1255 NE 95 St (4)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date • / • D / Job Address /9..,c7 P .. i f f -Tax Folio
Legal Description � 2 Historically Designated: Yes No
/ Tenant /4 t,, ,7, / L L // X3 k R 7 Master Permit #
Owner's Address /0- 6'" ( /i , . 9 J' �i2 �� C Phone ,P26-- 7 V- .2 ' a
Contracting Co. t. /` . tt. r j�/ / ri a / -%? Vag- 3 f . 0 2 / f 7_ 4 e/ U 4
Qualifier T ()A- J i P l< 4-
SS# - Phone J5 t/ - f'•,7,-6
State # CF C- D '/7 // Municipal # Competency # Ins. Co.
Architect/Engineer ND� Address
Bonding Company N l4
Mortgagor /-'
of owner and/or Condo President
DD
•
11c, I
OWNER'S AFFIDAVIT: I ce
construc , and zo f g. F - . or = I au
11 . r
Notary as to Owner
My Commission Ex
I
' �o�� �� .:ion
•; . E tree 2005
'sue r'> Bond TL n
Atlantic Bonding Co., Inc.
, •ilel;
V/
FEES: PERMIT ll� RADON
APPROVED:
Zoning Building
Mechanical Plumbing
orize the above -named contractor to d
— 16-o)
Date
/
ate
C.C.F.
Address
Address
Permit Type (circle one): BUILDING ELECTRICA PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION & >✓'GG /Z �j /P./ .r 7 ,/f N Ai /5" / D/ - 3X 7,?A
(p V ,, f.t Al I) 5.A i/ a if ..1'3'
Square Ft. Estimated Cost (value) /6 d 19
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 re. ' ed for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
ify that all the foregoing information is accurate and th
Sign'' ;` Contractor or Owner -B
Notary as to Contract
My Commission Ex
p hi
Eiklbert
,Gommiasion
E ExPfres
Bonded Th a
Atlantic Bonding tb., Inc.
NOTARY 0 -` BOND
TOTAL DUE le 0
n
Electrical
all applicable laws regulating
Date
Date
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
ELECTRICAL
MECHANICAL
TEM UNIT
ATH TUB
FEE
, ITEM
SWITCH OUTLETS
UNIT
FEE'
SPACE HEATERS
UNIT
FEE
IDET
LIGfT OUTLETS
CENTRAL HEATING
ISHWASHER
RECEPTACLES
A/C (WIN))
ISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
SINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
'_OCR DRAIN
SERVICE REPAIR/1ETER CHANGE
REFRIGERATION
EASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
VTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
;VATORY
OVEN
ABOVE GROUND TANKS
:UNORY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
_CITIES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
'OWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
INK, POT /3 COMP.
MOTCRS OVER 3- 5 I•P
MECHANICAL VENTILATION
•NK, RESIDENCE
MOTCRS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES •
.NK, SLOP
MOTCRS OVER S- 10 HP
ELEVATORS/ESCALATORS
:MPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
IIN AL
MOTORS OVER 25-100 HP
COOLING TOWERS
;TER CLOSET
MOTORS OVER 100 HP
VIOLATION
•DIRECT WASTES
A/C WINDOW
REINSPECTION
TER SUPPLY TO:
AIR CONDITIONERS
•
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
'
HEATER -NEW INST.
GENERATORS TRANSFORMERS
;EATER- REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
HATER SERVICE
SIGN TUBES
lER CONNECTIONS
_
SIGN TRANSFORMERS
ILITY -SEWER •
SIGN TIME CLOCK
LITY -WATER
'TIC
FIXTLRES
TANK
ANTENNA
AY
TELEVISION OUTLETS
, INFIELD, 4' TILE/RES.
VIOLATION
P & ABANDON SEPTIC TANK
REINS?ECTION
XAGE PIT CU. FT.
CH BASIN
DiARGE WELL
ESTIC WELL
A DRAIN •
F INLET
AR WATER HEATER
STANDPIPE
. PIPING
I
SPRINKLER SYSTEM
RANGE .
