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PLUMBING474 N. E. 95th St. "trip( F. nnito (o) -g.- �'a�•rrnr rj - year annual tax /4s/ period used /a ,b/• 5f s °c7l amount paid date paid receipt # /lo ..41001 PAID BY �S y ✓ f '�/ �/ / YEA 'ANNUAL TAX . PERIOD USED AMOUNT PAID . °P°6 DATE PAID b NUMBER // f AlIFAM „., ,/e._.- 0 1940 i ' ` / _ i. � .r i/ 1941 / L/ J / -c. - / &43--_2, Al. e. I / , 1942. l0 O0 / .1 7 -s‘) - 7 -J as:// '/7' )- 5 P7 71) a e ?/61 6 , 1 Altil. ? f f , //t J/.... -x ' 1943 /V ' o o , ( r 1944 1945 * / 3-0 /../8”- a •- /et ei'� /d II 1946 M. 0 6 , - 0 % "'" `7/ 1947 h. 0 O IV 3 / ` -J�v / 'i 1948 1949 /a�^ 9' 00 /.?'r� / -`/ /1p3/ °V7 /a - J/ 5 f/ Q II 7'2 9 /1- 3e - (ft a - - c5 4 / /D F/7 /A 6/0 /7f77 1 r ii - ( o ' - - /o?•ijf 1950 LOCATION 474 lv. .;. 95th titreot GARBAGE TAX RECORD OWNER LOT BLOCK SUBDIVISION — 1 646 X- 1' :7 04:1 Al gkirfr;* r'll'20-' Viiii----1--- Issued to y ✓ j to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing 1 d`nd drainage work done in Miami Shores Village, Florida. 7 "' building at r L � For a_/ story Fixtures Fixtures Sewer *tic Tank c1iami chores9llage F L O S I D A LUMBING PERMIT N9 1130 20 43 Total $ Village Plumbing Inspector Received Payment by r • OWNER x LOT BLOCK SUBDIVISION g J' 7 : ' el 1 A Issued to For a —/story Fixtures Fixtures Sewer Y aiami chores9llage F L O A ID A PLUMBING PERMIT N° 1249 to install the following described plumbing, in accordance lations of Miami Shores Village, Florida and the State of drainage work done in Miami Shores Village, Florida. , r I !�� . � building at '� rde. *tic Tank / L $ with the laws, statutes and regu- Florida, governing plumbing and Total $ Village Plumbing Inspector Received Payment by Permit No Q--- - MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 work. — • • Owner's Name and Address_a_irS___ 1? arY'_Qli,i No srl ! ____ Street f= - • t • Registered Architect and /or Engineer 7 • L Employing Plumber's Name :.�C�i.dU X111_ _?1'�7.�2.1._]rl�__�2._sIT 7 Street---- ____- _'.__-''- _ '- _ '- _- _ Location and Legal Description Lot — — _______ Block_____— Subdivision _____________ Street and Number where work is to be performed—No ________ __ ": __ I Street 95th St • State work to be performed and purpose of building (By Floors) New Building Remodeling Addition____ Repairs Size Septic Tank Type of Tank Capacity Gals._ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $ .3-- •-Q0 - -- - --_ (Signed) - rt / The undersigned d e _%/ � ` 1 ` `� L ' ' ed a licant for this building permit does hereby certify t hat he understands and accepts his obli ati gn pp • g y p g paws an employer of labor der the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- p ed 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) ss. No. of Stories J'lumbing Inspector. STATE OF FLORIDA, t COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persona' to me well known, and who, being by me first duly swom, upon oath deposes and says that he is the_ of the above described construction, that he has fully read the foregoing application, and that he did sign the same, and 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 wen such re- inspection is made necessary by improper notice for inspec' materials and /or workmanship. Master Plumber CLOSETS BATH TUBS E 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- kiec 1 - ..ute�r � _ __.eai. CONTR. LIST CHECK Permit No Q--- - MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 work. — • • Owner's Name and Address_a_irS___ 1? arY'_Qli,i No srl ! ____ Street f= - • t • Registered Architect and /or Engineer 7 • L Employing Plumber's Name :.�C�i.dU X111_ _?1'�7.�2.1._]rl�__�2._sIT 7 Street---- ____- _'.