710 NE 94 St (7)HUILDING
ELECTRICAL
PLUMBING
HOOFING
Architect
Contractor
or Builder
Legal
Description
Lot
S !
Owner of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N° 6552
Work to be performed under this Permit
B1
Address of
Building
DATE I
Contractor's
BY AUTHORITY
195
License No.
Subdi-
vision
Value of II Amount of
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:
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.
Permit No
Date___ I l 4 412 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.
Owners Name and Address 14. el 64€ -I Iv
No 1 l - Street. ?et' 5 T
Registered Architect and /or Engineer
Employing Plumber's Nye -. - - - S te.
-
Location and Legal Description Lot. 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
Size Septic Tank_.- it `
Feet of Drain Tile k
Nature of Water Supply: City-Well. Size of Soakage Pit.
Amount of Permit $
STATE OF FLORIDA, I
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
_Type of Tank._._ -.____ ----- .-- •-- -_._.,
Feet of Tank or Drain Field from Well ..- _.__ -..-
(Signed)
4(cx.,
Capacity Gals..._..
No. of Stories........._........ _
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perin ent 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 die Act. The undersigned agrees to employ only such sub - contractors, n work to be performed under this permit, as are
licensed by Miami Shores Village.
Notary Public, State of Florida
j e:71/7C (te(C---fiZ•
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.
mater a in aaaashipee of 81.00 will be made when such re- lnspect on V made'necesaary by improper notice for inspection, or faulty
CLOSETS
BATH
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINK/
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
-
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WILL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
9-J
CHECK
Permit No
Date___ I l 4 412 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.
Owners Name and Address 14. el 64€ -I Iv
No 1 l - Street. ?et' 5 T
Registered Architect and /or Engineer
Employing Plumber's Nye -. - - - S te.
-
Location and Legal Description Lot. 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
Size Septic Tank_.- it `
Feet of Drain Tile k
Nature of Water Supply: City-Well. Size of Soakage Pit.
Amount of Permit $
STATE OF FLORIDA, I
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
_Type of Tank._._ -.____ ----- .-- •-- -_._.,
Feet of Tank or Drain Field from Well ..- _.__ -..-
(Signed)
4(cx.,
Capacity Gals..._..
No. of Stories........._........ _
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perin ent 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 die Act. The undersigned agrees to employ only such sub - contractors, n work to be performed under this permit, as are
licensed by Miami Shores Village.
Notary Public, State of Florida
j e:71/7C (te(C---fiZ•
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.
mater a in aaaashipee of 81.00 will be made when such re- lnspect on V made'necesaary by improper notice for inspection, or faulty
BUILDING
ELECTRICAL
PLUMBING
ROOFING
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 6313
Owner of
Building
Architect
Contractor
or Builder
t .egal Lot
Description Bl
DATE ?
Contractor's
License No.
Work to be performed under this Permit
195
Subdi-
vision
Address of F Value of II Amount 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 application
horefor 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: y ,
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the wprk 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. In ac•
-epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
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 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. `� a (A` f-
Owner's Name and Address ...... No._ — ._.
------ --__ -- _ - Street
Registered Architect and /or Engin
Employing Plumber's Name
Location and Legal Description Lot_.__._._ ..... _________ - - -__ r _____-- Block
Street and Number where work is to be performed —No tree
State work to be performed and purpose of building (By Floors)___ G _4. - -- y
New Building _- Remodeling__ Addition______.___ Repairs No. of Stories.
Amount of Permit $ ‘4.■ _ :.._� ( Signed) - v _ •�
S a ATE OF FLORIDA, 1
COUNTY OF DADE.
es.
My mission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING ; ,#101'
K ze
Date
Street.
Subdivision
Notary Public, State of Florida
Size Septic Tank _ _ Type of Tank_ Capacity Gals . - -_ -_
Feet of Drain Tile_ ______ - stFeet of Tank or Drain Field from Well
Nature of Water Supply: City — Weil.______ _____________________ ______Size of Soakage Pit
lumbing 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 wrath 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
req4iaeel by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
hicn3d by Miami Shores Village.
Master lslumber:= "j-',
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
tkeretm 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 worilmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CON' .
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CH3CX
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 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. `� a (A` f-
Owner's Name and Address ...... No._ — ._.
------ --__ -- _ - Street
Registered Architect and /or Engin
Employing Plumber's Name
Location and Legal Description Lot_.__._._ ..... _________ - - -__ r _____-- Block
Street and Number where work is to be performed —No tree
State work to be performed and purpose of building (By Floors)___ G _4. - -- y
New Building _- Remodeling__ Addition______.___ Repairs No. of Stories.
Amount of Permit $ ‘4.■ _ :.._� ( Signed) - v _ •�
S a ATE OF FLORIDA, 1
COUNTY OF DADE.
es.
My mission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING ; ,#101'
K ze
Date
Street.
Subdivision
Notary Public, State of Florida
Size Septic Tank _ _ Type of Tank_ Capacity Gals . - -_ -_
Feet of Drain Tile_ ______ - stFeet of Tank or Drain Field from Well
Nature of Water Supply: City — Weil.______ _____________________ ______Size of Soakage Pit
lumbing 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 wrath 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
req4iaeel by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
hicn3d by Miami Shores Village.
Master lslumber:= "j-',
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
tkeretm 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 worilmanship.
, •
MIAMI SHORES 1/11°,e,GE
PLUMBING INSPECTION DEPARTMEI
APPLICATION FOR PLUMBINS '
Permit No ? _ Date i 1 / •„) 6
Application is hereby made for the approval of the detailed statement of ti7, piens and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conf.,r; Ity with the 'wilding Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Snores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified ,- - no.. A copy of approved plans and specifications must be kept at
biding during progress of work.
