PLUMBINGBUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
n
PERMIT N? 13475
Work to be performed under this Permit
BL
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 ' e statements or specifications and th he assumes responsibility for work
done by his agents, servants or employees. -
Signed•
INSPE C}J�',
In consideration of the issuance to me of this permit I agree to perform the work coverell hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, star or jpecifications submitted to the proper authorities of Miami Shores Village.
, my agent, servant or employee.
In accepting this permit I assume responsibility or all work done b either,
CONTRACTOR OR BUILDER
BY
DATR
Contractor's
License No
Amt. of
Permit
4 495
AUTHORITY
Architect
Contractor
or Builder
Leggy "`dot
Description
ar A � ,,
Address of
Building �C rd,:
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
BUILDING
ELECTRICAL 1 1 PERMIT N? 13289
PLUMBING
ROOFING
❑ Work to be pert rmbd under this Permit
Owner of A / ',�f "N , ,�'
Building j : y , " 4�.+` -., 4.r
r"
f
BI.
Subdi-
vision
Value of
Project $
Signed
INSPECR
BY
DATE
6)/V -t 195 .r
Contractor's
License No
Amt. of
Permit
AUTHORITY
This permit is granteVto the contractor or buil r named above to cdnstruct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances perta ing thereto and with the tin tanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to Arid approve by e 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.
ordinances nd regulations
In consideration of the issuance to me of this hermit I agree to .perform the work covered hereunder in compliance with all
pertaining thereto and in strict conformity with the plans, drawinggs, statements or specifications submitted to the proper authorities of Miami �hores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CLOSETS
corm. i
war
CHECK 2S0
Amount of Permit 1 -- —
OATH
TUBS
/ S
SEPTIC SEWER
TANK CONN.
SHOWERS
`6
DRAIN
FIELD
CONTR.
CHICK Pc)
Size Septic Tank
Feet of Drain Tile
Nature of Water SupplyQCBWel
0
LAVA-
TORIES
225
SOAKAOE
PIT
2t5
z
1 J�
APPLICATION FOR PLUMBING PERMIT - . _ r
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Permit No.... ._..__
Application is hereby mad or the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein descri . This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of th 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, th, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. / t . ; ; , ' ' '
Owner's Name and Address =- - - - -=- - -- No. Street
Registered Architect and /or Engineer_ _-- __.__ __._..............__ -
Employing Plumber's Name ' - - -- ---- -- - - - -. - ' , — No. — -- --- — Street.
and Legal Description Lot Block
_ __
Location
Lose where work is to be performed —No.. w i �K �-- Street.
Street and Number - --• 'i'
State work to be performed and purpose of building (By Floors) _ —. -. .--- ..- ___.._ .._ ._.._-- .- -.__.. _..___.. -_ -• --
Remodeling _ ... Addition_._._....... -. -.__ Repair& No. of Stories
Now Building '�'�• -"
SINK.
15
GREASE
TRAP
SLOP
SINKS
HEATER •
fir
LAUNDRY
Tuns URINALS
a.
DEEP
WELL
: :Tye of Tank- ---_ .- —
SPRKLR.
STETEM
CATCH
BASIN
SWIM
POOL
FLOOR
DRAIN
Capacity Gals
/ . e le. Feet of Tank or Drain Field from Well.
i
_..._ ..... .... -._.. .Size of Soakage Pit.. - --- - - - ---
DRINKING
FOUNT' NS
1
The undersigned applicant for this building permit does hereby . • fy that - derstands and accepts his obligations an•employer .f labor
under the Florida Workmen's Compensation Act, being Section 6968, " ' p -' eral Laws of Florida Pennanent Supplement, and as com-
plied with the provisions thereof, and will require similar compliance ' ' ,Il contractors or sub - contractors employed by him in rk 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 notices as as are
are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under
Beamed by Miami Shores Village
y
TOTAL
FIXTUNII
STATE OF FLORIDA, 1 m ,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appears
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 fur
therein by him stated are true.
_....._._._ My Commission Expires .� .�_. Notary Public, State of Florida
�• n such re- inspection is made necessary by improper notice for inspection, or feu)
Permit No. F'
Application is hereby made for the approval of the detailed statement of the plans and specifications here ttlsubmitted r 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
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot___
Street and Number where work is to be performed -No
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
r ,
�_.L- __�`�_ No.____ Street
No Street
___ -- Block..
6 �
o o_ _ - -- - - -- - -- _ _ —_�_ (Signed
Subdivision
E,'
- �. F
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 Dist. Feet of Tank or Drain Field from We1L
Nature of Water Supply: City-Well- Size; of Soakage Pit
P) imbing Inspector.
The undersigned applicant for this building permit does hereby certify that he . erstands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ce eral Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all actors 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 arc
/ /' /
licensed by Miami Shores Village.
(Signed) � - - --
Mast
My Commission Expires Notary Public, State of Florida
umber.
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.
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
TUBE
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.
LIST
CHECK
Permit No. F'
Application is hereby made for the approval of the detailed statement of the plans and specifications here ttlsubmitted r 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
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot___
Street and Number where work is to be performed -No
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
r ,
�_.L- __�`�_ No.____ Street
No Street
___ -- Block..
6 �
o o_ _ - -- - - -- - -- _ _ —_�_ (Signed
Subdivision
E,'
- �. F
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 Dist. Feet of Tank or Drain Field from We1L
Nature of Water Supply: City-Well- Size; of Soakage Pit
P) imbing Inspector.
The undersigned applicant for this building permit does hereby certify that he . erstands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ce eral Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all actors 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 arc
/ /' /
licensed by Miami Shores Village.
