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PLUMBINGPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY Job Address Legal Description ' d 79 � }� 4SSt / Master Permit it : C s„- fe 6 ner Lessee / Tenant Owner's Address / Contracting Co. Qualifier . tf ����� (OWNER TO RETAIN COPY) State# Competency# Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Tax Folio // ,3 e , ? , e6 / 02/0 phone Address "./0" -- • SS# - - ( / phone g= sz s 5= 7 Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION f/ic / en. 7 � /� /- cXt�' � 7 Square Ft. Estimated Cost ;/,-=.-> 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. 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 Dat ■ Notary as to Owner and /or Condo President Notary as to Contractor My Commission Expires: My Commission Expires: * * * * * * * * * * * * * * PERMIT FEE: APPROVED: Fire Other s `. w Mechanical Plumbing MerA fit Zoning Building l • v't7 -91 ( Electrical of'-Gentractor or Owner - Builder Elctcry y ublic St to of Florida W1y Csmmission EttgirCs 9/18/'2 Eon2J Storater,Vams Staeat or Owner - Builder Engineering PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) 9 OS- �S 9 Date �� ���` Z Job Address Folio ,, 2(4 ,0/? .-714 f6 Legal Description / , /9J J L`,/°r 44 ,i4-7 cec - / j/ , e Owner / Lessee / Tenant 57 � 8 JFileSel«0 Master Permit # ,1R P Owner's Address 1 P q C Sr✓w Phone Contracting Co. &1L) P. Vo/1; vz Address 6624 `-e-�/i'I t ii' Qualifier EVI4iJ P. Vedi Phone %/7063 ` 7151 State # Municipal # Competency # c /Zf Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL DESCRIPTION PLUMBING MECHANICAL ROOFING PAVING PRICE SIGN WO QQ q RK Sf Y1 YOW g(1,0644 21 Tl0 e VV Square Ft. Estimated Cost(value) 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 construpt)i.on and zoning. Furthermore, I auth rize the above d contractor to do the work stated. Signature of owner and /or Condo President Date: 3 °jq-q APPROVED: otary a to Owner a /or Condo President My Commission Expires: :��vpry�pIQ� � � � 1 g� pp 92 tl It C h 'J�Jp��/�1aV sG 149t- d o�Y 9 * lJlIVO I; Utl;:19 L � ca. l"3t4D. ** * * * * * * * Signature of Contractor or Owner- Builder Date: 3-19-92 otary as / o Contractor or Owner- Builder My Commission ExpiK UUMV R �, M STATY�L • O FLORIDA y O NNE Y/1� 7BONDED Y * i'y]W@ * * ** FEES: PERMIT 7 y ` e RADON C.C.F. 4 /A ® NOTARY TOTAL DUE 7/ Fire Other Zoning Building Electrical Mechanical Plumbing: ' N / r�J n eerinR Thsid VOS • Permit Noct 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. Owners Name and Address L t & O.10- ' 4 Vve kN Sc tz-i No R;; itered Architect and /or Engineer S YN A6kd 014-s , eo . Location and - gal 1Jesixiptilot e l /1' A A Street and Number where work is to be performed —No /yS State .work to be performed and purpose of building (By Floors)_._._ New Building.._...-- _.._. ..... ...._.. Remodeling -- - - -- Addition. B kx Size Septic Tank— Type of Tank__. ._.-------- •----- .----------------- __ -..0 Feet of Drain Tile Oast Feet of Tank or Drain Field from Well .. ._.__. Nature of Water Supply: City —WeIL Size of Soakage Pit. Amount of Permit $ M. My Commission Expires (Signed � "Is— a763 ra / '/S / _ 9 <5 ±.. (Signed) CC / .sI#- tics= S�.-Ce'Ts cc Subdlvlslon. - -4 1UE. street. Repairs No. of Stories ....... 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, nnJ bav corn- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wore to tix 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 or+ 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. Notary Public, State of Florida Muter Plumber. _ STATE OF FLORIDA, t 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 be did slips the same, and that all f acts therein by him stated are true. NOTE: A re- inspection fee of 11.00 will be mad. when seas u-Is peotlaa r snada•naoassary by improper notice for inspection, or faulty materials and /or wwrlonanahip. CLOSETS BATH TOSS SHOWERS LAVA. TORIES 11"4" SLOP SINK[ LAUNDRY Tura URINAL[ CATCH BASIN FLOOR DRAIN DRINKING FOUN7'NS TOTAL •IITUKES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAO[ PIT G TRAP SOLAR H KAT[R DEEP WELL BPRKLR. SYSTEM SWIM'G POOL ONE �y • � -k � • � nptti O I (.�f , I -- Cowre. LI aT r-- CHECK • Permit Noct 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. Owners Name and Address L t & O.10- ' 4 Vve kN Sc tz-i No R;; itered Architect and /or Engineer S YN A6kd 014-s , eo . Location and - gal 1Jesixiptilot e l /1' A A Street and Number where work is to be performed —No /yS State .work to be performed and purpose of building (By Floors)_._._ New Building.._...-- _.._. ..... ...._.. Remodeling -- - - -- Addition. B kx Size Septic Tank— Type of Tank__. ._.-------- •----- .----------------- __ -..0 Feet of Drain Tile Oast Feet of Tank or Drain Field from Well .. ._.__. Nature of Water Supply: City —WeIL Size of Soakage Pit. Amount of Permit $ M. My Commission Expires (Signed � "Is— a763 ra / '/S / _ 9 <5 ±.. (Signed) CC / .sI#- tics= S�.-Ce'Ts cc Subdlvlslon. - -4 1UE. street. Repairs No. of Stories ....... 