1090 NE 96 St (6)Permit No 5
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subrait;.A for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of MiE, ri Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatim; 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.
Ala Sandler 1090 N E 96th Street
Owner's Name and Address No Street.. !. ........
tegisterecl Architect and/or Engineer
Brooks-American Sprinkler Co 2430 N.W. 79th Street
.?,mploying Plumber's Name NO1•••■•••■•••,../ervo•vserm•maset.e.r: 8 treas..* :ere ',vs ..... •• • I-- -
Block
Street N,E,..96th Street
State work to be performed and purpose of building (By ) Lawn Sprinkler installation ___
New Building Remodeling Addition
Location and Legal Description Lot.
Street and Number where work is to be performed—No
Size Septic of Tank__
Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: of Soakage Pit
Amount of Permit $ 5.00
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)_
( Signed )__
6/1/79
Repairs No. of Stones ....
Capacity Gala
. ..... .
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 rup . lement, and has can-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed 1 y him in 'Le wcrk
performed under this permit; and will post or cause to be posted' for inspection on the site of Je work such pub!! notice 11 noicer ss au
required by the Act. The undersigned agrees to employ only such sub-contractors, on to be performed n this p malt, au ,
licensed by Miami Shores Village.
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 be has carefully read the foregoing application, and that he did sign the same, and that all :acts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Mast Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personatEr t ppearec.
NOTE: A re-inspection fee of $1.00 will be made when such r.l.pect*m Is mede.necessary by improper notice for inspection, us faulty
materials and/or workmanship.
CLOSETS
BATH
rues
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
SAWN
FLOOR I
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTI. RES
—_
CONTR.
Liar
CHICK
—
SEPTIC
TANK
SIWIER
CONN.
DRAIN
FIELD
SOAKAGIt
PIT
G
TRAP
SOLAR
H
DEEP
WILL
SPRKLR.
SYSTEM
SWIM
POOL
CONTR.
Lt ST
CHECK
5.00
..-
,
ar....
Permit No 5
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subrait;.A for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of MiE, ri Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatim; 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.
Ala Sandler 1090 N E 96th Street
Owner's Name and Address No Street.. !. ........
tegisterecl Architect and/or Engineer
Brooks-American Sprinkler Co 2430 N.W. 79th Street
.?,mploying Plumber's Name NO1•••■•••■•••,../ervo•vserm•maset.e.r: 8 treas..* :ere ',vs ..... •• • I-- -
Block
Street N,E,..96th Street
State work to be performed and purpose of building (By ) Lawn Sprinkler installation ___
New Building Remodeling Addition
Location and Legal Description Lot.
Street and Number where work is to be performed—No
Size Septic of Tank__
Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: of Soakage Pit
Amount of Permit $ 5.00
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)_
( Signed )__
6/1/79
Repairs No. of Stones ....
Capacity Gala
. ..... .
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 rup . lement, and has can-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed 1 y him in 'Le wcrk
performed under this permit; and will post or cause to be posted' for inspection on the site of Je work such pub!! notice 11 noicer ss au
required by the Act. The undersigned agrees to employ only such sub-contractors, on to be performed n this p malt, au ,
licensed by Miami Shores Village.
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 be has carefully read the foregoing application, and that he did sign the same, and that all :acts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Mast Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personatEr t ppearec.
NOTE: A re-inspection fee of $1.00 will be made when such r.l.pect*m Is mede.necessary by improper notice for inspection, us faulty
materials and/or workmanship.
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 regulation of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specthcations must be kept at
building during progress of work.
Owner's Name and Address
Amount of Permit $
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
4,/ _Vc P /V ) tee_ ./‘ 7
D6
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
..tegistered Architect and /or Engineer
.mss J'�U G,0 No,.-i7Q .G/lC street... ce,1 U. rn......
Employing Name. .... ....... .... � �.� - �
Location and Legal Description Lot. Block SubdivWon.-_-..
Street and Number where work is to be performed —No. /0 9 0 '� Street- 96 6
State work to be performed and purpose of building (By Floors) /
New Building _ Remodeling___._ _ Addition.- _...__ Repairs Y
Size Septic Tank-_._._--- --- ------- -- --- - -- ----Type of Tank._ - - — — -- - Capacity Gals. - --
Feet of Drain Tile._012 O 5 __Dist. Feet of Tank or Drain Field from Well. . - - -- 4
Nature of Water Supply: City — Well _______._____. _____ _ .. -Size of Soakage Pit
(Signed) _
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 5988, Compiled General Laws of Florida Permanent Cupilement, and has con -
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed l y him in P!-e wcrk
performed under this permit; and will post or cause to be posted for inspection on the site of the work such pub!! notice .3r notice.^ as as
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed this y rims, as az
licensed by Miami Shores Village.