•
:R SET (GAS)
PIPING
, , 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
ELECTRICAL
MECHANICAL
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 9 U t / l7' 6 Ics Tax Folio x 61 – 3 2., 0 6 0/ c- ed
Legal Description
Owner/Lessee / Tenant U
Owner's Address
Job Address
[– O� a� 13/0 Hi 11 De
signated. 9 O '
Master Permit # g33 7
o
sto nca y
P1; I D
V,,l <<- A,(6r3►1Z
12-0 dl c7 I 5 /1 ,s (lickos
QualifierX,- )tz.S'L&S 4C.G6.
Contracting Co. e C U
er and/or Condo President
Notary as t,,`%► er and/or Condo Presi
My Commission Expires:
Date
ent Date
APPROVED:
Zoning Building
Mechanical Plumbing
Address
SS# /^ 51T— '/7
State # Municipal # 1 4 1 flw1 1 °D 1= Competency # 6Q8 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor % Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION f L() 7 V l/ 1 L L V- L-- Ce - > / - L L Ce c'
Square Ft. Estimated Cost (value) 3/96
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction . d zoning. Furthermore, I authorize the above -named contractor to do the work stated.
2-1q tal
Signature of Contractor or Owcfer7Builder Date
Notary as
My Co
NOTARY PUBLIC - CTATE 0P410RIDA
IS
NOTARY PUBLIC • CTA7! cm COMM N ERQ
LUIS NOry}gpO EXPIRES
9 MI
COMMISSION MS BONDED 11,IRU ASA f- 880.Np y
EXPIRES 1/212002
BONDED 1NR11 ASA 1-71813-NOTARY?
FEES: PERMIT ' O RADON C.C.F. r NOTARY O BOND
Yes
Phone —30s-7d L1, 7-60 `1
S777 k
tractor or Owner - Builder
sion Expires:
Electrical
No
/
Date
TOTAL DUE
Engineering
ATLAS:
SCALE: n I �
IV s
DRAWN BY: A
N
vv. P iL
So
10'
125
Lo - r 29-3,0
6/oc..lt 8`-f
48 HOURS BEFORE DIGGING CALL
SUNSHINE 1- 800 - 432 -4770
PkolpoS
2 Pt sopc, ic
CONSTRUCTION NOTES
4. ALL GAS PIPELINE CONSTRUCTION TO FOLLOW TECO
PEOPLES GAS STANDARDS.
5. TRAFFIC CONTROL SHOULD BE ;MAINTAINED AND
COORDINATED WITH THE APPROPRIATE GOVERNMENTAL
AGENCY.
6. ALL DISTURBED ASPHALT / CONCRET / SOD / AREAS TO BE
RESTORED TO PRIOR CONDITION UNLESS OTHERWISE
SPECIFIED,
rtawum= !DAM
I.2.__Cs A 5 s
/MM S e ��5
PQMse � i \ l Of �J
or of 7o o vat 02
DATE:
2 Z /0/
SHEET:
/
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No... . .:,[_r><— — 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.
i
Owner's Name and Address �L� No
Registered Architect and /or En_, eer
STATE OF FLORIDA,
COUNTY OF DADE. ae.
Employing l imbos's lama, s . - -11;x_
Location and Legal description Lot_ Mori, Subdivision
Street and Number where work is to be performed —No
State work to be perforueil and purpose of building (By Floors)------ .--
New Building . Remodeling____. . _ _ Addition.
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)_
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 •Cenertil Laws of Florida Pennanent Supplement, and has com-
plied with the provisions thereof, and will require similar complianct'ftbtt: f 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 w to be performed under this permit, as are
licensed by Miami Shores Village
w _n,a NO S 21150111 2=3=Siti=i1 S :3Sel=te f1
(Signed)
Repairs No. of Stories.
Capacity Gala..._... _.._.. _..___..
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-inspectionfee of $1.00 will be made when such re-inspection he made-necessary by improper notice for inspection, or faulty
materials and/or wor
CLOSETS
O ATH
SHOWERS
TORIES
SIN"
SINK•
LAUNDRY
Tus�
U RINALS
CATCN
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
—.
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
Dam
WELL
SPRKLR. ew IM O
SYSTEM POOL
I
CONTR.
LIST
X
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No... . .:,[_r><— — 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.
i
Owner's Name and Address �L� No
Registered Architect and /or En_, eer
STATE OF FLORIDA,
COUNTY OF DADE. ae.
