40 NE 95 St (6)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
Registered Architect and /or Engine______
Employing Plumber's Name
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-0--71-..1-f-/-7/ No.
No._
Location and Legal Description ______ Block_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) _
New Building_______ Remodeling
/
Street_ __.f.!r� -
Street__
Street.
Addition____________ Repairs No. of Stories . . .............. ......
Size Septic Tank .................. Type of Tank
Feet of Drain Tile _____Dist. Feet of Tank / oP.Drain Field from Well._
Nature of Water Supply: City — Well. t �__. Size of Soakage Pit
__ ______ ___ _ .
Amount of Permit $
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, 1
COUNTY OF DADE.
(Signed)_
(Signed)
Capacity Gals.
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•rlecessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
TUBS
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
mks IN
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
F OOL
CONTR.
LIST
CHECK
—
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
Registered Architect and /or Engine______
Employing Plumber's Name
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-0--71-..1-f-/-7/ No.
No._
Location and Legal Description ______ Block_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) _
New Building_______ Remodeling
/
Street_ __.f.!r� -
Street__
Street.
Addition____________ Repairs No. of Stories . . .............. ......
Size Septic Tank .................. Type of Tank
Feet of Drain Tile _____Dist. Feet of Tank / oP.Drain Field from Well._
Nature of Water Supply: City — Well. t �__. Size of Soakage Pit
__ ______ ___ _ .
Amount of Permit $
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, 1
COUNTY OF DADE.
(Signed)_
(Signed)
Capacity Gals.
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•rlecessary by improper notice for inspection, or faulty
materials and /or workmanship.
i
, 547
i t.
Nature of Water Supply: City —Well
Amount of Permit $
•
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Applu:aiion is bereby msde 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 _J_
No._ - Street
RegZdS rcec Plumber's Name�� — _1__4 1V _ I:_ MN Street
Location and Legal Description Lot__—_—___.__ — lock a Subdivision. ____._
Street and Number where work is t� be performed —No �� a Street
State work to be performed and purpose of building (By Floors)
New Building _____ ........ _____.. Remodeling___-_ ____ Addition__._ Repairs
Size Septic Tank Type of Tank__ Capacity Gals
C Feet of Drain Tile S - 4. Dist. Feet of Tank or Drain Field from Well _
_Size of Soakage Pit
( 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 5988, Compiled General Laws of Florida Permanent Supplement, and bus 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, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed )_____
Date _// A-". /
No. of Stories.
M aster Plumber.
SATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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.
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
plate ials and/or workmanship.
CLQBCrs
BATH
TUBE
SHOWERS
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
INAS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT' N5
TOTAL
FIXTURES
GONTR.
LIST
—
- -_
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM O
POOL
CONTN.
LIST
CHECK
, 547
i t.
Nature of Water Supply: City —Well
Amount of Permit $
•
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Applu:aiion is bereby msde 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 _J_
No._ - Street
RegZdS rcec Plumber's Name�� — _1__4 1V _ I:_ MN Street
Location and Legal Description Lot__—_—___.__ — lock a Subdivision. ____._
Street and Number where work is t� be performed —No �� a Street
State work to be performed and purpose of building (By Floors)
New Building _____ ........ _____.. Remodeling___-_ ____ Addition__._ Repairs
Size Septic Tank Type of Tank__ Capacity Gals
C Feet of Drain Tile S - 4. Dist. Feet of Tank or Drain Field from Well _
_Size of Soakage Pit
( 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 5988, Compiled General Laws of Florida Permanent Supplement, and bus 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, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed )_____
Date _// A-". /
No. of Stories.
M aster Plumber.
SATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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.
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
plate ials and/or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
:r'e•.. 4 z Date i•��
Application is hereby mai!e 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
buii'11r! during progress of work. -
Owae 'a Nart:e and Address _._______ __.-___ ____—___.