(Silk)
Before me, the undersigned aut a notary public, duly authorized to administer oaths and take acknowledgments, personal:;• eppeareo,
G1, 6 '4-e-v. 6IZ°/../
to me well lmown, 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 applica • . and that he did sign the same, and that all acts
therein by him stated are true . ;,, LARG
11 1, IL..0
. ;' ..a .,. . AO ,h1 ',1, - ,pztict
Date...
No. of Stories
Mesta, Plumber.
NOTE: A re- inspection fee of $L00 will be made when such re- inspection is a ede neoeasary by improper notice for inspection. or fouity
materials and /or workmanship.
CLO[[TE
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'Ns
TOTAL
FIXTURES
CONTR.
LI6T
_—
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
CHECK
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and 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 regulation of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specthcations must be kept at
building during progress of work.
Owner's Name and Address
Amount of Permit $
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
4,/ _Vc P /V ) tee_ ./‘ 7
D6
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
..tegistered Architect and /or Engineer
.mss J'�U G,0 No,.-i7Q .G/lC street... ce,1 U. rn......
Employing Name. .... ....... .... � �.� - �
Location and Legal Description Lot. Block SubdivWon.-_-..
Street and Number where work is to be performed —No. /0 9 0 '� Street- 96 6
State work to be performed and purpose of building (By Floors) /
New Building _ Remodeling___._ _ Addition.- _...__ Repairs Y
Size Septic Tank-_._._--- --- ------- -- --- - -- ----Type of Tank._ - - — — -- - Capacity Gals. - --
Feet of Drain Tile._012 O 5 __Dist. Feet of Tank or Drain Field from Well. . - - -- 4
Nature of Water Supply: City — Well _______._____. _____ _ .. -Size of Soakage Pit
(Signed) _
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 5988, Compiled General Laws of Florida Permanent Cupilement, and has con -
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed l y him in P!-e wcrk
performed under this permit; and will post or cause to be posted for inspection on the site of the work such pub!! notice .3r notice.^ as as
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed this y rims, as az
licensed by Miami Shores Village.
(Silk)
Before me, the undersigned aut a notary public, duly authorized to administer oaths and take acknowledgments, personal:;• eppeareo,
G1, 6 '4-e-v. 6IZ°/../
to me well lmown, 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 applica • . and that he did sign the same, and that all acts
therein by him stated are true . ;,, LARG
11 1, IL..0
. ;' ..a .,. . AO ,h1 ',1, - ,pztict
Date...
No. of Stories
Mesta, Plumber.
NOTE: A re- inspection fee of $L00 will be made when such re- inspection is a ede neoeasary by improper notice for inspection. or fouity
materials and /or workmanship.
Registered Architect and /or En:' eer
Employing Plumber's Name
Location and Legal Description Lot
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No '° D (9 Date..1.._ _-._ .. 7 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 spedficatlons must be kept at
building during progress of work. e
Owner's Name and Address Mee 41 e- �'v/ � No \3'a I / f , /
Bloom ubdMaLon
-
Street and Number where work is to be performed —No /9 9, � � Street.. ........_.
State work to be performed and purpose of building (By Floors)._ — - -._— f
New Building - -------- •- •- ..._.__. Remodeling - -- Addition - - - -_ ._.. __.. Repairs...
No. of Stories. ......
Size Septic Tank —
Feet of Drain Tile
—
Na Water pply: City—W
Amount of Permit $
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 5988, Compiled General Laws of Florida Pennanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor 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 k to be performed under th) pp as are
licensed by Miami Shores Village.
STATE OF FLORIDA, 1 u
COUNTY OF DADE. I
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 be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him dated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be snide when seek roispotkm is snade•stemesery by improper notice for lbsspection, err faulty
materials and /err worlonanship.
apt #--z2
Type of Tank__.—. —
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit..
L
(Signed)
Plumbing Inspector.
Master Plumber.
CLOUTS
BATH
T
SHOW[Ra
LAVA.
Tomas
SINKS
SLOP
SINK[
LAUNDRY
Tugs
URINALS
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
Ft
CONTK.
LIST
CHICK
SEPTIC
TANK
SEWIR
CONK.
DRAIN
FIILD
SOAKAGI
PIT
GRIMM
TRAP
SOLAR
NIATIR
Daub
WILL
SPRKLR.
SY$TtM
SW 1M'a
POOL
CONTR.
LIrr
CHICK
Registered Architect and /or En:' eer
Employing Plumber's Name
Location and Legal Description Lot
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No '° D (9 Date..1.._ _-._ .. 7 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 spedficatlons must be kept at
building during progress of work. e
Owner's Name and Address Mee 41 e- �'v/ � No \3'a I / f , /
Bloom ubdMaLon
-
Street and Number where work is to be performed —No /9 9, � � Street.. ........_.
