445 NE 94 St (11)Permit No ° V I Date_ ____ ` _/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address __
Registered Architect and /or Engineer ___ ____— ____�__.
Employing Plumber's Name
Location and Legal Description Lot_
Street and Number where work is to be performed —No
State work to be performedi and purpose of building (By Floors) _
New Building ____._ Remodeling
Size Septic Tank
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.
i".� No. -- -- -- - Street_ P - Subdivision.._..., -.____
Street
Type of Tank_— Capacity Gals
Feet of Drain Tile. __ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well.
Amount of Permit $___ - ....
STATE OF FLORIDA, 1
COUNTY OF DADE.
NOTE: A re-
materials and /or • . lananship.
Addition_____________________ Repairs___ No. of Stories
Size of Soakage Pit
(Signed)_
(Signed )-
My Commission Expires Notary Public, State of Florida
■
Street.
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by 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.
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.
on fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
CLOSETS
BATH
TUBS
SHOWER•
LAVA-
TORIES
SINKS
SLOP
S INKS
LAUNDRY
TUes
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT'NS
TOTAL
FIXTURES
CONTs.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
ln60
Permit No ° V I Date_ ____ ` _/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address __
Registered Architect and /or Engineer ___ ____— ____�__.
Employing Plumber's Name
Location and Legal Description Lot_
Street and Number where work is to be performed —No
State work to be performedi and purpose of building (By Floors) _
New Building ____._ Remodeling
Size Septic Tank
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.
i".� No. -- -- -- - Street_ P - Subdivision.._..., -.____
Street
Type of Tank_— Capacity Gals
Feet of Drain Tile. __ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well.
Amount of Permit $___ - ....
STATE OF FLORIDA, 1
COUNTY OF DADE.
NOTE: A re-
materials and /or • . lananship.
Addition_____________________ Repairs___ No. of Stories
Size of Soakage Pit
(Signed)_
(Signed )-
My Commission Expires Notary Public, State of Florida
■
Street.
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by 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.
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.
on fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
Permit N_
1
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.
� �j /M
Owner's Name and Address d- - J✓Q �f "°- ®___.f- d__?_7_1 e____JxL4___ -•____ No._ __4 n __•------ ___ -_— Streetj_ -- -• ...rt.- —
Registered Architect and /or Engineer ____-- ____- -_ - -__ —
---- -- - - -- -- -- --
Employing Plumber's Name___. _.� 4 2_ZZ ' � J Vii_) d in No.
e __ j :y ` Street. /V die /:2 _ }' 1l C __
P Y�g — e. r, -
Location and Legal Description Lot._._ _ 4_ __—__ '1::r9. Su� l�/_i bdivision 01___ 2�! _5 1.,
Street and Number where work is to be performed —No 4'5 4/ E Street ,`7_ Su _/ —
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
Nature of Water Supply: City — Well. - Size of Soakage Pit
Amount of Permit $__
STATE OF FLORIDA, 1
COUNTY OF DADE. J
(Signed)_
( Signet) - --
Date o �' 10 I�
' �✓ ...
!r
No. of Stories. - ..1
My . . ion Expires Notary Public, State of Florida
Master Plumber.
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 5968, 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.
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 = •spection fee of $1.00 will be made when such re- inspection is made-necessary by improper notice for inspection, or faulty
materials and/ • workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
T+ORRIIES
I3
'
SINKS
I
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
��
)V A/1
/
.LE4'L�'
a h
I'
`J
TOTAL
FIXTURES
CONTR.
LIST
.ot
a~
4141
✓
CHICK
g�d
y,'
ci I
f %vrd
2
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
come.
LIST
` --
CHECK
Permit N_
1
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.
� �j /M
Owner's Name and Address d- - J✓Q �f "°- ®___.f- d__?_7_1 e____JxL4___ -•____ No._ __4 n __•------ ___ -_— Streetj_ -- -• ...rt.- —
Registered Architect and /or Engineer ____-- ____- -_ - -__ —
---- -- - - -- -- -- --
Employing Plumber's Name___. _.� 4 2_ZZ ' � J Vii_) d in No.
e __ j :y ` Street. /V die /:2 _ }' 1l C __
P Y�g — e. r, -
Location and Legal Description Lot._._ _ 4_ __—__ '1::r9. Su� l�/_i bdivision 01___ 2�! _5 1.,
Street and Number where work is to be performed —No 4'5 4/ E Street ,`7_ Su _/ —
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
Nature of Water Supply: City — Well. - Size of Soakage Pit
Amount of Permit $__
STATE OF FLORIDA, 1
COUNTY OF DADE. J
(Signed)_
( Signet) - --
Date o �' 10 I�
' �✓ ...
