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PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
098 N 6:7 q.- s 17/t-.1
P 4 ( S.LL 2 Ltd- / Less
Pt
Tenant�)C.;b��1d_ (A_�
Date 6Xp>/
Legal Description
Ome
Lessee /
Owner's Address
Contracting Co ; £ / L �j
Qualifier
State #
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL
WORK DESCRIPTION2"S7'
_ .917b 0
Square Ft.
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 PROPEF,TY (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 the work stated.
16
ignat
Date:
otary as to
My Commission
* *
PERMIT FEE:
Address
67,22c-0.,(/,/25.ory
Owner and/or
Expires:
* - *
APPROVED:
Mechanical
Competency# S Ins . Co.
Address
Address
Address
r or Condo Pres.
Condo ,g @ went
State of Florida at large
myimmasion [x*es lm, 3,199
Fire
Zoning Building
Phone 5 ; 1 9 3
Tax Folio /I
. P - o 0 /0
s Pe i itpi 3�
Phone 373- 7300 7S'- 0
Address J Y:C,CiAZ:`j 2 e ! —
PLUMBING MECHANICAL PAVING FENCE SIGN
Estimated Cost
Signature of Con rac to or Owner- Builder
Date-
Notary as to Contractor or Owner- Luilder
My Commissio
pires:
AWAANDO G*CUBAS * *
MY COMMISSION EXPIRES
April 7, 1995
m,;�
Electrical
Engineering
JILDING
ECTRICAL
UMBING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 8657
Work to be performed under this Permit
Amer of
iilding
chitect
DATE 194_
Contractor's
License No
)retractor
Builder
:gal Lot Bl. Subdi-
scription vision
'dress of Value of Amt. of
riding 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-
ion herefor in strict compliance with all ordinances pertaining thereto and w'th the understanding that the work will be performed in compliance with any
ns, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
-mit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
.ulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
ility 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
taining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
accepting this permit I assume responsibility for a work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
lUILDING
LECTRICAL
'LUMBING
)wner of
3uilding
architect
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
PERMIT N? 8642
Work to be performed under this Permit
Contractor's
License No
: ontractor
)r Builder
.cgal Lot II B1_. Subdi-
)escription vision
address of Value of Amt. of
luilding 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=
ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
,lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Pen may be revoked
t 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
, ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
cgulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
ibility 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
ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
BY AUTHORITY
-
GLOOMY°
BATH
TUDO
6.
LAVA-
7000m
BIN"
SLOP
ISMS'
LAUNOtY
Tuns
URINALS
VAal::
FLOOR
DRAIN
Daikm P40
Fr 01.9471411
TOTAL
17 IIITOR110
CONTR.
LIOT
SEPTIC
TANS
SZWIL/1
CONN.
DRAIN
OF Irmo
SOANAOS
PIT
GR AS S
TRAP
SOLAR
HEATIIR
MOW
WELL
SPRKLR.
SYSTIM
SW IOC a
POOL
CONTR.
LIST
CNIECS
Pennit No (9,f elDg
Application is hereby made for the opprovol of the detailed statement of the piano and specifications herewith submitted for the building 07 other
structure herein described. This application is made In complianoe and conformity with the Building Ordinance) of Miami Stares Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Mia1011 Shares Village and all rules and regulations of the Building Division
of. Miami Shores Village shall be complied with, whether herein specified ce net A copy of approved plans and specificati ns nu Se be kept as
building during progress of work.
Figura 898 N E 95th St
Owner's Name and Adcbes No Street ._.
Registered Architect and/or Engineeilica..T. . 111
EmPloYing Minks* ItTnrno
4Le
and LegaI Description WI L. id, 7 woe,
Amount of Permit 9
NOTE: A re-inspection feet
materials and/or WC0111.4ShiP.
775,0U
■•■4
••••••,•
Subdivision& / th :gal'
Street and Number other() work III to In perfoallal—Ho. 9 5 Street in,
State work to be performed and purpose of building (By Fleces)__
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. Size of Soakage Pit
My Commission Ezygrea
0 SNORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUM:4NO PERMIT
(Signed)
0
Repair a No. of St 'ries ....
PIu nbing In vector.
.....
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as ail employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pennanent Supplement, and Isar com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the wort. to be
performed under this permit; and will post or amuse 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 be under Is permit, as are
licensed by Miami Shores Village.
Notary Public, State of Flosids
I star. Plum ber.
