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PLUMBINGBUILDING ELECTRICAL PLUMBING • Owner of Building Architect Contractor or Builder Legal Lot Bl. Description Address of Building 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 appli- cation 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 unicipal 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 hanged 'tho uthorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above ass ; rs the ' .nsib' ' y f. orough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the s em: is o specifications and that he assumes respon- sibility for work done by his agents, servants or employees. ` Signed //. r�l./� : r j R By In consideration of the issuance to me of this permit I agree to perform the wor c ive hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specific ons submitted to the proper authorities of Miami Shores Village. In,accepting this permit I assume responsibility for all work done by either myself, my age t, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE i .:e n2 / 194 E R M I T N° 5365 No Contractor's 76. Work to be performed under this Permit (2.499‘ is C„ Tam a0 Subdi- vision Value of Project Arnt. of Permit w BY AUTHORITY 2 ,O_ �� ,. Permit 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 woik. Owner's Name and Address Amount of Permit $____' STATE OF FLORIDA, ) COUNTY OF DADE. Registered Architect and /or Engineer Employing Plumber's Name _ =, ." Nature of Water Supply: City -Well ss. • l c- MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ' -! 1 No Street__ No ; . �? C.: / t 'tSileet Location and Legal Description Lot _______ __________ — 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 Addition____ Repairs Size Septic Tank Type of Tank Feet of Drain Tile - Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) My Commission Expires Notary Public, State of Florida i r Subdivision °` Street No. of Stories 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 afl' 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. 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 FOU NT' 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. ST LIST ✓ 7G�_ }� _ CHECK ,. Permit 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 woik. Owner's Name and Address Amount of Permit $____' STATE OF FLORIDA, ) COUNTY OF DADE. Registered Architect and /or Engineer Employing Plumber's Name _ =, ." Nature of Water Supply: City -Well ss. • l c- MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ' -! 1 No Street__ No ; . �? C.: / t 'tSileet Location and Legal Description Lot _______ __________ — 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 Addition____ Repairs Size Septic Tank Type of Tank Feet of Drain Tile - Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) My Commission Expires Notary Public, State of Florida i r Subdivision °` Street No. of Stories 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 afl' 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. 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 $ STATE OF FLORIDA, t COUNTY OF DADE. ell 1 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____,G.? e'raisZC ___ _1..re',:Le No._ Registered Architect and /or Engineer Employing Plumber's Name_____ 1_!_ .,,, .____ °Pi_ :_____14°1,.2_LLr___t'r!'('( No. J -./_,6 Street d` a „ v Location and Legal Description Lot/ __y * __'s _it L9 Block • Subdivision_) iZ ` I1 1" L .18_°____ Street and Number where work is to be performed —No 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 (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 perforned 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. Street__ .� d •f �'� __ �� Date__ • ' c e Street 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 LAUNDR TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS /. ��� TOTAL FIXTURES CONTR. LIST ,.. y� _L______ .. /. CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL //f�',,° ,.. q,,, :g . CONTR. LIST / CHECK Permit No Amount of Permit $ STATE OF FLORIDA, t COUNTY OF DADE. ell 1 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____,G.? e'raisZC ___ _1..re',:Le No._ Registered Architect and /or Engineer Employing Plumber's Name_____ 1_!_ .,,, .____ °Pi_ :_____14°1,.2_LLr___t'r!'('( No. J -./_,6 Street d` a „ v Location and Legal Description Lot/ __y * __'s _it L9 Block • Subdivision_) iZ ` I1 1" L .18_°____ Street and Number where work is to be performed —No 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 (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 perforned 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. Street__ .� d •f �'� __ �� Date__ • ' c e Street 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. fro ! .1 Ar /jfia BUILDING 'ELECTRICAL PLUMBING • Work to be performed under this Permit "2-2 e r„ �uilding v' 0 1 n ( j `-� 1 .� Architect Contractor or Builder Legal Description MIAMI SHORES VILLAGE, FLORIDA DATE 14. ' /, i 1. 1 1"1944 RMIT N9 5256 License tors I i1 7 1 No. 01.1,- A . / A c �Jp ��� � Signed. Subdi- vision s1. � .r w Value of Amt. of e Address of Building i ' d f i • Proje P a This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been .submitted to and approved by the proper municipal authorities. This Permit nay be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assume e respozi.'lity for . thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or draw' s or th a men or s. �� ications and t1,hetE[s�umes respon- sibility for work done by his agents, servants or employees. �s �/ a ( INSPECT By In consideration of the issuance to me of this permit I agree to perform the work covered here e tlider in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications sull�Smitted to the proper authorities of Miami Shores Village., In acc p ing this permit I assume responsibility for all work dpne by eithe dsyself gent, servant or em 0, PA 8 .$i 0 CONTRACTOR OR BUILDER AUTHORITY MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No a 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_ _ _/' 1! �!11_�_' _---- _- - -__ -_ No. ` _ - Registered Architect and /or Engineer _ . Employing Plumber's Name, -W.- .ta_422L. 7'', 74 -t r. No., 2 Street4l 177 Location and Legal Description Lot________ Block_ Subdivision _ ____.:___._ Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors )_ New Building Remodeling.— Addition_ Amount of Permit $ STATE OF FLORIDA, as. COUNTY OF DADE. (Signed). Date t0`�� / `y am Stree �. Street f Repairs No. of Stories. Septic Tank_- __ --_ -_ / -- -_ - --- — o Type of Tank Feet of Drain Tile. F� 4 �i� — ` -- Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.