1269 NE 94 St (8)Permit No CC -- _ L4_ Date__ ,..d._-_....,25 if 5
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith(s'ubmitted for the building or other
structure herein described. This n 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 building during progress of work.
d with, whether herein specified or not. A copy of approved plans and specifications must be kept at
Registered Architect and/or Engineer ,
Plumber's Name,i_.� A /1
Employing �i�N' L� Ce,p__±���ft �� -� Street_ ki".3 ez-A--( •
Location and Legal Description Lot ______________ -- _-_-_______-- Block___ __ Subdivision - - -- ,- •- -- -- 7.a
/ Street
Street and Number where work is to be performed —No 4 /
State work to be performed and purpose of building (By Floors)
New Building ____ Remodeling__ ______ Addition__-_ Repairs No. of Stories..... ...........
Amount of Permit $._
STATE OF FLORIDA, I
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street ._ L _..__ V 04 c c
Size Septic Tank ' _ Type of Tank
Feet of Drain Tile_ J _ L i Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well �______________._._______ _ Size of Soakage Pit
(Signed)__
Capacity Gals.
( Signed ) - -- 1
�- -- - - -- - Plumbing Inspector. ing pector.
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 bus 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 perinit, as are
licensed by Miami Shores Village.
"1
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
TUB S
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
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
•
-
Permit No CC -- _ L4_ Date__ ,..d._-_....,25 if 5
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith(s'ubmitted for the building or other
structure herein described. This n 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 building during progress of work.
d with, whether herein specified or not. A copy of approved plans and specifications must be kept at
Registered Architect and/or Engineer ,
Plumber's Name,i_.� A /1
Employing �i�N' L� Ce,p__±���ft �� -� Street_ ki".3 ez-A--( •
Location and Legal Description Lot ______________ -- _-_-_______-- Block___ __ Subdivision - - -- ,- •- -- -- 7.a
/ Street
Street and Number where work is to be performed —No 4 /
State work to be performed and purpose of building (By Floors)
New Building ____ Remodeling__ ______ Addition__-_ Repairs No. of Stories..... ...........
Amount of Permit $._
STATE OF FLORIDA, I
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street ._ L _..__ V 04 c c
Size Septic Tank ' _ Type of Tank
Feet of Drain Tile_ J _ L i Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well �______________._._______ _ Size of Soakage Pit
(Signed)__
Capacity Gals.
( Signed ) - -- 1
�- -- - - -- - Plumbing Inspector. ing pector.
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 bus 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 perinit, as are
licensed by Miami Shores Village.
"1
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.
n
PERMIT N? 11993
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
1
11
❑ Work to be performed under this Permit
l
MIAMI SHORES VILLAGE, FLORIDA
Bl.
Subdi-
vision
Value of
f Project $ /!
DATF. _ I 195
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 drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed :... ,.._ BY .
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
• ~
CONTRACTOR OR BUILDER BY AUTHORITY
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity' with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address _ .___. -� `* ' ; No. Street__
Registered Architect and /or Engineer
Employing Plumber's Name._
Location and Legal Description Lot
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___
Size Septic Tank ...
Feet of Drain Tile -- ,O - - 1-7 )
Nature of Water Supply: City —Well
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
ss.
No. Street
Block Subdivision
7
Type of Tank
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)
(Signed)
Street
Repairs
j
Bate 9, T : i J /
Capacity Gals..
No. of Stories
Plumbing Inspector.
The undersigned appli nt for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
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.
Master Plumber.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT' 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
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity' with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address _ .___. -� `* ' ; No. Street__
Registered Architect and /or Engineer
Employing Plumber's Name._
Location and Legal Description Lot
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___
Size Septic Tank ...
Feet of Drain Tile -- ,O - - 1-7 )
Nature of Water Supply: City —Well
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
ss.
No. Street
Block Subdivision
7
Type of Tank
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)
(Signed)
Street
Repairs
j
Bate 9, T : i J /
Capacity Gals..
No. of Stories
Plumbing Inspector.
The undersigned appli nt for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
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.
Master Plumber.
Architect
Contractor
or Builder
Legal
Description
Address of
Building
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building �.• t s_
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT IN? 12038
por
❑ Work to be performed under this Permit
BI.
Subdi-
vision
Value of
Project $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my- agent, servant or employee.
a
�.. r
BY
DATE 195
Contractor's
License No
Amt. of
Permit $
AUTHORITY
. MIAMI SHORES VILLAGE
"t - 4. - " PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/V:
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. ;
Owner's Name and Address No — ! Street ° r
Registered Architect and /or Engineer
Permit No. _ ____ _J L _J
Date__
Employing Plumber's Name No d $treat ..r
Location and Legal Description Lot / Block Subdivision
Street and Number where work is to be performed —No L _ Street _ _____r___
State work to be performed and purpose of building (By Floors)
New Building / Remodeling Addition Repairs No. of Stories_ .._
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile
Nature of Water S u p
Amount of Permit $ /12
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Dist. Feet of Tank or Drain Field from Well
r ' Size of Soakage Pit
ss.