!r
No. of Stories. - ..1
My . . ion Expires Notary Public, State of Florida
Master Plumber.
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 5968, 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.
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 = •spection fee of $1.00 will be made when such re- inspection is made-necessary by improper notice for inspection, or faulty
materials and/ • workmanship.
ew ur ..tag.....---- - -- - -- -
C LO•sT•
BATH
TUBS
r,NC1V[R•
LAVA•
TORII%
�_ SLO. �LA UNOR T URINAL*
T
" I K• i SINK/ TUBE t
CATCH
SA•IN
FL.00R
DRAIN
DR I N Kt NO
F PUNT' N•I
I PO/ W.i .
6Ri 4
0041 - I tl
CO PA/ 1
tO7AL
FIXTURE•
LIST
CHECK
1
TANK
TANK
1'!• SEWER
CON N.
SOAKAGE
P F CLO
_
-�
GHIA HEATER
WELL
.
��
SYSTEM
SW POOL
i
TRAP
�_._
CN[CK
MiAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/ C � 7 ' .. Date / _ 7g .
Pe rmit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept et
building during progress of work..Q� .�1,�
Owners Name and Address acei � - �G ele &-
Registered Architect and /or En racer.._ ._.- _- _-- --.- -- --
Employing Plumber's Name i • -
.. ` ►1.� No, S' 6 t 8treet..4. .. ..1 . ...•.
Location and Legal Description Lot ) , ' / —Block_ Subdivision . - —
1[ .�_._..__..__.�._ _ Street. ... . 9. 9.
State work to be performed purpose .:... - -. . - - •. _ ._.._
Street and Number where work is to be performed- 11ti.__�____..
�t
ormed and u se of building (By Floors) - •----- •---- ..._ - - - -- - -
N B • -1, Remodeling Addition..._ •- ......... Repairs
....__ ___________-__Type of Tank
Size Septic Tank_____ ..... .
_Dist. Feet of Tank or Drain Field from Welt.
.Size of Soakage Pit
Feet of Drain Tile._.. -
Nature of Water Supply: City - Well...__----- - -...:
--
Amount of Permit 5 -- -- - - --•• - --
(Signed)
The undersign^" -d applicant for this building permit does hereby certify that he understands and accepts his atlons as an employer of labor.
under the Florida \Vorkmen's Compensation Act, being Section 5E6d, Compiled General Laws of Florida Permanent Supplement, and hal com-
plied with the provisions there°f, and will require similar Lttiulpnance 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 agreta to employ only each Sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shorts Village.
( Si
Capacity
No: of Stories
.L.
NotarJ Public, State of Flo/ Ida
Plumbing inspector.
Master Plumber.
STATE OF FLORIDA, I
COUNTY OF DADE.
3eiore me, the undersigned authority, a notary puhll •. duly authorized to adnunistor oaths and take acknowledgments. personally appeared
to me well known, :.mud who, I,eu r b; nie first duly sworn, oath ;leppoana Had says that he is the .........
• of tie above described constriction, Mast be has care/tally mad the foregoing application, and that he did sign the same, and that all fads
therein by bin. stated are true.
- - - -.__ _ My Corns i.tiiun Frpires
NOTE: A rc.-ir.,spection fax of 01'•oo will be made Isriu,ro re•lnspoctinn Is wader ne ,ssaury by bnprrtper notice for inspection, our faulty
materials and /or workmanship.
lwriet
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engine
Employing Plumber's Name
Location and Legal Description _ - �'!I� �. _ Block Subdivision /s i
Street and Number where work is to be performed -No 4 4 A I Street f
State work to be performed and purpose of building (By Floors)
New Building _ - -- Remodeling__ --- _ - -_.__ Addition.
Size Septic Tank _Type of Tank._ ...Capacity Gals
i
Feet of Drain Tile__ . _ / J-�! it i st. Feet of Tank or Drain Field from Well
Nature of Water Supply: City-Well
Amount of Permit $__ -. ------------------------------ - - - -__ (Signed)_
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 5966, Compiled General Laws of Florida Permanent upplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl ed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No._
__Size of Soakage Pit
No. - - - - - - ---- Street
Repairs
Date_ .. ,'S7____ _
Street. — - - ---- - - - - -
No. of Stories.