__-''- _ '- _ '- _- _ Location and Legal Description Lot — — _______ Block_____— Subdivision _____________ Street and Number where work is to be performed—No ________ __ ": __ I Street 95th St • State work to be performed and purpose of building (By Floors) New Building Remodeling Addition____ Repairs Size Septic Tank Type of Tank Capacity Gals._ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $ .3-- •-Q0 - -- - --_ (Signed) - rt / The undersigned d e _%/ � ` 1 ` `� L ' ' ed a licant for this building permit does hereby certify t hat he understands and accepts his obli ati gn pp • g y p g paws an employer of labor der the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- p ed 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) ss. No. of Stories J'lumbing Inspector. STATE OF FLORIDA, t COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persona' to me well known, and who, being by me first duly swom, upon oath deposes and says that he is the_ of the above described construction, that he has fully read the foregoing application, and that he did sign the same, and 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 wen such re- inspection is made necessary by improper notice for inspec' materials and /or workmanship. Master Plumber UILDING ECTRICAL LUMBING wner of gilding A n - CONTRACTOR' OR BUILDER MIAMI SHORES VILLAGE, FLORIDA t DATE „jar._ 1 PERMIT N9 8662 Value of Project e buil under . roved are c sumes awings or . y the ange . e r :.. Aint. of Permit Work to be performed under this Per /-4 -chitect =tractor Builder :gal Lot escription idress of Aiding This perm is granted to the contractor or buil named above to onstruct tion herefor in strict compliance with all ordinances .ertaining thereto d with th ins, drawings, statements or specifications that may have been submit -d to and a any time if the work is not done in compliance with such ordinances or if the pla rmit is granted is the understanding that the contractor or buil ...named above ulations pertaining to the work covered hereby whether slip n on the p ,ility for work done by his agents, servants or employees. le 6 itor Subdi- vision BY Contractor's License No. 194 g or\ to install the equipment or device described in the ap andin that the work will be performed in compliance with any roper municipal authorities. This Permit may be revoked without authorization. A further condition upon which this onsibility for a thorough knowledge of the ordinances and statements or specifications and that he assumes respon- Signed' t ",, 'V;B;a S CTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordi staining thereto and in strict conformity with th plans, drawings, statements or specifications submitted to the proper authorities o accepting this permit I same lresporlsibi ' r all work done by either myself, my agent, servant or employee. antes and regulations Miami Shores Village. AUTHORITY H WILL BE SUFFICIENT :AN BE CLEARLY SHOWN rr+ THIS SPACE FOR PLAN SKETCH Show location of stacks and horizontal drains inside building, lettering each opening to correspond with the stock con- nections as shown on the elevation sketch on opposite page. Where ground work is concealed, draw floor plan of build- ing showing location of walls, partitions, columns, etc., and the location of all horizontal soil and waste pipes, in ref- erence to same. F N W Sketch position of building and lot lines in square (which represents an entire city block) , showing on which street the building and lot faces; also show exact locations of "Y" in street and position of lateral or srtici tank. Show sewer and any change in direction same may make. The purpose of this plan is to have an aceur , layout of all underground pipes for future references. ' J • WEST NORTH A EAST Remarks: NORTH SOUTH • In alterations to existing work show the old work in red ink and the new in black ink. Letter each stack to correspond with the opening shown in floor plan or ground plan on opposite page. THIS SPACE FOR. ELEVATION SKETCH A PERSPECTIVE SKETC `J PROVIDED THE WORK CLOSETS 2 BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES 1 1 2 1 1 8 A -244 5M 3-38 Address I herewith submit the following plan of plumbing for approval: Employing Plumber CITY PLUMBING COMPANY New For a Dwelling Owner or Agent Builder or