1026 NE 97 St (11)Permit No - Date_._.
Application s hereby made for the approval of the detailed statement of the plans and specifications herewith 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. , ,
. � . rY' //' 9 mss t7 c' -
Owner's Name and Address '_ _ ___ �.__ _._ No._ ---- ..- -___ -_ Street. -- ...2.4
Registered Architect and /or
Epsp awakes Nam ... t o.
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performe8 and purpose
New Building--- - - -_ -_ _.. Remodeling __.__— ..--- _— __.
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
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR P
Bloo1r
® 7 ( Stmt
Repairs. __.X
Addition.
(Signed) _
( Signed) _—.._._ __-
PERMIT
Street.
Subdivision.. -774-
,cif`, ';*4 r
Ne:nsi*
Capacity Gals
Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building per3i does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the si Qf the work such, public notice or notices as are
required by die Act. The undersigned agrees to employ only such sub- contractors, on fo be per ormed' under this permit, as are
require by Miami Shore Village.
„
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persoally 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
OATH
Tuns
$MOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuv6
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
PIXTUREs
CONTR.
LIST
CHECK
_
r
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
Coffin.
LIT
CHECK
Permit No - Date_._.
Application s hereby made for the approval of the detailed statement of the plans and specifications herewith 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. , ,
. � . rY' //' 9 mss t7 c' -
Owner's Name and Address '_ _ ___ �.__ _._ No._ ---- ..- -___ -_ Street. -- ...2.4
Registered Architect and /or
Epsp awakes Nam ... t o.
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performe8 and purpose
New Building--- - - -_ -_ _.. Remodeling __.__— ..--- _— __.
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
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR P
Bloo1r
® 7 ( Stmt
Repairs. __.X
Addition.
(Signed) _
( Signed) _—.._._ __-
PERMIT
Street.
Subdivision.. -774-
,cif`, ';*4 r
Ne:nsi*
Capacity Gals
Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building per3i does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the si Qf the work such, public notice or notices as are
required by die Act. The undersigned agrees to employ only such sub- contractors, on fo be per ormed' under this permit, as are
require by Miami Shore Village.
„
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persoally 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.