
No. of Stories
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as all employer of labor
under the Florida Workmen's Compensation Act, being Section 5888, Compiled General Laws of Florida Permanent Supplement, and has c i n-
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 an
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
STATE OF FLORIDA, u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
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 tar
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 foul
materials and /or workmanship.