Employing l imbos's lama, s . - -11;x_
Location and Legal description Lot_ Mori, Subdivision
Street and Number where work is to be performed —No
State work to be perforueil and purpose of building (By Floors)------ .--
New Building . Remodeling____. . _ _ Addition.
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)_
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 •Cenertil Laws of Florida Pennanent Supplement, and has com-
plied with the provisions thereof, and will require similar complianct'ftbtt: f 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 w to be performed under this permit, as are
licensed by Miami Shores Village
w _n,a NO S 21150111 2=3=Siti=i1 S :3Sel=te f1
(Signed)
Repairs No. of Stories.
Capacity Gala..._... _.._.. _..___..
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-inspectionfee of $1.00 will be made when such re-inspection he made-necessary by improper notice for inspection, or faulty
materials and/or wor
1
APPLICATION FOR PLUMBING PERMIT /
si
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
Size Septic Tank
Feet of Drain Tile
Amount of Permit $__1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
•
Registered Architect and /or Engineer , ;. I
Employing Plumber's Name _ ;:__ _______
____�__�__,,
1
Location and Legal Description Lot__rr `__e Bl ck
Street and Number where work is to be performed —No.
_�_•__ _ �.L! No Street
State work to be perfor ed and purpose of building (By Floors)
New Building________ _____________ Remodeling Addition Repairs ____ No. of Stories
Type of Tank _ Capacity
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
_ (Signed)
No.__.
Street
•
S
Street__-- r4`---- ___� - -� --
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) rr
1
r . .
Master Plumber.
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 be 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
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
'
p(w
t
r
I
t
1
CHECK
T
SEPTIC
TANK
SEWER
CONN.
DRAIN
FI ELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
f
CHECK
1
APPLICATION FOR PLUMBING PERMIT /
si
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
Size Septic Tank
Feet of Drain Tile
Amount of Permit $__1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
•
Registered Architect and /or Engineer , ;. I
Employing Plumber's Name _ ;:__ _______
____�__�__,,
1
Location and Legal Description Lot__rr `__e Bl ck
Street and Number where work is to be performed —No.
_�_•__ _ �.L! No Street
State work to be perfor ed and purpose of building (By Floors)
New Building________ _____________ Remodeling Addition Repairs ____ No. of Stories
Type of Tank _ Capacity
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
_ (Signed)
No.__.
Street
•
S
Street__-- r4`---- ___� - -� --
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) rr
1
r . .
Master Plumber.
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 be 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
Materials and /or workmanship.
'
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Permit No.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date May 5 *19_41_ _______
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whet l 1 zein gpecified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address D
Registered Architect and /or Engineer
Employing Plumber's Name Acme Sept C Tan'. Co.
Location and Legal Description Lot 29 -30
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
No Street
No 57A5 ___bi�___I"t�____ street_ __ 2.2#�h__Alt�.
Subdivision_
Miami ___ ShO; @i___$eO
Block 84
1255 N. E5t- 95tcY1 St_ =_ - -- Street__
Repairs —___ No. of Stories
Size Septic Tank
Feet of Drain Tile 100
Nature of Water Supply: City —Well Size of Soakage Pit
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
ss.
appeared
Type of Tank. precast. _Capacity Gals. _80_Q
My Commission Expires
Dist. Feet of Tank or Drain Field from Well
LLCM _ (Signed)
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
ACE SE PTIe TA.. C . .
(Signed)
authorized to administer oaths and take acknowledgments, 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
therein by him stated are true.
Notary Public, State of Florida
Master Plumber.
the same, and that all facts
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
X
X
Permit No.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date May 5 *19_41_ _______
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whet l 1 zein gpecified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address D
Registered Architect and /or Engineer
Employing Plumber's Name Acme Sept C Tan'. Co.
Location and Legal Description Lot 29 -30
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
No Street
No 57A5 ___bi�___I"t�____ street_ __ 2.2#�h__Alt�.