State work to be performed and purpose of building (By Floors)._ — - -._— f
New Building - -------- •- •- ..._.__. Remodeling - -- Addition - - - -_ ._.. __.. Repairs...
No. of Stories. ......
Size Septic Tank —
Feet of Drain Tile
—
Na Water pply: City—W
Amount of Permit $
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 5988, Compiled General Laws of Florida Pennanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor 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 k to be performed under th) pp as are
licensed by Miami Shores Village.
STATE OF FLORIDA, 1 u
COUNTY OF DADE. I
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 be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him dated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be snide when seek roispotkm is snade•stemesery by improper notice for lbsspection, err faulty
materials and /err worlonanship.
apt #--z2
Type of Tank__.—. —
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit..
L
(Signed)
Plumbing Inspector.
Master Plumber.
City of Miami Shores
Miami Shores, Fla.
Attn: Building and Zoning Department
To Whom It May Concern:
This letter is to authorize Mr. Thomas Daddona's
signature for permit applications at the City of
Miami Shores Mechanical Department.
JD: dg
A. D. AIR DESIGNE. INC.
2456 W. 8TH COURT
HIALEAH, FLORIDA 33010
PHONE: 885 -8986
BROWARD 525 -2844
January 25, 1979
Sincerely Y
Joseph Daddona
President
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT Q
Permit N
o
2. Date. ° .17.x__....-
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 M r •
&Mrs . Alan Sandler
Location and Legal Description Lot.S_2 3 Block -83
Street and Number where work is to be performed —No 1 090 N . F,. 9F St .
Size Septic Tank_
Feet of Drain Tile
Nature of Water Supply: City—Well.
No 1090
Registered Architect and /or Engineer Wi 11_1 are Sheldon
All Dade Plumbin,
Employing Plum's . — � . _...._ - ....r.., *4—.97?
Type of Tank__
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit.
Amount of Permit $ I 04 ( Signed)71
(Signed)
Street.
r(' AzAu n c 2: LkKQ.s
94 x.4.2.8
street.T . l:. 96 St-
,,�� Miami Shores
Sg j ?. B . 10 Pg. 37
State work to be performed and purpose of building (By s ).T2 at _sspa a n cL.runl pip.tng t o Equ ipmen t
New Building.__...._ _ _ Remodeling.___._.._. —__ Addition Repairs No. of Stories...............
saiY
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 Ilas 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 e m p l o y only s u c h sub- contractors, on work to be performed under t i permit, as are
licensed by Miami Shores Village.
aster Plumber.
STATE OF FLORIDA, I u.
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 dep oses and says that be is the _.._..._.._.--- .._... _ _...._.
of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Maid.
NOTE: A re- inspection fee of $1.00 will be shade whoa wolf r laspaotfos it made•aaoawry by improper node, for inspection. or faulty
materials and /or workmanship.
TOTAL
FIXTURES
CLOSETS
BATH
Tuns
BMOWERn
LAVA-
TORIES
IN
SINKS
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
MEATIER
our
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
'--
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT Q
Permit N
o
2. Date. ° .17.x__....-
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 M r •
&Mrs . Alan Sandler
Location and Legal Description Lot.S_2 3 Block -83
Street and Number where work is to be performed —No 1 090 N . F,. 9F St .
Size Septic Tank_
Feet of Drain Tile
Nature of Water Supply: City—Well.
No 1090
Registered Architect and /or Engineer Wi 11_1 are Sheldon
All Dade Plumbin,
Employing Plum's . — � . _...._ - ....r.., *4—.97?
Type of Tank__
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit.
Amount of Permit $ I 04 ( Signed)71
(Signed)
Street.
r(' AzAu n c 2: LkKQ.s
94 x.4.2.8
street.T . l:. 96 St-
,,�� Miami Shores
Sg j ?. B . 10 Pg. 37
State work to be performed and purpose of building (By s ).T2 at _sspa a n cL.runl pip.tng t o Equ ipmen t
New Building.__...._ _ _ Remodeling.___._.._. —__ Addition Repairs No. of Stories...............
saiY
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 Ilas 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 e m p l o y only s u c h sub- contractors, on work to be performed under t i permit, as are
licensed by Miami Shores Village.
aster Plumber.
STATE OF FLORIDA, I u.
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 dep oses and says that be is the _.._..._.._.--- .._... _ _...._.
of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Maid.
NOTE: A re- inspection fee of $1.00 will be shade whoa wolf r laspaotfos it made•aaoawry by improper node, for inspection. or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
D
/X/ 15 ' Date..._ a .4_ ... .f_ 9 '7
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 Dopy of approved plans and specifications must be kept at
building during progress of work.
Owners Name and Address S 09 " 4 L E/i No / � 0 7 e Street &t ?e /e/ . ..
Registered Architect and /or Engineer
Employing Plumber's Name IMP O A:1 _ 2 11'71 7 (.211 '' 6 Na,. . ,z, ......... aroma. �e..:2 .`J6......
