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560 NE 95 St (3)MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 co$y'of approved plans and specifications must be kept at building during progress of the work. Date ' .......... , 19 Owner's Name and Address i� NA �r �/ CTL- �} . ( No 4 ' mo b Q Street e 1 J fI/ Registered Architect and /or Engineer Name and address of licensed contractor 1 /R- ..> � �P. 4.1.AJtt...G..L.�a_ Location and legal description of lot to be built on: Lot Block d ivisi J ' r f2 Street and Number where work is to be done ,1 State work to be done and purpose of building (by floors) ci%rr.S-, a " - .L and for no other purpose. New Building Remodeling. Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required - .Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit 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 Act. The undersigned agrees to employ only such subcont a tors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) ,, STATE OF FLORIDA, p y ZJj6 COUNTY OF DADE. I Ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chainnan 7 Member Member Member Member .... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. • I , -it ° Q 7 1T Section: Scale: / : '-L /- Dwg,By: Peoples Water and Gas Company North Miami, Florida Date:'? Sheet:/ J . 0. Form No. 237 parcel contiguous to and across which suci such repairs and if the owner shall not p 3 hereof, within 30 days after the date of in said section, the said Village may brie be entitled to claim, in addition to the rate of 6% together with the costs of rea= curred by the prosecution of such suit. Section 5. All persons whc shall be punished by a fine not exceeding not exceeding 30 days, or both in the di "s( imprisonment shall be in addition to any may have hereunder. Section 6. All ordinances with or inconsistent with the provisions its passage. ATTEST: Ca LAWTON MCCALL VILLAGE MANAGER AND CLERK &JC 61 Vi vll .1.{ lily ygy.K •iii Section 7. This Ordinance PASSED AND ADOPTED this 1t 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 confornuty 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 nnt. 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 Location and Legal Description Lot 11 ___L5 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 Size Septic Tank l9 • m - -- Type of Tank Feet of Drain Tile..__ - ° � 4—C -Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._______ __ ____Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILIAGZ PLUMBING INSPECTION DEPARTMEkwc'.' APPLICATION FOR PLUMBING No._ No._ Repairs No. of Stories (Signed)_ Date Street_-rc o -2 - ,9;5— Pc. Street_. Subdivision - - - - Street Capacity Gals The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent upplement, 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 required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be perform under this permit, as licrnsed by Miami Shores Village. ?-7/../C (Signed - -- - ��- ,• =- - - -- -�_ •-_ _ aster 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 o -rsi - ens. umbing Inspector. are are 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 TU86 SHOWERS LAVA. TORIES SI NKS SLOP SINKB 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 H EATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL 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 confornuty 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 nnt. 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 Location and Legal Description Lot 11 ___L5 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 Size Septic Tank l9 • m - -- Type of Tank Feet of Drain Tile..__ - ° � 4—C -Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._______ __ ____Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILIAGZ PLUMBING INSPECTION DEPARTMEkwc'.' APPLICATION FOR PLUMBING No._ No._ Repairs No. of Stories (Signed)_ Date Street_-rc o -2 - ,9;5— Pc. Street_. Subdivision - - - - Street Capacity Gals The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent upplement, 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 required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be perform under this permit, as licrnsed by Miami Shores Village. ?-7/../C (Signed - -- - ��- ,• =- - - -- -�_ •-_ _ aster 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 o -rsi - ens. umbing Inspector. are are 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. Street and Number where work is to be performed -No Amount of Permit $ 4 -- STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. > Y... Date S 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 ,r No. ____ . - i cleet ` _,,f Registered Architect and /or Engineer.._.—.- -.___.— ______.- - ______---- -_------------•----_-_----- lY Employing Plumber s Name _- -•_ - -. =_ �. -_ -_ -`*^ No... Q..�2� _1��./ -6� St>�et.. � ' Location and Legal Description k_.__._______— .