271 NE 95 St (7)BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
v
MIAMI SHORES VILLAGE, FLORIDA
DATE �+ —�-- / 1 954_
Contractor's
License No
Li PERMIT N? 10667
Work to be performed under this Permit
Owner of
Building
Subdi.
vision
Legal Lot Bl.
Description
Address of ;
Building f° / 4. i i �s , .„ b.
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 a y
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 permitjis
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 statelnetts or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Value of
Project $
Amt. of
Permit
Signed: 1 r r BY d.
I SPECTOR
$ /.._----- ••∎•∎∎ •,...
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.
f..rrA ./�] •P CONTRACTOR OR U LbER w BY A
ORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 'C 1951_
Contractor's
License No
H PERMIT N? 10107
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project $
Amt. of
Permit $
BY AUTHORITY
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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of /
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 10117
Work to be performed under this Permit
BI.
f
Subdi-
vision
Value of
Project $
DATE
s
i
Amt. of
Permit $
BY AUTHORITY
195 y
Contractor's
License No
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 statem is or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • ., . 4* r BY
INSPECTOR 1
In consideration of the issuance to me of this permit I agree to porform the work covered hereunder in compliance with 1 ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper autho ties of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
"vrsriit. No.- -- 7
Date �'/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or, other
st- cture 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
Registered Architect and /or En . ..__
Employing Plumber's Name
Location and' Legal Description Lot
Street and Number where work is to be performed —No
New Building ___ ___ Remodeling Addition._
Size Septic Tank
Feet of Drain Tile_________
Amount of Permit $
9
Nature of Water Supply: City —Well.
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
A DDM_ICA_ TIAAI CAD .DII IMRIMG_AERMIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.__— —
State work to be performe8 and purpose of building (By Floors) ____.___.... _.....
_________.___
Street
Street. - _._
Subdivision_ .... --- ..............
- - - Street
Repairs No. of Stories.
_ ( Signed)_
Capacity Gals
Drain Field from Well
_Size of Soakage Pit
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) - -Q/ ' °CY " . .1"4
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.
• 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 faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
rues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N6
TOTAL
FIXTURES
CONTR.
LIOT
CHECK
—_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'S
POOL
CONTK.
LIST
- - --
CHECK
_
"vrsriit. No.- -- 7
Date �'/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or, other
st- cture 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
Registered Architect and /or En . ..__
Employing Plumber's Name
Location and' Legal Description Lot
Street and Number where work is to be performed —No
New Building ___ ___ Remodeling Addition._
Size Septic Tank
Feet of Drain Tile_________
Amount of Permit $
9
Nature of Water Supply: City —Well.
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
A DDM_ICA_ TIAAI CAD .DII IMRIMG_AERMIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.__— —
State work to be performe8 and purpose of building (By Floors) ____.___.... _.....
_________.___
Street
Street. - _._
Subdivision_ .... --- ..............
- - - Street
Repairs No. of Stories.
_ ( Signed)_
Capacity Gals
Drain Field from Well
_Size of Soakage Pit
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) - -Q/ ' °CY " . .1"4
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.
• 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 faulty
materials and /or workmanship.
t
Size Septic Tank
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No / 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 No. Street
Registered Architect and /or Engineer
' i
Employing s Name U % ` "' No ��" 4 "'`—`= -- Street / 1 ' 'CV Y irti
Location and Legal Description Lot �' l Block Subdivision �
Street and Number where work is to be performed —No � i. X 17 s - � Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Type of Tank Capacity Gals.____
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit / 4 )/
Amount of Permit $ (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.
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
(Signed)
My Commission Expires Notary Public, State of Florida
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 workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
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
CHECK
/ r as C>
/ •
t
Size Septic Tank
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No / 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 No. Street
Registered Architect and /or Engineer
' i
Employing s Name U % ` "' No ��" 4 "'`—`= -- Street / 1 ' 'CV Y irti
Location and Legal Description Lot �' l Block Subdivision �
Street and Number where work is to be performed —No � i. X 17 s - � Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Type of Tank Capacity Gals.____
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit / 4 )/
Amount of Permit $ (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.
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
(Signed)
My Commission Expires Notary Public, State of Florida
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 workmanship.
Permit No.!
Amount of 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.
Owner's Name and Address__ 12
Registered Architect and /or Engineer
Employing Plumber's Name
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
Location and Legal Description Lbt r%
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•1
/ ° No. 2 d
�v7 2f
( Signed)
Street
No 4 1 i. al Street lv
Block s_ Subdivision t ° ' _'
Street and Number where work is to be performed —No P _2 / Street___- q..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 Well
Nature of Water Supply: City —Well Size of Soakage Pit
� v
(Signed) '
, Inspector.