STATE OF FLORIDA, I
as.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, dilly anthceized to administer oaths and take acknowledgments, pi %%mien,' appeared
to me weU known, end who, being by me first duly amen, upon oath deposes acid says that be ta the ____
of the above described construction, that hens carefully read the foregoing application, and that be did sign the sawn, and thee all facts
therein by him stated are true.
01.00 wiul be meats whew omit les4sepezeice fL odo by Daiwprepor wake few inspection, 0:7 hulay
Permit No._____ ___d Date___
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for t he building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Sho .es 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 tl e Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specificatic ns must be kept at
building during progress of work.
Owner's Name and Address No
Registered Architect and /or Engineer 4 Employing Plumber's Name �e�__l.� 4 Ot1i2� - No Q �� _ Street___
Location and Legal Descriptiorf ot Block____— Subdivision
Street and Number where work is to be performed —No. Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Ss.
Nature of Water Supply: City —Well._
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
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
r / / J/
v ,, Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he iai/erstands and accepts his oblig bns as ar employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplem ;nt, 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 th s permit, as are
licensed by Miami Shores Village.
Alb
W1 'Street
•
Notary Public, State of Floride
v
4
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
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
. CHECK
.i I
I. .
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL.
SPRKLR.
SYSTEM
SWIM'G
POOL
1 /
CONTR.
LIST
CHECK
Permit No._____ ___d Date___
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for t he building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Sho .es 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 tl e Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specificatic ns must be kept at
building during progress of work.
Owner's Name and Address No
Registered Architect and /or Engineer 4 Employing Plumber's Name �e�__l.� 4 Ot1i2� - No Q �� _ Street___
Location and Legal Descriptiorf ot Block____— Subdivision
Street and Number where work is to be performed —No. Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Ss.
Nature of Water Supply: City —Well._
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
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
r / / J/
v ,, Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he iai/erstands and accepts his oblig bns as ar employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplem ;nt, 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 th s permit, as are
licensed by Miami Shores Village.
Alb
W1 'Street
•
Notary Public, State of Floride
v
4
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
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No
Employing Plumber's Name
building during progress of work.
i
Owner's Name and Address
Registered Architect and /or Engineer
�.
Nature of Water Supply: Cityx -Well
Amount of Permit $__j
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1
(Signed)
(Signed)
• _ 'Jaw
Date / 0 - -�
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for t he building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Sho.'es 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 ti e Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specificatic ns must be kept at
No Street
No Street
Location and Legal Description Lot Subdivision
Street and Number where work is to be performed— No.__U __9._____ e
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition. Repairs No. of Stc ries
Street
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
�
PIui nbing Inspector.
The undersigned applicant for this building permit does hereby certify that h °"u i nderstands and accepts hi o ligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, 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
perfonned 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.
C -mot.
Ma ster Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pc rsonally 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, ind 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
L ( I'
•'' , ,
TOTAL
FIXTURES
CONTR.
LIST
��
hl
/
_,4
/
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
_
Permit No
Employing Plumber's Name
building during progress of work.
i
Owner's Name and Address
Registered Architect and /or Engineer
�.
Nature of Water Supply: Cityx -Well
Amount of Permit $__j
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1
(Signed)
(Signed)
• _ 'Jaw
Date / 0 - -�
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for t he building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Sho.'es 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 ti e Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specificatic ns must be kept at
No Street
No Street
Location and Legal Description Lot Subdivision
Street and Number where work is to be performed— No.__U __9._____ e
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition. Repairs No. of Stc ries
Street
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
�
PIui nbing Inspector.
The undersigned applicant for this building permit does hereby certify that h °"u i nderstands and accepts hi o ligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, 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
perfonned 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.
C -mot.
Ma ster Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pc rsonally 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, ind 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.
/'
Size Septic Tank
. Feet of Drain Tile
Nature of Water Supply: City —Well
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(Signed)
APPLICATION FOR PLUMBING PERMIT
Permit No Date 2 / C .
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 Shires 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 t he Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specificati ons must be kept at
building during progress of work.
V i
Owner's Name and Address No % ` ' , - Street___: ^ • I r'' ° "
Registered Architect and /or Engineer_____ _
Employing Plumber's Name r
No Street
Location and Legal Description Lot Block Subdivision__
c,.
: 7
Street and Number where work is to be performed —No Street__fc: ..'
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of St ides
Capacity Gals
My Commission Expires Notary Public, State of Florida
JI
Type of Tank___,)
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Amount of Permit $ • L (Signed)
Plulnbing Inspector.
bli
The undersigned applicant for this building permit does hereby certify that he un erstands and accepts his o g ations as ar employer of
labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplemont, 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 the s permit, as are
licensed by Miami Shores Village.