--- - - -___ _ _Block Subdivision..._. :___.__.._._ ......... ___.._.... State work to be performed and purpose of building (By Floors) _ —_ New Building--__ Remodeling —_ -. __ .__ Addition__ (Signed)- Street Repairs No. of Stories.. _....1 Size Septic Tank.- -------- ----- ------ -- --- - - - - -- -Type of Tank Feet of Drain Tile_._____ ____ ...... . ...... ...... Feet of Tank or Drain Field from Well Nature of Water Supply' C 2Vell. _ Size of Soakage Pit Capacity Gals. umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio.: as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pennanent 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. / 2 (signed) 1 t A R �' 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 e-necescary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS TUBS Toes SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY Toes U CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES GLS LI T / / / • / CHECK + — SEPTIC TANK SEWER CONK. DRAIN FIELD SOAKAGE PIT GREASE TRAP SCALAR. DEEP WELL SPRKLR. SYSTEM SW IM'G POOL HEATER LIST CONTR. CHECK / - -- Street and Number where work is to be performed -No Amount of Permit $ 4 -- STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. > Y... Date S 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 ,r No. ____ . - i cleet ` _,,f Registered Architect and /or Engineer.._.—.- -.___.— ______.- - ______---- -_------------•----_-_----- lY Employing Plumber s Name _- -•_ - -. =_ �. -_ -_ -`*^ No... Q..�2� _1��./ -6� St>�et.. � ' Location and Legal Description k_.__._______— .--- - - -___ _ _Block Subdivision..._. :___.__.._._ ......... ___.._.... State work to be performed and purpose of building (By Floors) _ —_ New Building--__ Remodeling —_ -. __ .__ Addition__ (Signed)- Street Repairs No. of Stories.. _....1 Size Septic Tank.- -------- ----- ------ -- --- - - - - -- -Type of Tank Feet of Drain Tile_._____ ____ ...... . ...... ...... Feet of Tank or Drain Field from Well Nature of Water Supply' C 2Vell. _ Size of Soakage Pit Capacity Gals. umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio.: as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pennanent 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. / 2 (signed) 1 t A R �' 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 e-necescary by improper notice for inspection, or faulty materials and /or workmanship. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Owner's Name and Address.. W • 5...< dye_ Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date Date Registered Architect and /or Engineer Name and address of licensed contract Location and legal description of lot to be built on Lot Block � ivision � 9 ...CI Street and Number where work is to be done State work to be done and purpose of building (by floors) _ _ • -•_ - _ i'�C_�._L.i 1 v ,19. //,� � No. - 0 Sleet... ..� ,!Q Notary Public, State of Florida cv 02-d& /ga and for no other purpose. New Building Remodeling. Addition Repairs No. of Stories, To be constructed of Kind of foundation. Roof Covering Total cost of improvements $...!.� -r Amount of Permit $.._ Zone cubage required .Plan Cubage Distance to next nearest building..._ Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit 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 Act. The undersigned agrees to employ only such subcontr .ctors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 for application, and that he did sign the same, and that all facts therein by him stated are true. Permit Date 7 ° Read, Sworn to and Subscribed before me. BuildInspect g My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member _ Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. _iILDING .ECTRICAL UMBING OOFING wner of >ilding chitect )ntractor Builder gal scription ldress of tiding /r t Lot MIAMI SHORES VILLAGE. FLORIDA ❑ DATE 2 - 195_L_ ®. PERMIT N° 3310 Contractor's License No `/ 0 ❑ Work to be performed under this Permit 1 1 Bl fr'i Amount of Permit $ Subdi- vision Value of Project $ l 1 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 refor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, !wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any e 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 nted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations taining 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 ;e by his agents, servants or employees. Signed. / BY it.„ INSPEgfOR =_, `". In consideration of the issuance to me of this permit I agree to perform the work covered 1 e eunder in compliance with all ordinances and regulations 'taining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- iting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER $Y( °' AUTHORITY amp MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ DATF 4 . 