PLUMBINGPermit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street and Number where work is to be performed—No 1293 NE 9
State work to be performed and purpose of building (By Floon)
New Building _ Remodeling Addition
Size Septic Tank_ _Type of Tank--_
Feet Drain Tile
40 0 SCf • Feet of Tank or Drain Field from Well _
of
Nature of Water Supply: City—WelL SUS of Soakage Pit
My Commission rapine
7,0- 717/
Date.---J44111-a-ry—X6- -21.9.a6- —
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 li 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 specificatiosu must be kept at
building during progress of work.
Owner's Name and Address labman N 1293 NE 9 st jiliami Thores .
Registered Architect and/or Engineer
N 800 ny....2.1L..,„
EmployinxPlushbor's North Dade Sextic,Tarlic
. 1212
// Loden / LA:e t gaI Lotka. v4r 41 ' , / 25 s5 BkA (4. Subdivision
st Miami Shores
Repairs No. of Scorns .....
(si uic-vmu- '\K
Amount of Permit $ ...... Z °a
Plumb'ng Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an eriployer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and Itivc com-
plied with the provisions thereof, and will require similar compllance from all contractors or sub-contractors employed by him it the woe 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 arr
required by the Act. The undersigned agrees to employ only such sub-contractors, on k to be performed unde!Ahls permit, iui are
licensed by Miami Shores Village.
(Signed)
Master Plumber.
STATE OF FLORIDA, i
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 depress and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that be 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 anis rwaupeodoe mede by improper webor for brapedlen. or hilly
materials and/or workmanship.
cLos yrs
BATH
-ruse
a
"""
LAVA-
TORItS
a I N "
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOO R
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
COMM
LIST
CHICK
•■•-•
SEPTIC
TANK
SEWER
corm
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
MEATIER
MEP
WELL
SPRKLR.
SYSTEM
SW IM •O
POOL
CONTR.
LIST
CHICK
Permit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street and Number where work is to be performed—No 1293 NE 9
State work to be performed and purpose of building (By Floon)
New Building _ Remodeling Addition
Size Septic Tank_ _Type of Tank--_
Feet Drain Tile
40 0 SCf • Feet of Tank or Drain Field from Well _
of
Nature of Water Supply: City—WelL SUS of Soakage Pit
My Commission rapine
7,0- 717/
Date.---J44111-a-ry—X6- -21.9.a6- —
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 li 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 specificatiosu must be kept at
building during progress of work.
Owner's Name and Address labman N 1293 NE 9 st jiliami Thores .
Registered Architect and/or Engineer
N 800 ny....2.1L..,„
EmployinxPlushbor's North Dade Sextic,Tarlic
. 1212
// Loden / LA:e t gaI Lotka. v4r 41 ' , / 25 s5 BkA (4. Subdivision
st Miami Shores
Repairs No. of Scorns .....
(si uic-vmu- '\K
Amount of Permit $ ...... Z °a
Plumb'ng Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an eriployer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and Itivc com-
plied with the provisions thereof, and will require similar compllance from all contractors or sub-contractors employed by him it the woe 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 arr
required by the Act. The undersigned agrees to employ only such sub-contractors, on k to be performed unde!Ahls permit, iui are
licensed by Miami Shores Village.
(Signed)
Master Plumber.
STATE OF FLORIDA, i
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 depress and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that be 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 anis rwaupeodoe mede by improper webor for brapedlen. or hilly
materials and/or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-
Permit No.
i Date - --4'
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address'.tyrs,; ° J- //,,- Registered Architect and /or Engineer
Employing Plumber's Name
;,..-7' ' �:A_-___ I ~ o- �;� " -, ; ; ' No.___:��. " _ .__: Street
Location and Legal Description Lot_____ 2,/....`:: ___ :____�_�_____ Block:______ Subdivision
Street and Number where work is to be performed —No EI %)___ �? __________________ Street l9f 2 ^
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..
Dist. Feet of Tank or Drain Field from WeIL
Nature of Water Supply:- City 'Well / T __Size of Soakage Pit
Feet of Drain Tile
Amount of Permit $ 1 1 -- ( Signed) _
Y
No. ____ /___f 9 i Street
(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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, I ss
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
•
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 fat.
therein by him stated are true.