Subdivision_
Miami ___ ShO; @i___$eO
Block 84
1255 N. E5t- 95tcY1 St_ =_ - -- Street__
Repairs —___ No. of Stories
Size Septic Tank
Feet of Drain Tile 100
Nature of Water Supply: City —Well Size of Soakage Pit
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
ss.
appeared
Type of Tank. precast. _Capacity Gals. _80_Q
My Commission Expires
Dist. Feet of Tank or Drain Field from Well
LLCM _ (Signed)
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
ACE SE PTIe TA.. C . .
(Signed)
authorized to administer oaths and take acknowledgments, 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
therein by him stated are true.
Notary Public, State of Florida
Master Plumber.
the same, and 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.
JOB:
BUILDING
ELECTRICAL :
PLUMBING
•
•
•
•
Inspector's Report:
•
•
•
•
•
•
•
•
AD:
: WORK
: DONE BY:
. REQUESTED
•
•
•
•
•
•
•
•
•
The following is ready for Inspection:
•
•
•
•
•
•
•
: WILL BE READY
•
•
:as)
JOB:
BUILDING
PLUI:-MBING
ELECTRICAL :
Inspector's Report:
•
•
•
•
. WORK
: DONE BY:
. REQUESTED
:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
The following is ready for Inspection:
AD: / -3— ) / t c
r
•
. WILL BE READY
•
•
•
•
•
•
•
•
•
•
•
•
•
z
�r �
7 : ' t
JOB:
BUILDING
•
•
ELECTRICAL
PLUMBING
•
•
•
- Fa
Inspector's Report:
•
•
r AD: 1 c >"
•
•
WORK
DONE BY:
• : REQUESTED
The following is ready for Inspection:
•
•
•
•
: WILL BE READY
Permit No. 2 1
f
Location and Legal Description Lot 29 -30
STATE OF FLORIDA, }
COUNTY OF DADE. ss.
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, whet herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. , 6' //7
Owner's Name and Address ___�'J � / �� No. Street
I
Registered Architect and /or Engineer
Employing Plumber's Name Acmg Septic Tank Co. No. 5.205 Street ___ 22th___Aue-.
Block B4 Subdivision Miami Shoree Sec
3
Street and Number where work is to be performed —No 1255 N. 95th 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 precast. Capacity Gals
Feet of Drain Tile 100 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $ L_,.0 (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. ACME SEPTIC TANK CO.
(Signed)
Date May 5
ef Z. , .
l %
My Commission Expires Notary Public, State of Florida
600
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.
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
SW IM'G
POOL
CONTR.
LIST
CHECK
X
X
Permit No. 2 1
f
Location and Legal Description Lot 29 -30
STATE OF FLORIDA, }
COUNTY OF DADE. ss.
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, whet herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. , 6' //7
Owner's Name and Address ___�'J � / �� No. Street
I
Registered Architect and /or Engineer
Employing Plumber's Name Acmg Septic Tank Co. No. 5.205 Street ___ 22th___Aue-.
Block B4 Subdivision Miami Shoree Sec
3
Street and Number where work is to be performed —No 1255 N. 95th 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 precast. Capacity Gals
Feet of Drain Tile 100 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $ L_,.0 (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. ACME SEPTIC TANK CO.
(Signed)
Date May 5
ef Z. , .
l %
My Commission Expires Notary Public, State of Florida
600
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.
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
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, whethet herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
' l
Owner's Name and Address
Feet of Drain Tile_
APPLICATION FOR PLUMBING PERMIT
Date ,7// :
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Registered Architect and /or Eiigi»eer___ __(
Employing Plumber's Name 4 — : f? Street -
E, ? t �,. :
--- -- `---=------- �--- - - - - --
Location and Legal Description Lot__ _ _° Block •
Street
Street and Number where work is to be performed— No. ___
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 Ga15':__-
Dist. Feet of Tank or Drain Field from Well__
Nature of Water Supply: City —Well. Size of Soakage Pit
oC7
Amount of Permit $_ -(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
(Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he.64iderstands 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.
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
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
SWIM'O
POOL
CONTR.