Contractor is SELF Sewer Connections Plan No. MIAMI SHORES VILLAGE Date r ;1* a DIVISION OF PLUMBING INSPECTION DEPARTMENT OF PUBLIC SERVICE FLORIDA Old ❑ Story CU Store ❑ DUNNING PROPERTIES ( Rr, NOLDS Work executed by A. J,HILD Address Address Lot No. 3 & W . - Of iBlock No. 52 Subdivision MIAMI SHORES 474 N.E. 95 St At center of St. ❑ At curb ❑ JUNE 30, 1939 , 19 Addition ❑ Remodeled ❑ Garage ❑ Apartment ❑ Hotel ❑ Office Bldg. ❑ At property line ❑ Existing in alley ❑ Existing bldg. sewer ❑ To septic tank CZ Existing bldg. drain ❑ To dry well ❑ A charge of $1.00 will be made for correcting any inaccuracies in the foregoing information. DO NOT WRITE IN SPACE BELOW. THIS IS FOR THE USE OF THE DIVISION OF PLUMBING INSPECTION ONLY. ROUGH -IN INSPECTION Ground Rough -In Rain Leader AM P M. Approved by Condemned by REMARKS Date SEWER INSPECTION AM P M Approved by Condemned by REMARKS Sewer Permit No AM P M Approved by Condemned by REMARKS Date FINAL INSPECTION Date: / '' d -. v I herewith submit the following application for a permit covering the installation of a Septic Tank Relaying: Installed by : For a (Store: NEW: Old: Story: (Garage wash floor: Building has: Stores; Owner or A_•ent: LOT NO ��- LOCK NO. 2. Address of work: II No. of Plumbing Fixtures: Size of Soakage Pit: Additional information: Ready for Inspection: Date: e APPROVED BY �'C�/',, Remarks: PERMIT NO. /i • DADE COUNTY ZONING ICE Garage: DIVISION OF PLUMBING INSPECTION Form #11 Apt.: Laundry Tubs: Nature of water supply: City: V Well: Soakage Pit: New: Offices. Apts.; SUBDIVISION Purpose of same: CONDE! ED BY: Feet of drain tile/ Address: Addition: Rbatodeled: Hotel: Office Bldg: Res: Waste water from a: z Type of tank installed: Tank capacity in iallons: Hotel Rms; Floor Drains: w Feet distant from all wells: Time: sz-- -- Bedrms 't ■, • BUILDING ELECTRICAL PLUMBING Owner of Building CONTRACTOR,/ OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 8976 Work to be performed under this Permit Architect Contractor / or Builder �% `, { ' 4 ' Legal Lot Bl. Description / Address of ) . - r:.0 Value of Amt. of Building f� / 1 �� ! / Project Permit 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 $swings or in the state nknts or specifications and that he assumes respon- ,. ■ Subdi- vision sibility for work done by his agents, servants or employees. ; , r: f Signed. DATE— / 19aC Contractor's License No By 'V INSPECTOR In consideration of the issuance to me of this permit I agree to perform the w4rk covered hereunder in compliance with all 9tdirOnces and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities o €'Miami Shores Village. Incepting this permit I assume responsibit for all work t � done by either myself, y agent, servant or employee. ' ' .. AUTHORITY V /- Permit No .___L —_ Owner's Name and Address Registered Architect and /or En ineer I Employing Plumber's Name nz_) L Location and Legal Description Lot Street and Number where work is to be performed— No.______ ..... State work to be performed and purpose of building (By Floors) Amount of Permit $ err MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 1 1 l 4 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...„ (Signed) _ ___ Date A_tZIZ-! (0 No Street T' C& .r'_L!!s1_ C!^_• Street-- -- __-- -__ -__ -_ Subdivision Street ( f.7.)C New Building Remodeling Addition v 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 Plug 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. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. J 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 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 /I� /eo r /- Permit No .___L —_ Owner's Name and Address Registered Architect and /or En ineer I Employing Plumber's Name nz_) L Location and Legal Description Lot Street and Number where work is to be performed— No.______ ..... State work to be performed and purpose of building (By Floors) Amount of Permit $ err MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 1 1 l 4 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...