PLUMBINGPermit 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, 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
Amount of Permit $
Registered Architect and /or Engineer ______________________ _ _ _ - .... ___ ________________---- -- - -_ - -.
- - - -- - -- -- - - - - --
Employing Plumber's Naive �i�'�� `__�s �; ��'` , No. - - -- - - -- Street_
Location and Legal Description L6t._ .-_-14--- .._______ ______.__-__ B14 _ Subdi
/
Street and Number where work is to be performed —No / 4/ C ` m Street--l-,�:_
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
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING r ;4• ►yWIT
- -- (Signed)-
Date °.'� /
Li
Street.
Capacity Gals.
1I
My Commission Expires Notary Public, State of Florida
Y '
Plumb g 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 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) - r -� - 4/ .? - '
Masr 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 his, 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
ruse
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKI N6
FOUNT' NS
/ r
ij ski
19 /'
F%TURES
CONTR.
LIST
p/4
•,.4
t a'v
/
.,
r
��
M
,
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOi.AW
HLATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
COMM.
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, 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
Amount of Permit $
Registered Architect and /or Engineer ______________________ _ _ _ - .... ___ ________________---- -- - -_ - -.
- - - -- - -- -- - - - - --
Employing Plumber's Naive �i�'�� `__�s �; ��'` , No. - - -- - - -- Street_
Location and Legal Description L6t._ .-_-14--- .._______ ______.__-__ B14 _ Subdi
/
Street and Number where work is to be performed —No / 4/ C ` m Street--l-,�:_
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
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING r ;4• ►yWIT
- -- (Signed)-
Date °.'� /
Li
Street.
Capacity Gals.
1I
My Commission Expires Notary Public, State of Florida
Y '
Plumb g 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 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) - r -� - 4/ .? - '
Masr 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 his, 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.
Pennit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su g
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.
New Building
Amount of Permit $
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING °' ;a�,iWIT
Owner's Name and Address
Registered Architect and /or Eggi
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)___ iQ
Remodeling_____ _._. Addition
(S�ed )
i
No._. / L!' -- _--..__ - -- -- Stree
r�r
Repairs ' No. of Stories.
Size Se tic Tank .--- -_ - - -- Type of Tank
p — --
_ _
Feet of Drain Tile — - - -- - -._ Dist. Feet of Tank o ain Field from Well
Nai re of Water Supply: City —Well _ __._ _____Size of Soakage Pit
The undersigned applicant for this building permit does hereby certify that he derstan
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gen. al La
plied with the provisions thereof, and ' •.. y ar comp ance r
performed under this permit; . • 11 post or cause to be posted for inspection on
required by the Act. Th undersigned agrees to employ only such sub- contractor
!i'ensed by Miami Shores Village.
(Signed).
Date _ 0(7
bmitted'for the bui or other
Street___
Subdivision
Capacity Gals
Plumbing Inspector.
and accepts his obligations
of Florida Permanent Su
ub- contractors employe
work
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments,
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is OE e.
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
Master Plumber.
an employer of labor
ement, and has com-
him in the work to be
notice or notices are
s p: -...t,
sonally appeared
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 worlananship.
CLOSETS
BATH
TUBE
SHOWlRf
LAVA.
TORICS
SINKS
SLOP
SINKS
LAUNDRY
Tuns
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SW IM'O
POOL
SEPTIC
TANK
SEWER
CONK.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
Cowrie.
LIST
,
1
CHECK
Pennit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su g
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.
New Building
Amount of Permit $
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING °' ;a�,iWIT
Owner's Name and Address
Registered Architect and /or Eggi
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)___ iQ
Remodeling_____ _._. Addition
(S�ed )
i
No._. / L!' -- _--..__ - -- -- Stree
r�r
Repairs ' No. of Stories.
Size Se tic Tank .--- -_ - - -- Type of Tank
p — --
_ _
Feet of Drain Tile — - - -- - -._ Dist. Feet of Tank o ain Field from Well
Nai re of Water Supply: City —Well _ __._ _____Size of Soakage Pit
The undersigned applicant for this building permit does hereby certify that he derstan
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gen. al La
plied with the provisions thereof, and ' •.. y ar comp ance r
performed under this permit; . • 11 post or cause to be posted for inspection on
required by the Act. Th undersigned agrees to employ only such sub- contractor
!i'ensed by Miami Shores Village.
(Signed).
Date _ 0(7
bmitted'for the bui or other
Street___
Subdivision
Capacity Gals
Plumbing Inspector.
and accepts his obligations
of Florida Permanent Su
ub- contractors employe
work
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments,
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is OE e.
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
Master Plumber.
an employer of labor
ement, and has com-
him in the work to be
notice or notices are
s p: -...t,
sonally appeared
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 worlananship.
,r
MIAMI SHORES VILLAGE, FLA.
• 103 VA. 2 2 .x, s
ADDRESS i Z Y
INSPECTION R c 0
TIME READY , —
.0 _ 4¢ fc
N° 6267
-_ - 7
REMARKS
.c�vC r) S 2m T tf ✓L
f"
1J P-� ---
S eve"
INSPECTOR DATE
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Architect
Contractor
or Builder
Legal Lot
Description Bi
MIAMI SHORES VILLAGE.
PERMIT N? 5728
Owner of
Building
Address of
Building
CONTRACTOR OR BUILDER BY
F'LORIDA
DATE
195
Contractor's
License No.
Work to be performed under this Permit
Subdi-
vision
This permit is granted to the contractor or builder named above to construct the building or to install they 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.
Value of ! I Amount of
Project $ 1 1 Permit $
Signed. BY
INSPECTOR
In coderation of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining th reto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this miff" r" assume . for cal work by either, myself, my agent, servant or employee.