LIST
1
CHECK
Permit No
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, whethet herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
' l
Owner's Name and Address
Feet of Drain Tile_
APPLICATION FOR PLUMBING PERMIT
Date ,7// :
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Registered Architect and /or Eiigi»eer___ __(
Employing Plumber's Name 4 — : f? Street -
E, ? t �,. :
--- -- `---=------- �--- - - - - --
Location and Legal Description Lot__ _ _° Block •
Street
Street and Number where work is to be performed— No. ___
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 Ga15':__-
Dist. Feet of Tank or Drain Field from Well__
Nature of Water Supply: City —Well. Size of Soakage Pit
oC7
Amount of Permit $_ -(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
(Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he.64iderstands 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.
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.
Permit No.
• MIAMI SHORES VILLAGE
Pi ti
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 _ .______ ___ — ________: -___ ___-- � L__- :_- - __1__ 1 ? No Street
Registered Architect and /or Engineer
Employing Plumber's Name =tr'r '•"e
Location and Legal Description Lot___- `: —;,: L__�___2
_Black_
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_
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
Amount of Permit $_
t
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No Street
(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 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)
f
Subdi tsion__ ./- '
Street
a
f
ft
My Commission Expires Notary Public. State of Florida
Plumbing Inspector.
Master Plumber.
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 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
wi
l
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.
• MIAMI SHORES VILLAGE
Pi ti
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 _ .______ ___ — ________: -___ ___-- � L__- :_- - __1__ 1 ? No Street
Registered Architect and /or Engineer
Employing Plumber's Name =tr'r '•"e
Location and Legal Description Lot___- `: —;,: L__�___2
_Black_
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_
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
Amount of Permit $_
t
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No Street
(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 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)
f
Subdi tsion__ ./- '
Street
a
f
ft
My Commission Expires Notary Public. State of Florida
Plumbing Inspector.
Master Plumber.
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 necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Pericit No._ 7i Z 6
Date - 3 - -2 7
Application is hereby ma ae 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 Flori all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, hethar herein spaded or not. A copy of approved plans and specifications must be kept at
building during progress of work. � �
Registered Architect and /or Engineer__
Employing Plumber's Name - in /c
Size Septic Tank ..... _
Feet of Drain Tile
Nature of Water Supply: City —Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Owner's Name and Address ' No.__ Street
Amount of Permit $_
Location and Legal Description Lot Block
Street and Number where' work is to be performed —No J.S$
State work to be performed and purpose of building (By Floors)
New Building _ -_ _ -- Remodeling_ -___ ____ —_ Addition- -- -__ -._ Repairs No. of Stories - -.- ------- ----------
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed)_ _1(..4
Street_ _
Subdivision
Street ______ "2-7. -di
in - Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts • . 'gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida nanent 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 t}►e Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed )..fir .Z2€J !e
Master Plumber.
STATE OF FLORIDA, I
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'neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SH
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
MELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
t
_
-
Pericit No._ 7i Z 6
Date - 3 - -2 7
Application is hereby ma ae 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 Flori all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, hethar herein spaded or not. A copy of approved plans and specifications must be kept at
building during progress of work. � �
Registered Architect and /or Engineer__
Employing Plumber's Name - in /c
Size Septic Tank ..... _
Feet of Drain Tile
Nature of Water Supply: City —Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Owner's Name and Address ' No.__ Street
Amount of Permit $_
Location and Legal Description Lot Block
Street and Number where' work is to be performed —No J.S$
State work to be performed and purpose of building (By Floors)
New Building _ -_ _ -- Remodeling_ -___ ____ —_ Addition- -- -__ -._ Repairs No. of Stories - -.- ------- ----------
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed)_ _1(..4
Street_ _
Subdivision
Street ______ "2-7. -di
in - Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts • . 'gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida nanent 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 t}►e Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed )..fir .Z2€J !e
Master Plumber.
STATE OF FLORIDA, I
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'neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
Penxri: No 2 3 Date Z
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.
A 12.P./'
Owner's Name and Address
Registered Architect and /or Engineer __ ____._____
Employing Plumber's Name /(// 0 PG /-a C - - - -- No..1 '� _ ! ` �-__ Street--__L 6 / 2- '
Location and Legal Description Lot._. __._______�_.__._ ____Block_ _ _ Subdivision
Street and Number where work is to be performed —No / /1/... ' 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_
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well._______ _______._______ ___Size of Soakage Pit
Y Amount of Permit $ Z
um . .. _ Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts tQ..ligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid: ►nanent 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 w to be performed under this permit, as are
licensed by Miami Shores Village. a 1 v e
c,
My Commission Expires
MIAMI SHORES VILLAGE - -1oa
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No._ / _ _ Street C2 r
(Signed)- - -�'s�
Capacity Gals
Master Plumber.