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, nnJ bav corn- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wore to tix 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 or+ 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. Notary Public, State of Florida Muter Plumber. _ STATE OF FLORIDA, t 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 be did slips the same, and that all f acts therein by him stated are true. NOTE: A re- inspection fee of 11.00 will be mad. when seas u-Is peotlaa r snada•naoassary by improper notice for inspection, or faulty materials and /or wwrlonanahip. (- DATE AMT. OF ACCOUNT AMT. PAID BALANCE 4D'UE CASH CHECK MONEY BORDER _. 19 No. 8267 v • Permit No 7\ 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 mud be kept at building during progress of work. Owner's Name and Address Registered Architect and /or En ' __... _ _.- . ... .. 7 MtAM� Orre n.. rec K ��� � / L N / >r pl c Pluu N e. _�,1e1 - � -T Na. ..., ..c.S.� .t...... mrs•L J.�...d.. :.. 91v7 - i �t and g£� 3escrt�No J. ff e �J 8 Subdivision.. . � /..626) d. Street and Number where work is to be performed —No Street- . .Si . S _F .. S State work to be performed and purpose of building (By Floors j _.1_ `e k6.._Y .._ . c q .. 7' ... O n New Building _ — _.._....... -.._.. Remodeling —_.__. ______ Addition ..._._ ____ .__..... Repair No. of Stories Size Septic Tank._. Feet of Drain Tile Nature of Water Supply: City—Well. Amount of Permit $ —.� My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Type of Tank Dist- Feet of Tank or Drain Field from Well... ____ Size of Soakage Pit. WO v. zi ,27 Date (Si No streeLtd: I S7 (Signed)_ Notary Public, State of Florida 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, anti liar com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contra • s employed by him in the worn to }AP performed under this permit; and will post or cause to be posted' for inspection on the site of the or such public notice or notices as arr required by the Act. The undersigned agrees to employ only such sub - contractors, on work - • . under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, 1 u. COUNTY OF DADE. 1 Before me, the undersigned authority, a notary public, duly antbarized to administer oaths and take acicnowledgments, 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 whoa snob sedaspeotfoe >r snada•oaosssary by improper notice for Wspectfoe, or faulty materials and /er woelonanshcp. CLOSETS BATH TUBS 6 LAVA- TORIES a1NKS •SINKS SLOP LAUNORY Twos URINALS U RINALS CATCH FLOOR DRAIN DRINKING FOUNT'N• TOTAL FIxTURIEe Comm LIST — � CHECK SEPTIC TANK SEWER CONK. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR MEATIER DEEP WELL SPRKLR. S Swum '0 POOL CoH T . LIST .-- CHICK Permit No 7\ 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 mud be kept at building during progress of work. Owner's Name and Address Registered Architect and /or En ' __... _ _.- . ... .. 7 MtAM� Orre n.. rec K ��� � / L N / >r pl c Pluu N e. _�,1e1 - � -T Na. ..., ..c.S.� .t...... mrs•L J.�...d.. :.. 91v7 - i �t and g£� 3escrt�No J. ff e �J 8 Subdivision.. . � /..626) d. Street and Number where work is to be performed —No Street- . .Si . S _F .. S State work to be performed and purpose of building (By Floors j _.1_ `e k6.._Y .._ . c q .. 7' ... O n New Building _ — _.._....... -.._.. Remodeling —_.__. ______ Addition ..._._ ____ .__..... Repair No. of Stories Size Septic Tank._. Feet of Drain Tile Nature of Water Supply: City—Well. Amount of Permit $ —.� My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Type of Tank Dist- Feet of Tank or Drain Field from Well... ____ Size of Soakage Pit. WO v. zi ,27 Date (Si No streeLtd: I S7 (Signed)_ Notary Public, State of Florida 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, anti liar com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contra • s employed by him in the worn to }AP performed under this permit; and will post or cause to be posted' for inspection on the site of the or such public notice or notices as arr required by the Act. The undersigned agrees to employ only such sub - contractors, on work - • . under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, 1 u. COUNTY OF DADE. 1 Before me, the undersigned authority, a notary public, duly antbarized to administer oaths and take acicnowledgments, 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 whoa snob sedaspeotfoe >r snada•oaosssary by improper notice for Wspectfoe, or faulty materials and /er woelonanshcp. Permit # Miami Shores Village, Fla. Permission is hereby granted u`< °_. y -'''. -xt to install the following described plumbing, in accordance with the laws, statutes and regulations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Vi .lage Florida. T � A For a �.�.•,r'�' 4`y At No. Lot Fixtures As Shown on attached approved plans. FIXTURES ROUGHED IN FIXTURES SET SEWER SEPTIC TANK TOTAL:;' Village Plumbing Inspector MIAMI SHORES VILLAGE Plumb-ing Permit Block Subdivision .40, def I r e r• ' .