(Signed) � - - --
Mast
My Commission Expires Notary Public, State of Florida
umber.
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.
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.
11 ZilAOHP,
• _ .25 C
T3a gay,: .;
_ mrAfl
1
1-74 -Fa.]
r
_ // t.77 e.
•
BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑
ROOFING ❑
Owner of `l .
Building
Architect
Contractor
or Builder
Legal
Description
MIAMI SHORES VILLAGE, FLORIDA
DATE__�i- 1 10
PERMIT
0
Lot
B1
N° 5249
I t
Subdi-
vision
Contractor's
License No. '
Work to be performed under this Permit_
Address of
t Value of II Amount of �1
Building # -2 ' ( ; i Project $ I� Permit $ �.1
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. if 'a _ / INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compli. ce with all ordinances and regulations
pertaining thereto and in strict conformity, with the plans, drawings, statements or specifications submitted to the proper • thorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my age t, servant or employee. ;
s •
— 1 ` coNTRACrOR OR BUILD' ' BY AUTHORITY .INOT
Permit No '
c �- -
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.
Size Septic Tank
Feet of Drain Tile_
Amount of Permit
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Owner'a Name and Address No.
Registered Architect and /or Engin --___ /1
Employing Plumber's Name � — .4/� - Street
Location and Legal Description Lot_--__- _.___.______-_---__- ��Bjjlf�ock Subdivision
Street and Number where work is to be performed —No 1 9 — dffi - -_ Street
State work to be performed and purpose of building (By Floors) __- . _____._____.___________._____
New Building ____ ___ Remodeling— ___.____.____ ____ Addition______.__ Repairs No. of Stories.
Date.
s" s�
Street.
Capacity Gals.
ee 'o j ank or Drain Field from Well
Nature of Water Supply: City— Well.____ —______ _______________ .... _____._Size of Soakage Pit
C Q
Plumbing Inspector.
(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 5988, 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 perform ed 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
Master Plumber.
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
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
comm.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
`
Permit No '
c �- -
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.
Size Septic Tank
Feet of Drain Tile_
Amount of Permit
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Owner'a Name and Address No.
Registered Architect and /or Engin --___ /1
Employing Plumber's Name � — .4/� - Street
Location and Legal Description Lot_--__- _.___.______-_---__- ��Bjjlf�ock Subdivision
Street and Number where work is to be performed —No 1 9 — dffi - -_ Street
State work to be performed and purpose of building (By Floors) __- . _____._____.___________._____
New Building ____ ___ Remodeling— ___.____.____ ____ Addition______.__ Repairs No. of Stories.
Date.
s" s�
Street.
Capacity Gals.
ee 'o j ank or Drain Field from Well
Nature of Water Supply: City— Well.____ —______ _______________ .... _____._Size of Soakage Pit
C Q
Plumbing Inspector.
(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 5988, 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 perform ed 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
Master Plumber.
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.
Permit No 1°C? 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 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___ _ _ _ _ ..._ ° IL
Registered Architect and /or Ennggineer'S4_-_ _
p—_ � �',�/
Employing Plumber's Name J v il "1_:1=W (--5 No. L 4- 3
Location and Legal Description Lot Blor1r Subdivision
l
Street.! / Y ✓�
Street and Number where work is to be performed -No
S t a t e w o r k t o be performed and purpose of b u i l d i n g (By Floors)_ ___ -- 42/ ViY _-S/ R/NXI- E
New Building
Size Septic Tank.. -____-________— _—_--- _____Type of Tank_
Feet of Drain Tile ______Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - l� - / _) 4 �_ _ __- __ __Size of Soakage Pit
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE. j
Remodeling_ __ ______ .____ Addition
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) _
No. _ ___� Streetl___ F174 S 7-
Plumbing Inspector. -
The undersigned applicant for this building permit does hereby certify that he understands and accept f is 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 tlie Act. The undersigned agrees to employ only such sub- contractors, 0, work to be performed under this permit, as are
licensed by Miami Shores Village.
�"•- 1,
(Sign
- Street[
My Commission Expires Notary Public, State of Florida
7`' 57°'
Repairs No. of Stories . . .....................
Capacity Gals.
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.
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
TUBS
S
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N6
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
1---r
CHICK
Permit No 1°C? 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 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___ _ _ _ _ ..._ ° IL
Registered Architect and /or Ennggineer'S4_-_ _
p—_ � �',�/
Employing Plumber's Name J v il "1_:1=W (--5 No. L 4- 3
Location and Legal Description Lot Blor1r Subdivision
l
Street.! / Y ✓�
Street and Number where work is to be performed -No
S t a t e w o r k t o be performed and purpose of b u i l d i n g (By Floors)_ ___ -- 42/ ViY _-S/ R/NXI- E
New Building
Size Septic Tank.. -____-________— _—_--- _____Type of Tank_
Feet of Drain Tile ______Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - l� - / _) 4 �_ _ __- __ __Size of Soakage Pit
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE. j
Remodeling_ __ ______ .____ Addition
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) _
No. _ ___� Streetl___ F174 S 7-
Plumbing Inspector. -
The undersigned applicant for this building permit does hereby certify that he understands and accept f is 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 tlie Act. The undersigned agrees to employ only such sub- contractors, 0, work to be performed under this permit, as are
licensed by Miami Shores Village.
�"•- 1,
(Sign
- Street[
My Commission Expires Notary Public, State of Florida
7`' 57°'
Repairs No. of Stories . . .....................
Capacity Gals.
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.
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.