STATE OF FLORIDA, t as.
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
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.
I CLOSETS — BATH
TUBS
SHOWERS
A•
TORI
SINKS
SLOP
SINKS
LAUNDRY
TUBS
UR L
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N8
TOTAL
FIXTURES
Cows.
LIS
..----
CHECK
..--,
m.....—
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWING
POOL
COHTR.
LIST
I
AA""
- --
CHECK
Penxri: No 2 3 Date Z
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.
A 12.P./'
Owner's Name and Address
Registered Architect and /or Engineer __ ____._____
Employing Plumber's Name /(// 0 PG /-a C - - - -- No..1 '� _ ! ` �-__ Street--__L 6 / 2- '
Location and Legal Description Lot._. __._______�_.__._ ____Block_ _ _ Subdivision
Street and Number where work is to be performed —No / /1/... ' 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_
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well._______ _______._______ ___Size of Soakage Pit
Y Amount of Permit $ Z
um . .. _ Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts tQ..ligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid: ►nanent 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 w to be performed under this permit, as are
licensed by Miami Shores Village. a 1 v e
c,
My Commission Expires
MIAMI SHORES VILLAGE - -1oa
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No._ / _ _ Street C2 r
(Signed)- - -�'s�
Capacity Gals
Master Plumber.
STATE OF FLORIDA, t as.
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
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.
YOUNGBLOOD ROOFING CO. 1100 N. W. 36th Street • Phone NEwton 5 -2501
OWNERS NAM E�'v1" - Address
JOB Address
a —s— ?z C
Phone Home
Office
•
°Salesman
Page Charged
&N,‘ 742t
Date
Work Completed by:
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Legal Lot ° Bl.
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 2132
Work to be performed under this Permit
Architect
Contractor
or Builder
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'o_ 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
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
1
Subdi-
vision
Value of
Project
DATE � 194L
Contractor's
License No
Amt. of i 1
Permit 7
CONTRACTOR OR BUILDER BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
contractor
?r Builder
Legal Lot
Description
Address of
wilding 1 -
MIAMI SHORES VILLAGE. FLORIDA
0
❑ DATE 195
PERMIT N° 4119 Contractor's
License No.
0
CONTRACTOR OR BUILDER
Work to be performed under this Permit
B1
BY
Subdi-
vision
Value of
Project $
it
Amount of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the 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,
irawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ime 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
;ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
:ertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work
one 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 ac-
:opting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY e
BUILDING
ELECTRICAL
PLUMBING
Owner of )14
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot �� 30
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 2184
ork to o - ormed under this Permit
Bl. r
Subdi-
vision
Value of
Project
BY
DATE
194/
Contractor's
License Nos
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 than without a i" orization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assum- : respons'. lity for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether show . he plans or d.. or n e statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees. I N,r
Signed • � — /, By
IN SECTOR
In consideration of the issuance to me of this permit I agree to perform th covered hereunder in compliance with all ordinances and regula-
AUTHORITY
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEI<''
APPLICATION FOR PLUMBING " . ,�,,,r�elT
Permit No ?l Date--.,1'r J S7 -r S SZc
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 cr nit. A copy of approved plans and specifications must be kept at
building during progress of work.
/ L, ypo G _ri
Owner's Name and Address_._ - : ___C�___� - r No / _ - .. 2 - Street
Registered Architect and /or Engineer ------- -___ - � _----_-----------------,.
Employing Plumber's Name tz c?._ 5_13 L° -- . -__._ No..- -_ L!_.P.__ ° -. -.__. Street-_ /:. • 3 - - --- . . . 5 ".
Subdivision
Street_
Location and Legal Description Lot_____________r___ —_— ___ 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.
Nature of Water Supply: City —Well.
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
_.Size of Soakage Pit
Amount of Permit $ 2 _- __ —___ ----- _ —_ - -- —_- -- ( Signed)_ --
cLAF
STATE OF FLORIDA, I
COUNTY OF DADE.