______ _ _ _ ___ Size of Soakage Pit 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 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 performed under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida Master Plumber. 1,9 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 TUBE SHOWERS LAVA• TORIES SINKS SLOP SINKS LAUNDRY TUB, URINALS CATCH BA,IJ1 FLOOR DRAIN DRINK! NO FOUNT' NS TOTAL FIXTURES CONTR. LIST a CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL COMM. LIST CHECK -- MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No a 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_ _ _/' 1! �!11_�_' _---- _- - -__ -_ No. ` _ - Registered Architect and /or Engineer _ . Employing Plumber's Name, -W.- .ta_422L. 7'', 74 -t r. No., 2 Street4l 177 Location and Legal Description Lot________ Block_ Subdivision _ ____.:___._ Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors )_ New Building Remodeling.— Addition_ Amount of Permit $ STATE OF FLORIDA, as. COUNTY OF DADE. (Signed). Date t0`�� / `y am Stree �. Street f Repairs No. of Stories. Septic Tank_- __ --_ -_ / -- -_ - --- — o Type of Tank Feet of Drain Tile. F� 4 �i� — ` -- Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.______ _ _ _ ___ Size of Soakage Pit 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 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 performed under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida Master Plumber. 1,9 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. JILDING , ECTRICAL UMBING PERMIT N2 5365 Work to be performed under this Permit wner of gilding •chitect MIAMI SHORES VILLAGE, FLORIDA Detractor Builder ;gal Lot Bl. escriptibn dress of gilding 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 appli- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any ms, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked 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 rmit is granted is the understanding that the contractor or builder named above assumes the responsibility fo ;-a thorough knowledge of the ordinances and =ulations pertaining to the work covered hereby whether shown on the plans or drawings or in,he statements or Specifications and that he assumes respon- ;ility for work done by his agents, servants or employees. - Subdi- vision Value of Project DATE Contractor's License No. Amt. of z) Permit ' f CONTRACTOR OR BUILDER BY AUTHORITY 1944 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 rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 9./Y Job Address 7/ /v( 9 Tax Folio 11 2 e6 /3 no (lJ Legal Description /a L J '/ Owner's Address Vie- ' Phone Contracting Co. ‘A/7/ I Vt/ n LJ'4' Address Qualifier ( AI Z- ss# ? Phone 073-'1138 State # CR' -035 '8&Municipa1 # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address I Permit Type(crcle one): BUILDING ELECTRICAL 'LUMBIN MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION :, otar -a to FEES: PERMIT -3©' Oo APPROVED: / Lessee / Tenant //b5 )7 Zoning Mechanical Square Ft. Estimated Cost(value) 4 Master Permit 4P J 3,a 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 beodone co with all applicable laws regulating construction and ping. Furthermore, I a{ithorize�� a bove -named contracto to do the work stated. First � - National Ban' oo FL. Signature of; 'p er and /or Conte• J� ICER Date' " • & p name o otary Public DOR Produced I.D ►e Idler Signa Date: er and /or Condo President My ° 65Mnissi•n Expires:Audr Fetscher AV PUBLIC S1FI OF ,� COISSION EXP. JAN.19,1995 ** * * IY =CIO GE kRAL INS, *UND, * N' ar 'as to Contracto `o'r e ' '�or � M Commission Ex Y take an th, DID NOT take an oath. RADON C.C.F. , -5 NOTARY 5 • O O TOTAL DUE -W.0 Fire Other Buildin: _ Electrical Plumbin neering Permit No. Street and Number where work is to be performed — No. Street State work to be performed and purpose of building (By Floors) New Building Size Septic Tank Feet of Drain Tile Nature of Water Supply: City - Well 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 the progress of work. Owner's Name and Address IWS'S I No. 4 1 Street / V k 9 5 S7 Registered Architect and /or Engineer in M. A M 1 P O 491010L QP1%r Zvi 4 .. Employ 6 g P /3 2 7 i 4 l M A SEPTie 7, s / Location and Legal Descripti Lot : ✓/' L J ke L.et y S b Remodeling Addition Repairs 1 . rILF Date 310 No. E J Street NE � ) A Block Subdivision )JL<C'J/ , �-� A/E 96 ()Mt t ' Type of Tank Capacity Gals. Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit No. of Stories 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 complied 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 he undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village (Signed) STATE OF FLOR tIA, COUNTY OF DA E. SS. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, an d 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 $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS 1 BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNTAINS 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. Street and Number where work is to be performed — No. Street State work to be performed and purpose of building (By Floors) New Building Size Septic Tank Feet of Drain Tile Nature of Water Supply: City - Well 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 the progress of work. Owner's Name and Address IWS'S I No. 4 1 Street / V k 9 5 S7 Registered Architect and /or Engineer in M. A M 1 P O 491010L QP1%r Zvi 4 .. Employ 6 g P /3 2 7 i 4 l M A SEPTie 7, s / Location and Legal Descripti Lot : ✓/' L J ke L.et y S b Remodeling Addition Repairs 1 . rILF Date 310 No. E J Street NE � ) A Block Subdivision )JL<C'J/ , �-� A/E 96 ()Mt t ' Type of Tank Capacity Gals. Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit No. of Stories 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 complied 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 he undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village (Signed) STATE OF FLOR tIA, COUNTY OF DA E. SS. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, an d 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 $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI 'SHORES VILLAGE, FLORIDA / ,,P'RMIT N° 5256 1 .•O.J 1 Work to be performed under this Permit " / Architect Contractor or Builder ti • Legal Lpx t r Bl. �» Subdi- Description I ✓ .V vision Address of Building r • Signed. Value of Project DATE Contractor's j License No. `� + Amt. of Permit CONTRACTOR OR BUILDER 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 appli- cation 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. r I - B , INSPECT9..* 194 l 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.