O Name and Address ��_ f �_____________ _ - No Street
Registered Arch°tect and /or Engineer C Le-t ; . 1 f
Employing Plumber's Name L A
r`� k 7l •
1
Location and Legal Description Lot.
1
Sweet and Number where work is to be performed —No
No.-
/ i'L e-
^_ _ Block _ Subdivision...:: __._ .... - -. __ - --
t C
Street ! - _ .-� • � �, � - -- --
Stan work to be performed and purpose of building (By
New Building _- - - - --- : . - -.•_ -- Remodeling__ -_ ._.___ Addition._
Si m. Septic Tank
Feet of Drain Tile.
Amount of Permit $
itiri'E CIF FLORIDA, l
g3'
OF DADE.
(Signed)-
(Signed)._
Street____
Repairs No. of Stories...
Type of Tank__ Capacity Gals._ -___
__Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City— Well. ._____�.Y 'e _. ._ t ) __Size of Soakage Pit
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
➢ic med by Miami Shores Village.
Fiefore me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me wye:i 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
therce1, by 1 - --n stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
NOTE: 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
• TU &S
t1RAFALB�
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N6
-
.
TOTAL
FIXTURES
LILY
4, /
CHECK
SEPTIC
TANK
SEWER
CORN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
" +•_'
UI/ , , i'. .�
Comm.
LIST
CHQC(
a
`i
, •
MIAMI SHORES 1/11°,e,GE
PLUMBING INSPECTION DEPARTMEI
APPLICATION FOR PLUMBINS '
Permit No ? _ Date i 1 / •„) 6
Application is hereby made for the approval of the detailed statement of ti7, piens and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conf.,r; Ity with the 'wilding Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Snores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified ,- - no.. A copy of approved plans and specifications must be kept at
biding during progress of work.
O Name and Address ��_ f �_____________ _ - No Street
Registered Arch°tect and /or Engineer C Le-t ; . 1 f
Employing Plumber's Name L A
r`� k 7l •
1
Location and Legal Description Lot.
1
Sweet and Number where work is to be performed —No
No.-
/ i'L e-
^_ _ Block _ Subdivision...:: __._ .... - -. __ - --
t C
Street ! - _ .-� • � �, � - -- --
Stan work to be performed and purpose of building (By
New Building _- - - - --- : . - -.•_ -- Remodeling__ -_ ._.___ Addition._
Si m. Septic Tank
Feet of Drain Tile.
Amount of Permit $
itiri'E CIF FLORIDA, l
g3'
OF DADE.
(Signed)-
(Signed)._
Street____
Repairs No. of Stories...
Type of Tank__ Capacity Gals._ -___
__Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City— Well. ._____�.Y 'e _. ._ t ) __Size of Soakage Pit
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
➢ic med by Miami Shores Village.
Fiefore me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me wye:i 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
therce1, by 1 - --n stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
NOTE: 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.
Registered Architect and /or EngiPe
er_
Employing Plumber's Name._
Size Septic Tank.___ ___.
Nature of Water Supply: C ity —W
Amount of Permit $_
STATE OF FLORIDA,
CCUNTY OF DADE.
IAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING E";kMIT
Permit No & - - - -- - - -- Date 1
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
Street and Number where work is to be performed —No
1
Location and Legal Description Lot Blork
1 0
State work to be performed and purpose of building (By Fl oors )______------ _•------ __ -_ __.
New Building _ ._----- - - - -- - - --___ Remodeling_ ---- _-- _---- _____ —_ Addition
No._
No._
Type of Tank Capacity Gals
Feet of Drain Tile. Dist. Feet of Tank or Drain Field from Well
�,��,�� ..________ _ ._Size of So it
7-4 ' W ` - - -- - - - vim
(Signed) -
Pl ing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations t an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suk ement, and has coin -
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- contract work to be rformed under this permit, as are
licensed by Miami Shores Village.
Street.
Stree
Subdivision
Street 11 S
Repairs No. of Stories
Le,
F y Commission Expires Notary Public, State of Florida
f-
Master Plumber.
'lefore 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 shove described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
th:se!n by hin. 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.
CI-"E"
TU BS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tue6
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK N6
FOUNT' NS
TOTAL
FIXTURES
CONTa.
LIST
CMCC%
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
UST
-
CH SCN
Registered Architect and /or EngiPe
er_
Employing Plumber's Name._
Size Septic Tank.___ ___.
Nature of Water Supply: C ity —W
Amount of Permit $_
STATE OF FLORIDA,
CCUNTY OF DADE.
IAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING E";kMIT
Permit No & - - - -- - - -- Date 1
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
Street and Number where work is to be performed —No
1
Location and Legal Description Lot Blork
1 0
State work to be performed and purpose of building (By Fl oors )______------ _•------ __ -_ __.
New Building _ ._----- - - - -- - - --___ Remodeling_ ---- _-- _---- _____ —_ Addition
No._
No._
Type of Tank Capacity Gals
Feet of Drain Tile. Dist. Feet of Tank or Drain Field from Well
�,��,�� ..________ _ ._Size of So it
7-4 ' W ` - - -- - - - vim
(Signed) -
Pl ing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations t an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suk ement, and has coin -
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- contract work to be rformed under this permit, as are
licensed by Miami Shores Village.
Street.
Stree
Subdivision
Street 11 S
Repairs No. of Stories
Le,
F y Commission Expires Notary Public, State of Florida
f-
Master Plumber.
'lefore 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 shove described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
th:se!n by hin. 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.