My Commission Expires Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hiss 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.
(Signed) ) ..... ,. 4 ` -- -- , .�` - � -
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.
NOTE: A re- inspection fee of $LOO will be made when such re- inspection is made by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Twos
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 DEPARTMEI<''
APPLICATION FOR PLUMBING " . ,�,,,r�elT
Permit No ?l Date--.,1'r J S7 -r S SZc
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 cr nit. A copy of approved plans and specifications must be kept at
building during progress of work.
/ L, ypo G _ri
Owner's Name and Address_._ - : ___C�___� - r No / _ - .. 2 - Street
Registered Architect and /or Engineer ------- -___ - � _----_-----------------,.
Employing Plumber's Name tz c?._ 5_13 L° -- . -__._ No..- -_ L!_.P.__ ° -. -.__. Street-_ /:. • 3 - - --- . . . 5 ".
Subdivision
Street_
Location and Legal Description Lot_____________r___ —_— ___ 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.
Nature of Water Supply: City —Well.
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
_.Size of Soakage Pit
Amount of Permit $ 2 _- __ —___ ----- _ —_ - -- —_- -- ( Signed)_ --
cLAF
STATE OF FLORIDA, I
COUNTY OF DADE.
My Commission Expires Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hiss 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.
(Signed) ) ..... ,. 4 ` -- -- , .�` - � -
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.
NOTE: A re- inspection fee of $LOO will be made when such re- inspection is made by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Legal Lot Bl.
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 2184
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
Builder
Subdi-
vision
Value of
Project
DATE 194
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
;,e 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 drawingcor in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees. "*...,
.
Signed. By
INSPECTOR 4 •.
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
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Legal Lot Bl.
Description
Address of
Building 7
CONTRACTOR OR BUILDER
BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 2210
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Subdi-
vision
Value of
Project
DATE
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 regula-
tions 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 respo sibility for all work done by either myself, my agent, servant jar employee.
r
,. s i4r t... 4.:.e.
BY
94
Contractor's ,r
License No.
Amt. of
Permit
!," ,�
RUTH 1'I`
Permit No - '
Registered Architect and /or Engineer
_ i t
Employing Plumber's Name
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, whethe herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
i/ ,4 ! ,t ....
Owner's Name and Address ' _ -
•
No Street.
Location and Legal Description (- Block
Street and Number where work is to be performed— No.__
Date •-w
Street -- – - -� -== " ►,r s dr4w
. a
_ �
State work to be performed and purpose of building (By Floors) New Building________ _ Remodeling 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 $
°1 G
8S.
Capacity Galr`s'' ! / 40
:- - - - -- - - - -- - -_—
_ (Signed) _— _r_��: - - -- ---=— = - - -'` !- - - - - -- _ -_ _
PlumbingInspector.
The undersigned applicant for this building permit does hereby certify that he 4riderstands 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 9 , be performed under this permit, as are
licensed by Miami Shores Village. -
(Signed)
STATE OF FLORIDA, 1
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
No. of
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
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
7-
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No - '
Registered Architect and /or Engineer
_ i t
Employing Plumber's Name
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, whethe herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
i/ ,4 ! ,t ....
Owner's Name and Address ' _ -
•
No Street.
Location and Legal Description (- Block
Street and Number where work is to be performed— No.__
Date •-w
Street -- – - -� -== " ►,r s dr4w
. a
_ �
State work to be performed and purpose of building (By Floors) New Building________ _ Remodeling 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 $
°1 G
8S.
Capacity Galr`s'' ! / 40
:- - - - -- - - - -- - -_—
_ (Signed) _— _r_��: - - -- ---=— = - - -'` !- - - - - -- _ -_ _
PlumbingInspector.
The undersigned applicant for this building permit does hereby certify that he 4riderstands 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 9 , be performed under this permit, as are
licensed by Miami Shores Village. -
(Signed)
STATE OF FLORIDA, 1
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
No. of
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING ❑
ELECTRICAL El
r` 195
PLUMBING PERMIT No 9371 Contractor's
License No
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building o ..: , 3 .. 5 1
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Bl.
,. 4
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
Permit $
4.
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`
INSPECT6R
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and tagulations
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.
d"
BY AUTHORITY