Ma ster Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pe rsonally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
23
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
/'
Size Septic Tank
. Feet of Drain Tile
Nature of Water Supply: City —Well
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(Signed)
APPLICATION FOR PLUMBING PERMIT
Permit No Date 2 / C .
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 Shires 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 t he Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specificati ons must be kept at
building during progress of work.
V i
Owner's Name and Address No % ` ' , - Street___: ^ • I r'' ° "
Registered Architect and /or Engineer_____ _
Employing Plumber's Name r
No Street
Location and Legal Description Lot Block Subdivision__
c,.
: 7
Street and Number where work is to be performed —No Street__fc: ..'
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of St ides
Capacity Gals
My Commission Expires Notary Public, State of Florida
JI
Type of Tank___,)
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Amount of Permit $ • L (Signed)
Plulnbing Inspector.
bli
The undersigned applicant for this building permit does hereby certify that he un erstands and accepts his o g ations as ar employer of
labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplemont, 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 the s permit, as are
licensed by Miami Shores Village.
Ma ster Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pe rsonally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
23
Permit No
Location and Legal Description Lot_
Amount of Permit $
My Commission Expires
OA : B SHORES MOLdiGC
PLUMBING INSPECTION DEPARTMENT
QPPLICATIO
r<
FOR PLUMBING P E R M I T
(Signed)
(Signed)
Date
c, 5/66
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tl e building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shorts 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 ifs! 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.
q '1. • ST
Owner's Name and Address M C No _ � N' C Street S
Registered Architect and /or Engineer __ ________ — ___
NI 11 577
Employing Plumber's Name ly LS/ oo r4E - - Sr T1G > ck- - _ C__ �?_.____ - -- No g•97/ ' IA> • Street
Block_________ Subdivision
Street and Number where work is to be performed— No.____ _.____ 9
�g � ��y_ �- Street s Si
State work to be performed and purpose of building (By Floors)
N B Remodeling Addition.. Repairs No. of Stories. _ ___._._._... ---
Size Septic Tank Type of Tank Capacity Gals.__._._
Feet of Drain Tile 38 X41 c% I Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
bing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatiol an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent •pleme it, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe 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 (T notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under thi: permit, as are
licensed by Miami Shores Village.
Ivlg: ter - ]'!amber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pei sonally 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, a nd that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of i$1.00 will be made when such re- inspection is made • necessary by improper notice for inspection, or faulty
materials and/oz 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.
LICIT
CHECK
Permit No
Location and Legal Description Lot_
Amount of Permit $
My Commission Expires
OA : B SHORES MOLdiGC
PLUMBING INSPECTION DEPARTMENT
QPPLICATIO
r<
FOR PLUMBING P E R M I T
(Signed)
(Signed)
Date
c, 5/66
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tl e building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shorts 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 ifs! 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.
q '1. • ST
Owner's Name and Address M C No _ � N' C Street S
Registered Architect and /or Engineer __ ________ — ___
NI 11 577
Employing Plumber's Name ly LS/ oo r4E - - Sr T1G > ck- - _ C__ �?_.____ - -- No g•97/ ' IA> • Street
Block_________ Subdivision
Street and Number where work is to be performed— No.____ _.____ 9
�g � ��y_ �- Street s Si
State work to be performed and purpose of building (By Floors)
N B Remodeling Addition.. Repairs No. of Stories. _ ___._._._... ---
Size Septic Tank Type of Tank Capacity Gals.__._._
Feet of Drain Tile 38 X41 c% I Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
bing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatiol an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent •pleme it, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe 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 (T notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under thi: permit, as are
licensed by Miami Shores Village.
Ivlg: ter - ]'!amber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pei sonally 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, a nd that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of i$1.00 will be made when such re- inspection is made • necessary by improper notice for inspection, or faulty
materials and/oz workmanship.
BUILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
DATE
PERMIT N2 8891
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
CONTRACTOR OR BUILDER BY AUTHORITY
194_
Contractor's
License No.
Legal Lot I Bi. Subdi-
Description vision
Address of Value of Amt. of
Building 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 w th 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- By
INSPECTOR
In consideration of the issuance to me of this pe -^ I agrce to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
Dat
Type Insp'n
Permit No.
Name
Address
Ca pany
Phone #
MIAMI SHORES VILLAGE
is U ILL)IIN U lltYAK 1 MEN' 1'
305- 795 -2204
Building Inspection Request
For Inspector: 1 (30 dame & Date
Approve
Correction
Re- Insp'n Fee