1276 NE 94 St (7)�illa�e o f Miami Shores
JOB l
ADDRESS
INSPECTION
TIME READY
REMARKS
INSPECTOR DATE
N9 4299
7
Penn Xrc. _
Application ' hereby made for the approval of the detailed statement of fa;. ;Mans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and co f:} . ity with the r •tilding Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miarn' Shores ViiiagF. aid all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified -- nr>.. A copy of approved plans and specifications must be kept at
building during progress of work ?
Owner's Name and Address 7 4 4 __ — - No.
Registered Architect and /or Engineer - - - - -
Employing Plumber's Name :t'"_t
'Location and Legal Descripti Lot____
Street and Number where work is to be performed- No.______ _ Street
STAT OF FLORIDA, t
COUNTY Or DADE.
as.
MIAMI SHORES VIL:_AG
PLUMBING INSPECTION DEPARTMEI' . '
APPLICATION FOR PLUMBING ' '
State work to be performed and purpose of building (By Floors)-_-_ ... __.____-
New Building f�" - Remodeling_____ Addition
Amount of Permit $-------------------- - - - - -- - --
Block
_ -^ ( Signed)
Date ,.
No._ _ Street ._
Street___ 9
Subdivision__
My Cammission Expires Notary Public, State of Florida
Capacity Gals.
1a- Lam.,
Repairs No. of Stories.
Size Septic Tank____ - Type of Tank 't__/
Feet of Drain Tile_ -..„.4__E Feet of Tank or Dram Field from Well
Nature of Water Supply: ity- Well.____ ( _ _Size of Soakage Pit
4-
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 Flo:rida 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.
aster Plumber.
9efore 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 hisn 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
SINK
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DFIAIN
DRINKING
FOUNT' NS
FJ.j 4
%/ .Li
/�j' a
FI%TURES TOTAL
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
LIST
j/
MM
CHECK
i`
El
Penn Xrc. _
Application ' hereby made for the approval of the detailed statement of fa;. ;Mans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and co f:} . ity with the r •tilding Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miarn' Shores ViiiagF. aid all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified -- nr>.. A copy of approved plans and specifications must be kept at
building during progress of work ?
Owner's Name and Address 7 4 4 __ — - No.
Registered Architect and /or Engineer - - - - -
Employing Plumber's Name :t'"_t
'Location and Legal Descripti Lot____
Street and Number where work is to be performed- No.______ _ Street
STAT OF FLORIDA, t
COUNTY Or DADE.
as.
MIAMI SHORES VIL:_AG
PLUMBING INSPECTION DEPARTMEI' . '
APPLICATION FOR PLUMBING ' '
State work to be performed and purpose of building (By Floors)-_-_ ... __.____-
New Building f�" - Remodeling_____ Addition
Amount of Permit $-------------------- - - - - -- - --
Block
_ -^ ( Signed)
Date ,.
No._ _ Street ._
Street___ 9
Subdivision__
My Cammission Expires Notary Public, State of Florida
Capacity Gals.
1a- Lam.,
Repairs No. of Stories.
Size Septic Tank____ - Type of Tank 't__/
Feet of Drain Tile_ -..„.4__E Feet of Tank or Dram Field from Well
Nature of Water Supply: ity- Well.____ ( _ _Size of Soakage Pit
4-
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 Flo:rida 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.
aster Plumber.
9efore 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 hisn 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.