The undersigned applicant for this building permit does hereby certify that he i dfrstands and accepts his obligations s an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene al Laws of Florida Permanent(S pplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contactors or sub- contractors employed by him in the work to be
performed under this permit; and will post or cause to be ppsted 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
licensed by Miami Shores Village.
Notary Public, State of Florida
this permit, as are
/
l .r
Master P,,It tuber.
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 workmanship.
S
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LA UNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT 'NS
�,. -
4 /
H. c:'
, . . i (,
/
TOTAL
FIXTURES
CONTR.
LIST
/
/ e
_.—.I—
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
ifrCyr
.. ,
CONTR.
LIST
/
/
J
C
CHECK
Permit No.!
Amount of 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.
Owner's Name and Address__ 12
Registered Architect and /or Engineer
Employing Plumber's Name
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
Location and Legal Description Lbt r%
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•1
/ ° No. 2 d
�v7 2f
( Signed)
Street
No 4 1 i. al Street lv
Block s_ Subdivision t ° ' _'
Street and Number where work is to be performed —No P _2 / Street___- q..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 Well
Nature of Water Supply: City —Well Size of Soakage Pit
� v
(Signed) '
, Inspector.
The undersigned applicant for this building permit does hereby certify that he i dfrstands and accepts his obligations s an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene al Laws of Florida Permanent(S pplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contactors or sub- contractors employed by him in the work to be
performed under this permit; and will post or cause to be ppsted 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
licensed by Miami Shores Village.
Notary Public, State of Florida
this permit, as are
/
l .r
Master P,,It tuber.
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 workmanship.
S
Permit No. /__ -
Registered Architect and /or Engine r
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No
Amount of Permit $ 4' 1
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
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.
,
Owner's Name and Address '! / �f �_ _ e No Street
No Street
Blo ck / Subdivision
2 / , A Street /
State work to be performed and purpose of building (By Floors)
New Building i ' Remodeling Addition Repairs No. of Stories
Size Septic Tank 0
Feet of Drain Tile 7 Dist. Feet of Tank or Drain Field from Well
r -1{
Type of Tank �-� i f it 4
( Signed)
Nature of Water Supply: City —Well Size of Soakage Pit
�, �r /
Date I �/
is
Capacity Gals
(Signed' jr_' -- i
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 $966, 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, o work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
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 workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
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. /__ -
Registered Architect and /or Engine r
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No
Amount of Permit $ 4' 1
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
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.
,
Owner's Name and Address '! / �f �_ _ e No Street
No Street
Blo ck / Subdivision
2 / , A Street /
State work to be performed and purpose of building (By Floors)
New Building i ' Remodeling Addition Repairs No. of Stories
Size Septic Tank 0
Feet of Drain Tile 7 Dist. Feet of Tank or Drain Field from Well
r -1{
Type of Tank �-� i f it 4
( Signed)
Nature of Water Supply: City —Well Size of Soakage Pit
�, �r /
Date I �/
is
Capacity Gals
(Signed' jr_' -- i
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 $966, 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, o work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
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 workmanship.
—_ —�
CLOSETS
BATH
TUS[
eNOW[RS
LAVA•
TORIES
SINKS
GLOP
SINKS
LAUNDRY
TUSS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT',,.
TOTAL
FIXTURES
Comm
LIST
CHECK
_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM
POOL
CONTR.
LIST
CHECK
APPLICATION FOR PLUMBING PERMIT
Permit No. . + K 1 � ) Date... - -•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 must be kept at
building during progress of work. <
.�eo �►�1�1't!lG' 9 % No Street/ v / ✓ S ..
Owner's Name and Address
Registered Architect and /or Engineer .4
Employing Plumber's Munro g god ��
/ anon A nuralfer e k / / •
$ where wor L t¢ be perf —No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
State work to be performed and purpose of building (By Floors)__._.— _ - _ — - 2'_ - -. u�
New Building - -_... _ — _.._........ -.._.. Remodeling_--._ —__ Addition.. - - -- —.._ Repairs
B °Z SuubclivWor2Lic i' A142
Street. /Vie l . s 7
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
`/
Amount of Permit $ ? (Signed) _ -� ` — 1 N l / _ - -- 1 ... .
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 5888, Compiled General Laws of Florida Permanent Supplement, and lids 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 public notice or notices as
required by the Act. The undersigned agrees to employ only such sub - contractors, work to
licensed by Miami Shores Village.
(SI
ormed under this permit, as
Master Plumber.
arP
are
STATE OF FLORIDA,
COUNTY OF DADE. r
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 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 $1.00 will ba ands when Walt miampBOtlan is mnade.naonnry by bnproper notice for impaction, or faulty
materials and /or workmanship.