--------------------------------
My Commission Expires
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul
eterials and /or workmanship.
Notary Public, State of Florida
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
.
"„ ,. /..
TOTAL
FIXTUREI
CONTR.
LIST
.-
a D
' '
n
__
CHECK
° , c
? �-
� �
_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
s . i
// -
J ,e) :9
/ . O'J
0
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-
Permit No.
i Date - --4'
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address'.tyrs,; ° J- //,,- Registered Architect and /or Engineer
Employing Plumber's Name
;,..-7' ' �:A_-___ I ~ o- �;� " -, ; ; ' No.___:��. " _ .__: Street
Location and Legal Description Lot_____ 2,/....`:: ___ :____�_�_____ Block:______ Subdivision
Street and Number where work is to be performed —No EI %)___ �? __________________ Street l9f 2 ^
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..
Dist. Feet of Tank or Drain Field from WeIL
Nature of Water Supply:- City 'Well / T __Size of Soakage Pit
Feet of Drain Tile
Amount of Permit $ 1 1 -- ( Signed) _
Y
No. ____ /___f 9 i Street
(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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, I ss
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
•
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 fat.
therein by him stated are true.
--------------------------------
My Commission Expires
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul
eterials and /or workmanship.
Notary Public, State of Florida
o I
7
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;
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Gown.
LIST
CLOSETS
T
1
BATH
TUBS
1
S HOWERS
OVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuve
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT•NS
TOTAL
FIII TUR IS
1
3 -
�/
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
NEATER
DEEP
WELL
8
S
SW IM•0
POOL
COMM.
LIFT
CHECK
Permit No C
My Commission Expires
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
stricture 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 LE. t4 M ll '' ''
Registered Architect and/or Engineer __d41 -N C
,r,20‘ Et Toying Pltutaber's Name - l4 `J S C E R-.. • ^� y a . , Na ._ . itr .._.....
// Location and g � Des cr ip K Lot :_r / �' G L' 7s 5 °� ock Subdivision. i? .
Street and Number where work is to be performed —No QQ L Street. ...._
State work to be performed and purpose of building (By Floors) __. T _ ?t. M 0 D E
New Building. _ Remodeling____._._ -- Addition. ..- .. —_..__ Repairs No. of Stories
Amount of Permit $ .st `
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Tank— Type of Tank —_-
Feet of Drain Tile Dist Feet of Tank or Drain Field from Well ..._. -
Nature of Water Supply: City —WeIL Size of Soakage Pit.
( Sigr ted )-- -- T c ------ •------------ • - - -••-
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 5988, Compiled General Laws of Florida Permanent Supplement, and kw( com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worn to hp
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 arc
required by the Act. The undersigned agrees to employ only such sub -contr- • k to • Ly .,.in - . rt .er this pmnit, as are
licensed by Miami Shores Village. 40
(St
No.
129' 3 street. E 1 . S
/ - 7
Date..._711
Notary Publics, State of Florida
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .- ._ -•.- •-- •-- ...- -• -• -•- _ _ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made wham 111106 r.haspeodas le made•IBeoanary by buproper notio0 for Inspection, or faulty
materials and/or wodomaashup.
/ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date,// � ` 7 Job Address / 2 3 /U'! a7. - - S ax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant jA
Owner's Address
Notary as to Owner and/or Condo President Date
My Commission Expires:
1±ES: PERMIT3S.' &..0 RADON C.C.F.
Master Permit # N", . -°� ,', 3 g /, 7
Phone
Contracting Co. � G� �' �, �i C+ Address / /kx? / ,� ,d e
Qualifier f A! S rTh g e ms. SS #‘7 q
State •# f e// q Municipal - G P 7 Competency # j/i/S Ins. Co 1' ' &/ a
C
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE
V / `� �
WORK DESCRIPTION / C) '7 $
SIGN
Square FL Estimated Cost (value) 6 - C
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAI
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date Signature of Contractnr or • wner; uilder Date
/%1 //- / Q
Notary 9 o Contraclor.oi owner- Builder Date
My Commission Expires • c •
NOTARY TOTAL DUE
APPROVED:
Zoning Building Electrical, " "�
Mechanical Plumbing Engineering