Registered Architect and /or Engin
Employing Plumber's Name - _Y_ -- No.__ -_— _ - __.._- Str
Location and Legal Descriptio t_._____ -_ _ _______ _ _ _ _ _ —Block Subdivisi
:itreet and Number where work is to be performed -No L E c � S ��- Street
/G
Siva work to be performed and purpose of building (By Floors) -.
Remodeling Add
New Building _ _- _ - -- g_._______._____.___. _S� ition_•
Size Septic Tank
Feet of Drain Tile_____
Type of Tank
Nature cf Water Supply: City - Well. - - -- ....... of Soakage Pit
Amount of Permit $ t_
My Commission Expires
(Signed)
Repairs
Capacity Gals
___Dist. Feet of Tank or Drain Field from Well
Street
No. of Stories. - .....t__..- .... .
Plumbing Inspector.
I
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob)Sgyhions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perinanefit 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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to are well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_
o; 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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•rleoessary by improper notice for inspection, or faulty
materials and /or workxnanship.
CLC'3Er
us YH
UCili
SHOWERS
LAVA-
TORIES
N
SINKS
NKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
Clz rare.
/
SZPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
F OOL
LIST ......
CHf_CK
(
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
:r'e•.. 4 z Date i•��
Application is hereby mai!e 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
buii'11r! during progress of work. -
Owae 'a Nart:e and Address _._______ __.-___ ____—___.
Registered Architect and /or Engin
Employing Plumber's Name - _Y_ -- No.__ -_— _ - __.._- Str
Location and Legal Descriptio t_._____ -_ _ _______ _ _ _ _ _ —Block Subdivisi
:itreet and Number where work is to be performed -No L E c � S ��- Street
/G
Siva work to be performed and purpose of building (By Floors) -.
Remodeling Add
New Building _ _- _ - -- g_._______._____.___. _S� ition_•
Size Septic Tank
Feet of Drain Tile_____
Type of Tank
Nature cf Water Supply: City - Well. - - -- ....... of Soakage Pit
Amount of Permit $ t_
My Commission Expires
(Signed)
Repairs
Capacity Gals
___Dist. Feet of Tank or Drain Field from Well
Street
No. of Stories. - .....t__..- .... .
Plumbing Inspector.
I
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob)Sgyhions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perinanefit 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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to are well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_
o; 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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•rleoessary by improper notice for inspection, or faulty
materials and /or workxnanship.
off
Cr
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
PERMIT
This permit is granted to the contractor or builder named above to construc 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.
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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant cr employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Bl.
Signed.
N9 2996
Work to be performed under this Permit
BY
Subdi-
vision
Value of
Project $
DATE 195.x;
Contractor's
License No.
BY
Amount of
Permit $
J.
AUTHORITY
1'
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 4 k.. No. 4'O_. _. __— Street/t/' 1
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot.
Street and Number where work is to be performed —No
6/d
State work to be performed and purpose of building (By Floors)____
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
New Building Remodeling_ . —.____ Addition
Size Septic Tank__— .- ___-•- --- --- -- - - - -- ._Type of TPrik_-
Feet of Drain Tile_ —___- — _-- -Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. —
Amount of Permit $
My Commission Expires
No .� .,...... Street..4ez. :, ..�°.
Bloch Subdivision._
Street -- - -_ __ — •—
Street' "x
ect2 i 1.�S- It -►t fl
Repairs No. of Stories
-__._-_—_-Size of Soakage Pit
(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 6888, Compiled General Laws of Florida Perinanent Supplement, and liar 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
Capacity Gals ._._...__.___._
77
PIumbing Inspector.
STATE OF FLORIDA, t ss.
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 lie is the ._.__.. -- • - - -- .• •-- •• - - - -• -- ....._ _..
of the above described construction, that be has carefully reed the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Publlo, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when arch re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
NOW [
SRS
LAVA-
TORIES
SINKS
SLOP
SINK[
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N•
TOTAL
FIXTURES
CONTR.
LIST
—
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
sPRKLR.
SYSTEM
SWI1
POCIL
-
-
CONTR.
LIST
� ,
�"
�
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 4 k.. No. 4'O_. _. __— Street/t/' 1
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot.