2 7 PLUMBING ❑ PERMIT N° _ 3595 Contract r' . . ROO ING i ❑ Owner of i ► J Building A - , ;r''*}'c if 1 Architect Contractor or Builder " Legal Lot 1 Subdi- Work to be performed under this Permit Description 1 B1 vision Address of i i ` / Value of Amount of Building /. J Project $ I 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 application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. BY i'7 x 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 or employee. /.4,- ( "' CCNTRACTOR OR BUILDER BY AUTHORITY it ,/,(7 195 — BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE. FLORIDA 0 PERMIT N? 3446 ❑ Owner of Building ' Architect Contractor or Builder Legal Lot Description Bl Address of Building Work to be performed under this Permit DATF e 195 Contractor's License No. Subdi- vision Value of Project $ Amount of 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 cr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. BY .r % : L .1f. 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 eith,r, myself,,mi agent, servant or employee. s ''.it 41:.;4, Ik - ' r ° i, , ,fs.s - r;' wry' S+:;' - ,: ...�� CONTRACTOR OR BUILDER BY AUTHORITY e BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 3947 I Work to be performed under this Permi B1 r CONTRACTOR OR BUILDER BY ae- DATE Contractor's License No. Subdi- vision Value of Project $ Amount of f 19 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. f 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 ao cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. AUTHORITY ABBOT PRINT 6. vitge of Miami Shores JOB /7- - ADDRESS 61 INSPECTION i !/ 7, N° 4164 TIME READY REMARKS . / //.&, ,•� / /1/4;/' y // ( INSPECTOR DATE Vi llaqe o f Miami Shores INSPECTION TIME READY p REMARKS +� ., .. � .� --14 1 41 0 ' 4117 / /r ( _ ��: r� e .03 3/a N? 3845 INSPECTOR 18% DATE df2 Pcirrtd! Location and Legal Description Lot_______ _________________ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby niade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or,other structure hei ein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address` ` _ _____._ _ No._ Registered Architect and /or Employing Plumber's Name -1l. _ Ee d ifte,4/‘ Block Street and Number where work is to be performed —No 3 O' A �} State work to be performe8 and purpose of building (By Floors ) -- _._.__--------------- __.__. New Building _- _--------- .- _ - -_ -- Remodeling ---------- .___.__._ Addition Size Septic Tank_--------------------______ - •-- - -____ -Type of Tank_ Feet of Drain Tile_-- __ -_ -- - - - -- _.__Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well.___ — ___________. _______________________ of Soakage Pit Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. (Signed) Date Street Subdivision. - - -- ------- -- ----- --- --- 2 4 S treek Repairs No. of Stories Capacity Gals (Signed)____ _ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat Ens s an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent upplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by tlie Act. The undersigned agrees to employ only such sub- contractors, 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. 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•neoessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS S LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURES CONTR. LIST / CHICK - -, SEPTIC TANK SEWER CONK. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW I POOL CONTR. LIST / - -_- _ CHICK df2 Pcirrtd! Location and Legal Description Lot_______ _________________ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby niade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or,other structure hei ein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address` ` _ _____._ _ No._ Registered Architect and /or Employing Plumber's Name -1l. _ Ee d ifte,4/‘ Block Street and Number where work is to be performed —No 3 O' A �} State work to be performe8 and purpose of building (By Floors ) -- _._.__--------------- __.__. New Building _- _--------- .- _ - -_ -- Remodeling ---------- .___.__._ Addition Size Septic Tank_--------------------______ - •-- - -____ -Type of Tank_ Feet of Drain Tile_-- __ -_ -- - - - -- _.__Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well.___ — ___________. _______________________ of Soakage Pit Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. (Signed) Date Street Subdivision. - - -- ------- -- ----- --- --- 2 4 S treek Repairs No. of Stories Capacity Gals (Signed)____ _ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat Ens s an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent upplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by tlie Act. The undersigned agrees to employ only such sub- contractors, 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. 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•neoessary by improper notice for inspection, or faulty materials and /or workmanship.