My Commission Expires Notary Public, State of Florida
0
Master Plumber.
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
URI
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
L113T
--
CHECK
- .
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'O
P001.
CON ea.
LIST
CHECK
lwriet
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engine
Employing Plumber's Name
Location and Legal Description _ - �'!I� �. _ Block Subdivision /s i
Street and Number where work is to be performed -No 4 4 A I Street f
State work to be performed and purpose of building (By Floors)
New Building _ - -- Remodeling__ --- _ - -_.__ Addition.
Size Septic Tank _Type of Tank._ ...Capacity Gals
i
Feet of Drain Tile__ . _ / J-�! it i st. Feet of Tank or Drain Field from Well
Nature of Water Supply: City-Well
Amount of Permit $__ -. ------------------------------ - - - -__ (Signed)_
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 5966, Compiled General Laws of Florida Permanent upplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl ed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No._
__Size of Soakage Pit
No. - - - - - - ---- Street
Repairs
Date_ .. ,'S7____ _
Street. — - - ---- - - - - -
No. of Stories.
My Commission Expires Notary Public, State of Florida
0
Master Plumber.
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
MIAMI SHORES VILLAGE. FLORIDA
0 DATE
' PERMIT 11To 2601
0
0
Lot 11
Value of
Project $
Contractor's
License No.
195
Work to be performed under this Permit
Subdi-
vision
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
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 i work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Er PERMIT
0
Architect
Contractor
or Builder
Legal Lot
Description
MIAMI SHORES VILLAGE, FLORIDA
CONTRACTOR OR BUILDER
B1
Signed.
N° 2443
DATE = 7 < 195 = ..
Work to be performed under this Permit
Contractor's
License No.
Subdi-
vision
Address of Value of r ,,�' js'
Building /7 ,; r' :� ,` Project $ �+ Permit $ Amount of �
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 strih 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 respgpsfbility for work
done by his agents, servants or employees.
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Permit No l ( 6
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPL CATION FOR PLUMBING PERMIT
N 69 -1328 787 -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.
Owner's Name and Address
A. J. SCappatiCCio No 445 — Street .__..NE 94 Street
Registered Architect and /or Engineer - -- __---------___--------__----____--
Employing Plumber's Name
Peoples Gas System _____ _ _. No.__ 564 NE 125th — —
Location and Legal Description Lot Blork
Street and Number where work is to be performed -No
State work to be performed and purpose of building (By Floors)
New Building ______._._____ ...... .- ____ -- ... Addition__ ...... Repairs No. of Stories . . . . .. ...... . . .
Size Septic Tank
Feet of Drain Tile_
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
D
Type of Tank Capacity Gals
_ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City- Well._____— ________ ..... ________________— __-_Size of Soakage Pit
(Signed) _
( Signed) ___
Date .--- --4. - /
Subdivision_______________
Street
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga s as an employer of labor
under the Florida Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen . pplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo. . 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 un.: 'this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _______________________________
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notica for insi n, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUB&
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUB&
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
roe.
urye
TOTAL
FIXTURES
CONTR.
LIST
1
1
2
CHECK
_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM - G
POOL
COMB.
LIST
CHECK
Permit No l ( 6
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPL CATION FOR PLUMBING PERMIT
N 69 -1328 787 -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.
Owner's Name and Address
A. J. SCappatiCCio No 445 — Street .__..NE 94 Street
Registered Architect and /or Engineer - -- __---------___--------__----____--
Employing Plumber's Name
Peoples Gas System _____ _ _. No.__ 564 NE 125th — —
Location and Legal Description Lot Blork
Street and Number where work is to be performed -No
State work to be performed and purpose of building (By Floors)
New Building ______._._____ ...... .- ____ -- ... Addition__ ...... Repairs No. of Stories . . . . .. ...... . . .
Size Septic Tank
Feet of Drain Tile_
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
D
Type of Tank Capacity Gals
_ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City- Well._____— ________ ..... ________________— __-_Size of Soakage Pit
(Signed) _
( Signed) ___
Date .--- --4. - /
Subdivision_______________
Street
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga s as an employer of labor
under the Florida Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen . pplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo. . 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 un.: 'this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _______________________________
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notica for insi n, or faulty
materials and /or workmanship.