Street and Number where work is to be performed —No
6/d
State work to be performed and purpose of building (By Floors)____
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
New Building Remodeling_ . —.____ Addition
Size Septic Tank__— .- ___-•- --- --- -- - - - -- ._Type of TPrik_-
Feet of Drain Tile_ —___- — _-- -Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. —
Amount of Permit $
My Commission Expires
No .� .,...... Street..4ez. :, ..�°.
Bloch Subdivision._
Street -- - -_ __ — •—
Street' "x
ect2 i 1.�S- It -►t fl
Repairs No. of Stories
-__._-_—_-Size of Soakage Pit
(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 6888, Compiled General Laws of Florida Perinanent Supplement, and liar 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
Capacity Gals ._._...__.___._
77
PIumbing Inspector.
STATE OF FLORIDA, t ss.
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 lie is the ._.__.. -- • - - -- .• •-- •• - - - -• -- ....._ _..
of the above described construction, that be has carefully reed the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Publlo, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when arch re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
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.
Owners Name and Address .,41e'Xit. Cv" No
Registered Architect and /or Engineer 0, 7 /S /ne'l a re, P
Employing Plwmberr Name
Location and Legal Description Lot Bloch SubdfvWon.______.
Street and Number where work is to be performed —No 'o /' // Street._ - 7e
State work to be performed and purpose of building (By Floors) ___ti�� eL _..__ /° a,C
New Building -- -- _ —_ - -- __. Remodeling— __._- _---__ Addition.- - -__. —_.._ Ropatrs_ No. of Stories ....
Size Septic Tank —
Feet of Drain Tile-L`L _. /! _Dist Feet of Tank or Drain Field from Well.
Nature of Water Supply: Ci —Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank___...
Size of Soakage Pit..
(Signed)-
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation s an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent pplement, and Ilan 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 u are
required by the Act. The undersigned agrees to employ only such sub - contractors, on w be perf�in� permit, as are
licensed by Miami Shores Villages
S/o , (iE
Street... i S
Capacity
P1
big Inspector.
Muter Plumber.
STATE OF FLORIDA, ( µ
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 fads
therein by him stated are true.
M Commission Expos Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made whet such rriaspemion le mede•mnaawry by improper notice for lbsspection, or faulty
materials and /or workmanship.
GLOetrs
BATH
Tuns
S
LAVA.
TORIES
SIN"
SLOP
SINKS
LAUNDRY
Tugs
URINALS
CATCH
SAS! If
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURE[
CONTR.
LIST
CHECK
�e
•_
SEPTIC
TANK
SEWER
Comm.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DRIP
WILL
SPRKLR
5
SW IN'S
POCIL
CONTR.
LIST
MI/ I YJ
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CHICK
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.
Owners Name and Address .,41e'Xit. Cv" No
Registered Architect and /or Engineer 0, 7 /S /ne'l a re, P
Employing Plwmberr Name
Location and Legal Description Lot Bloch SubdfvWon.______.
Street and Number where work is to be performed —No 'o /' // Street._ - 7e
State work to be performed and purpose of building (By Floors) ___ti�� eL _..__ /° a,C
New Building -- -- _ —_ - -- __. Remodeling— __._- _---__ Addition.- - -__. —_.._ Ropatrs_ No. of Stories ....
Size Septic Tank —
Feet of Drain Tile-L`L _. /! _Dist Feet of Tank or Drain Field from Well.
Nature of Water Supply: Ci —Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank___...
Size of Soakage Pit..
(Signed)-
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation s an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent pplement, and Ilan 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 u are
required by the Act. The undersigned agrees to employ only such sub - contractors, on w be perf�in� permit, as are
licensed by Miami Shores Villages
S/o , (iE
Street... i S
Capacity
P1
big Inspector.
Muter Plumber.
STATE OF FLORIDA, ( µ
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 fads
therein by him stated are true.
M Commission Expos Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made whet such rriaspemion le mede•mnaawry by improper notice for lbsspection, or faulty
materials and /or workmanship.