•,i Payment Received /? This permit issued subject to approval of County Plumbing Inspector *19 Permit # ''� o t Permission is hereby granted to install the following described plumbing, in accordance with thn laws, statutes and regulations of Miami Shores Village, Florida anct. the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a t . At N o . ) / r f � Lot Fixtures As Shown on attached FIXTURES ROUGHED IN SEPTIC TANK TOTAL Villag ' 'Plumbing Inspector Block Subdivision MIAMI SHORES VILLAGE Plumbing Miami Shores Village, Fla /0 -4.2'2 `. approved plans. FIXTURES SET SEWER 7 J nom" ...trio • • Payment Received By This permit issued subject to approval of County Plumbing Inspector • • Architect Contractor or Builder Legal Description Address of Building Lot BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building 11 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT 'N° 12922 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE j 1 1 - 195 Contractor's License No Amt. of Permit $ r' 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. BY AUTHORITY Permit No. __I -= 4 - ' �-- - 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 Divisior 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 Registered Architect and /or Engineer Employing Plumber's Name. l,' No Street Location and Legal Description Lot. Block Subdivision e • Street and Number where work is to be performed -No 'I Street 1 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 __Size of Soakage Pit Nature of Water Supply: City -Well Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._. - - \- - - Street Capacity Gals.__. (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. (Signed)-_ 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 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 fac 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 faul materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURE! CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LteT CHICK Permit No. __I -= 4 - ' �-- - 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 Divisior 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 Registered Architect and /or Engineer Employing Plumber's Name. l,' No Street Location and Legal Description Lot. Block Subdivision e • Street and Number where work is to be performed -No 'I Street 1 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 __Size of Soakage Pit Nature of Water Supply: City -Well Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._. - - \- - - Street Capacity Gals.__. (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. (Signed)-_ 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 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 fac 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 faul materials and /or workmanship. Permit No &P- 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. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Owner's Name and Address Registered Architect and /or En Employing Plumber' beer' Name / on are g 71- piton Lot_ E I L Street and Number where work L to be performed —No State work to be performed and purpose of building (By (Si No M' u 12r Street !• 1.41 / I/t4// f .:l Street X93 -7/�7 Date = ._. .. _1 S `-_ New Building___________ ...... Remodeling Addition..._.._ ..._ Repair No. of Stories Size Septic Tank— -Type of T ■mfr Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well..._._- .-- __._... _ Nature of Water Supply: City —WeIL ____._— _ - -. -- Size of Soakage Pit Amount of Permit 1 °2� O (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 5968, Compiled General Laws of Florida Permanent Supplement, and haT awn- 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 are required by the Act. The undersigned agrees to employ only such sub-contra k be . - , under this perinit, as are licensed by Miami Shores Village. Plumbing Inspector. Master Plumber. STATE OF FLORIDA, } u. 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 be 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of 11.00 will be made whoa scab minspaetfan !r mede by 'improper soda for Ia.psction, or faulty materials and/or workmanship. CLOUT. BATH BATH TUBS "°" "°" LAVA TORI[a sin" SLOP SINKS LAUNDRY TUat CATCH BASIN FLOOR DRAIN DRINK NO rOUNT•N[ I TOTAL TOTAL CONTR. Luz CHICK SEPTIC TANK SEWER CONN. DRAIN F I[LD SOAKAGE PIT G TRAP SOLAR HIAT[R DtUP WELL 6 SYST[M •WIM•O POOL I COMM LIST I CHECK ,-- Permit No &P- 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. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Owner's Name and Address Registered Architect and /or En Employing Plumber' beer' Name / on are g 71- piton Lot_ E I L Street and Number where work L to be performed —No State work to be performed and purpose of building (By (Si No M' u 12r Street !• 1.41 / I/t4// f .:l Street X93 -7/�7 Date = ._. .. _1 S `-_ New Building___________ ...... Remodeling Addition..._.._ ..._ Repair No. of Stories Size Septic Tank— -Type of T ■mfr Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well..._._- .-- __._... _ Nature of Water Supply: City —WeIL ____._— _ - -. -- Size of Soakage Pit Amount of Permit 1 °2� O (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 5968, Compiled General Laws of Florida Permanent Supplement, and haT awn- 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 are required by the Act. The undersigned agrees to employ only such sub-contra k be . - , under this perinit, as are licensed by Miami Shores Village. Plumbing Inspector. Master Plumber. STATE OF FLORIDA, } u. 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 be 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of 11.00 will be made whoa scab minspaetfan !r mede by 'improper soda for Ia.psction, or faulty materials and/or workmanship.