„ (Signed) _ ___ Date A_tZIZ-! (0 No Street T' C& .r'_L!!s1_ C!^_• Street-- -- __-- -__ -__ -_ Subdivision Street ( f.7.)C New Building Remodeling Addition v 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 Plug 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. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. J 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. Permit No ) P j 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 Engineer_._-__._ Employing Plumber's Name - °_ t No. -- .�� ____ - Street-- 11 ...?.‘"g_.? ....... _ -_ -_ -- Block Subdivision ______.__._..____. Street and Number where work is to be performed —No + N e. 9 S Street State work to be performed and purpose of building (By Floors )_._. ___------------- _-- ____ -- _......_ Location and Legal Description Lot_______________________ New Building.--- - - -.—. Remodeling_._- -__- _ ___ Addition Size Septic Tank-- __.________._______-_._._ —__-_— _-_--Type of Tank Capacity Gals ....... Feet of Drain Tile 3O 13 o C __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well..__--__- ....... _________ ..... _______ .Size of Soakage Pit Amount of Permit $_ f! _ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT doAii To No.__.___— 41 2' . d71 __ Street. e. / f (Signed)- (Signed).— Date.----- .... - -- - - - __ •- .. ...... Repairs.._ No. of Stories. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is 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. 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. Master Plumber. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 worlmianship. CLOSETS BATH TUBE SHOWERS LAVA TORIES SINKS SLOP SINKB LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKI NO FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER ()REP WELL SPRKLR. SYSTEM SW IM'CI POOL CONTR. LIST CHICK Permit No ) P j 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 Engineer_._-__._ Employing Plumber's Name - °_ t No. -- .�� ____ - Street-- 11 ...?.‘"g_.? ....... _ -_ -_ -- Block Subdivision ______.__._..____. Street and Number where work is to be performed —No + N e. 9 S Street State work to be performed and purpose of building (By Floors )_._. ___------------- _-- ____ -- _......_ Location and Legal Description Lot_______________________ New Building.--- - - -.—. Remodeling_._- -__- _ ___ Addition Size Septic Tank-- __.________._______-_._._ —__-_— _-_--Type of Tank Capacity Gals ....... Feet of Drain Tile 3O 13 o C __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well..__--__- ....... _________ ..... _______ .Size of Soakage Pit Amount of Permit $_ f! _ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT doAii To No.__.___— 41 2' . d71 __ Street. e. / f (Signed)- (Signed).— Date.----- .... - -- - - - __ •- .. ...... Repairs.._ No. of Stories. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is 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. 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. Master Plumber. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 worlmianship. Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE nE q5 .34- Job Address Legal Description ( Historically Designated: Yes Owner/Lessee / Tenant ,73 1 r R Owner's Address 4- ? 1 ► E W S� WORK DESCRIPTION Ce_ 't ■ 1C c ,D Square Ft. I S'bQ Tax Folio Master Permit # Phone 365— C( 3 - ( �( Contracting Co. OLL) 2- ( Address Qualifier SS# State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL ' LUMBING ECHANICAL ROOFING PAVING FENCE SIGN O c ) of Estimated Cost (value) ,, Phone ndca 4 `' No Q 02. rkQn, WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do thgwork stated. Signature of owner and/or Condo President Date Signs of Contracto or' Owribr- Builder Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date My Commission Expires: My Commission Expires: - - Electrical Date FEES: PERMIT RADON C.C.F. NOTARY C3 — BOND TOTAL DUE 44 7 12 .. APPROVED: Zoning Building Mechanical Plumbing Engineering