My Commission Expires
( Signed)
t
Plumbing Inspector.
( Signed) •` -• -
/ 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.
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
B ATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
I
N pl
TOTAL
FIXTURES
CONTR.
LIST
/
/
ii
CHECK
4.70
J
1 -,
/ ��
. ti
! �J f
/ ww
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM 'G
POOL
i tj A,
CONTR.
LIST
CHECK
C ,
t
. MIAMI SHORES VILLAGE
"t - 4. - " PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/V:
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. ;
Owner's Name and Address No — ! Street ° r
Registered Architect and /or Engineer
Permit No. _ ____ _J L _J
Date__
Employing Plumber's Name No d $treat ..r
Location and Legal Description Lot / Block Subdivision
Street and Number where work is to be performed —No L _ Street _ _____r___
State work to be performed and purpose of building (By Floors)
New Building / Remodeling Addition Repairs No. of Stories_ .._
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile
Nature of Water S u p
Amount of Permit $ /12
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Dist. Feet of Tank or Drain Field from Well
r ' Size of Soakage Pit
ss.
My Commission Expires
( Signed)
t
Plumbing Inspector.
( Signed) •` -• -
/ 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.
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
In consideration of the issuance to me
pertaining thereto and in strict conformity with
cepting this permit I assume responsibility for
NTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 1
PERMIT
Lot
B1
N9 6601
Work to be performed under this Permi
- 6 A 19
Contractor's
License No.
Subdi-
vision
Address of Value of Amount of
Building t ' Project $ Permit $ ''+
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed. - 's -- i ' . " A moy.. INSPECTOR
of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
ABBOT
1
CLOSETS
BATH
TUB[
SHOWER•
LA VA•
TORI[•
SINKS •
SLOP
KINK[
LAUNDRY
TUNIS
URINAL[
CATCH
eA•IN
FLOOR
DRAIN
DRINKING
FOUNT'N•
I
TOT..L
F + R[•
CONTR.
T
I
— LI
CHECK
I
__
_ ..
1
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
H
DEEP
WILL
BPRKLR.
Grimm
SWIN'O
POOL
I I
L.
CoNTR.
Lis"'
/
r"--
_
CHECK
_ �
—_ ...I.
y� �y
1' enru, Nu. �r .
`)wner's Name and Address...
Size Septic Tank_. .._.__ ......... _- --- ---- .__ - - -- ---Type of Tank
Amount of Permits
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
:,,,phrat lnl is hereby made for the approval of the detailed statement of the plans and specifications herewith subr.io ... l for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi.:. • t Shores Village, Florida,
4,-id all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic , of the Building Division
01 Miami Shores Village shall be complied with, whether herein specified or not A copy of approved plans and spec fications most be kept at
')uilding during progress of work.
.egictBred Architect and /or Eft Mee!
A7 LL L/ �/ 'e. QQ34 Atal 2 ✓E' vug
imp lo n Plumber's Name . �/
_. .. l�. f_..�!Q��_.!f�y NO.� -�•/ 8lttte�t
l/ .,fa s / o eo d e - 4 4'4 M, � F , � A , ... !„.e.:(11
Location and Legal Description Lot. 9 Block Subdivision.. __S.
/2 4,9 .VF 94 Street �+ /S
State work to be performed and purpose of building (By Floors) --------- .. t�}' M
New Budding.. ......._.__._ .................. Remodeling___. ..... Addition Repairs No of Stones
Feet of Drain Tile.______ ____._ - -_ —Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City — Well.___— ..._.._ ..... .._Size of Soakage Pit
Capacity ^
_.._. No /269 4 ' 94 Street. ..._... 41 /4M/
Date ... Woleisgeog /4,11
Street and Number where work is to be performed —No
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; 'thgv,h0EICsif citabiIIA read the foregoing application, and that he did sign the same, and
therein by bins stated arie,l ; / !; J :.! .: p I " .ES FL 1 14 1987
. j'C.NDHD ThW G:NE AL INSURANCE UND etAA
My Commission Expires Notary Public, State of Fl
_ ( Signed ) - "' ' tR _ C4 4/ ./.
Plumbin;; Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as on a n;Iloyet of !oho)
under the Florida Workinen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent :upi Iement, and lid, . -o -•
lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed 1 y him in ' I: •F, rk
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pubis notice no leer rs a:
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed this r rl.iit a:rr .
licensed by Miami Shores Village.
(Signed )/
/S Mesta Plumber.
d
STATE OF FLORIDA, 1 O
a..
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administ oaths and take acknowledgments, periurrt ; i ppear..
7 uz%v! K
filet all acts,
NOTE: A re-inspection fee of $1.00 will be made when such rs•laspoctfon is made•neoessary by improper notlee for fnspe t!on. cr touitry
materials and /or workmanship.