At. 34
AUTHORITY
Permit No -
xMO
Amount of Permit $1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of budding (By Floors)__.___
New Building - - - - -. _ - -- •- - - -• -- - ...__. Remodeling_______ Addition.
Size Septic Tani.- -Type of Tank-- •------ •--- - -....
Feet of Drain Tile __Dist. Feet of Tank oe Drain Field from Well .. ._.__
Nature of Water Supply: City —Well. Size of Soakage Pit
(Signed)
Date..._.._
Capacity Gals
(signed)_ - -1' t , " d1 2-1 -
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 di No
Registered Architect and /or Engineer A //
/l�07U�e/
Employing plumber's Name f o . %q i ` Na. e..l /ttwR_?rL.:...�.,% ..... �. -....
Location and Legal Description Lot Mort Subdivision Subdivon r
Street and Number where work is to be performed —No 0 7 / Street..._. ca _ ..._. 7 ..
Repairs No. of Stories
My Commission Expires Nuts,y Public, State of Florida
Plumbing In vector.
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 com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort. to he
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 err
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,
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 tams, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be load. whoa meth riispsodais >r ad. asoroary by improper notice for inspection, or faulty
materials and /or worlonanship.
CLOSRs
BATH
'rums
aNOW[Rn
LAVA-
TORIES
1194K•
8L01
SINKS
LAUNDRY
Tune
U RINAL.
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N•
TOTAL
IIIITUR[S
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
•
SYSTEM
•WIM•0
POOL
Cowls.
LIST
CHECK
Permit No -
xMO
Amount of Permit $1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of budding (By Floors)__.___
New Building - - - - -. _ - -- •- - - -• -- - ...__. Remodeling_______ Addition.
Size Septic Tani.- -Type of Tank-- •------ •--- - -....
Feet of Drain Tile __Dist. Feet of Tank oe Drain Field from Well .. ._.__
Nature of Water Supply: City —Well. Size of Soakage Pit
(Signed)
Date..._.._
Capacity Gals
(signed)_ - -1' t , " d1 2-1 -
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 di No
Registered Architect and /or Engineer A //
/l�07U�e/
Employing plumber's Name f o . %q i ` Na. e..l /ttwR_?rL.:...�.,% ..... �. -....
Location and Legal Description Lot Mort Subdivision Subdivon r
Street and Number where work is to be performed —No 0 7 / Street..._. ca _ ..._. 7 ..
Repairs No. of Stories
My Commission Expires Nuts,y Public, State of Florida
Plumbing In vector.
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 com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort. to he
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 err
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,
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 tams, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be load. whoa meth riispsodais >r ad. asoroary by improper notice for inspection, or faulty
materials and /or worlonanship.
Permit No Z5Y
Registered Architect and /or Engineer
Lion and eg Description /1
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.
� 1 /3 ! / ( "y 1 'i`
Owner's Name and Address �/ t %f No. I CY / Street.._—
8101
Ne `ae:. AA2Z 2 I K.�
SubdivWon:N.
Street and Number where work is to be performed —No Street.
State work to be performed and purpose of building (By Floors) _—._._
New Building - -__._ _ -- •-- ...... - -._ -. Remodeling--..._...._...__ Addition.. — Repairs No. of Stories
Size Septic Tank_._
Feet of Drain Tile
Nature of Water Sui)
Amount of Permit $ ! C
My Commission Expires
_Type of Tank__. ... Cals..._
Di Feet of Tank or Drain Field from Well -.__.. _ —
Size of li'oaki i Pit
v
( 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 Ilan com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wore• ro ix
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 u are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under s pps nits s are
licensed by Miami Shores Village.
(Sim) tJ ` l - G _ °GIN
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 this. - --
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.
Nceary Public), State of Florida
NOTE: A re- inspection fee of 11.00 will be mad. when web soiaspectioe r saedelexeurry by Improper nodes far hsepection, or faulty
materials and /or worl®anshup.
CLO•ETS
BATH
T
S HOWER•
LAVA
TORIES
NK•
SINKS
SINK•
LAUNDRY
Tu••
U RINALS
CATCH I FLOOR
BASIN DRAIN
DRINKING
FOUNT' NS
TOTAL
P11fTUm[•
Comm
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
NEATER
Day
WELL
SPRKLR.
SYSTEM
.W IM'O
POOL
CONTR.
LIST
I
,--
j
CHICK
Permit No Z5Y
Registered Architect and /or Engineer
Lion and eg Description /1
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.
� 1 /3 ! / ( "y 1 'i`
Owner's Name and Address �/ t %f No. I CY / Street.._—
8101
Ne `ae:. AA2Z 2 I K.�
SubdivWon:N.
Street and Number where work is to be performed —No Street.
State work to be performed and purpose of building (By Floors) _—._._
New Building - -__._ _ -- •-- ...... - -._ -. Remodeling--..._...._...__ Addition.. — Repairs No. of Stories
Size Septic Tank_._
Feet of Drain Tile
Nature of Water Sui)
Amount of Permit $ ! C
My Commission Expires
_Type of Tank__. ... Cals..._
Di Feet of Tank or Drain Field from Well -.__.. _ —
Size of li'oaki i Pit
v
( 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 Ilan com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wore• ro ix
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 u are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under s pps nits s are
licensed by Miami Shores Village.
(Sim) tJ ` l - G _ °GIN
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 this. - --
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.
Nceary Public), State of Florida
NOTE: A re- inspection fee of 11.00 will be mad. when web soiaspectioe r saedelexeurry by Improper nodes far hsepection, or faulty
materials and /or worl®anshup.