Location and Legal Description Lot_ 02 r3 stock_
�, FY Subd ivWon...rti'S . /
q
Street and Number where work is to be performed —No le ! /2 e / C / Street.._..
State work to be performed and purpose of building (By Floors)__Z✓ `'v �'4 ,".- W EI - . .... ..... .....— .
New Building - -__._ _ _.._ _.. Remodeling_ __ Addition.. -X . _ . Repairs. No. of Stories.... ".........
Type of Tangy
Hirt. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit ....
Size Septic Tank_ -
Feet of Drain Tile
Amount of Permits c &40
Capacity Cals.
(Signed)_"(73t IN&' Q)
M Commission Expires Notary Public, State of Florida
•
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 the Act. The undersigned agrees to employ only such subcontractors, on work to be y erformed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, 1 µ
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 dep oses and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that be 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 Snob r -baspaollati is mode•aeosesary by bnproper notice kr inspection, or leaky
materials and/or wrod®aosbip.
TOTAL
riming.
CLOSETS
BATH
TUBS
SHOWIRG
LAVA.
Tomas
SINK,
SLOP
SINKS
LAUNDRY
Tugs
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'Ns
WET
QA l e_
/
IUIOC i
___
CONTR.
LIST
/
a
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGI
PIT
GREASE
TRAP
SOLAR
HEATER
Daum
WELL
SPRKLR.
SYSTEM
SWIM'0
root.
LIST
CHICK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
D
/X/ 15 ' Date..._ a .4_ ... .f_ 9 '7
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 Dopy of approved plans and specifications must be kept at
building during progress of work.
Owners Name and Address S 09 " 4 L E/i No / � 0 7 e Street &t ?e /e/ . ..
Registered Architect and /or Engineer
Employing Plumber's Name IMP O A:1 _ 2 11'71 7 (.211 '' 6 Na,. . ,z, ......... aroma. �e..:2 .`J6......
Location and Legal Description Lot_ 02 r3 stock_
�, FY Subd ivWon...rti'S . /
q
Street and Number where work is to be performed —No le ! /2 e / C / Street.._..
State work to be performed and purpose of building (By Floors)__Z✓ `'v �'4 ,".- W EI - . .... ..... .....— .
New Building - -__._ _ _.._ _.. Remodeling_ __ Addition.. -X . _ . Repairs. No. of Stories.... ".........
Type of Tangy
Hirt. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit ....
Size Septic Tank_ -
Feet of Drain Tile
Amount of Permits c &40
Capacity Cals.
(Signed)_"(73t IN&' Q)
M Commission Expires Notary Public, State of Florida
•
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 the Act. The undersigned agrees to employ only such subcontractors, on work to be y erformed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, 1 µ
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 dep oses and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that be 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 Snob r -baspaollati is mode•aeosesary by bnproper notice kr inspection, or leaky
materials and/or wrod®aosbip.
Application re.y made for the approval the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application i 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 __�c-�,/--' .--- - -y!�!
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description L
Street and Number where work is to be performed —No _e
New Building _ Remodeling
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
APPLICATION FOR PLUMBING PERMIT
e,. /2-t/
My Commission Expires
PLUMBING INSPECTION DEPARTMENT
MIAMI SHORES VILLAGE
__(Signed)
//L 1 /1/ Street___
State work to be performed and purpose of building (By Floors)
Addition
Date
Street__
(it/Wee rio
to administer oaths and take
Su ]�division_
Notary Public. State of Florida
Repairs No. of Stories
Size Septic Tank________ — ____________ _ __ Type of Tank . Capacity Gals.______.____- __ �__w�
Feet of Drain Tile- _ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. _ Size of Soakage Pit
Plumb' Inspector.
The undersigned applicant for this building permit does hereby certify that he derstands 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 the Act. The under signed agrees to employ only such sub - contractors, on work tq be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized
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.
acknowledgments, personally
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
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
ELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
Application re.y made for the approval the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application i 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 __�c-�,/--' .--- - -y!�!
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description L
Street and Number where work is to be performed —No _e
New Building _ Remodeling
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
APPLICATION FOR PLUMBING PERMIT
e,. /2-t/
My Commission Expires
PLUMBING INSPECTION DEPARTMENT
MIAMI SHORES VILLAGE
__(Signed)
//L 1 /1/ Street___
State work to be performed and purpose of building (By Floors)
Addition
Date
Street__
(it/Wee rio
to administer oaths and take
Su ]�division_
Notary Public. State of Florida
Repairs No. of Stories
Size Septic Tank________ — ____________ _ __ Type of Tank . Capacity Gals.______.____- __ �__w�
Feet of Drain Tile- _ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. _ Size of Soakage Pit
Plumb' Inspector.
The undersigned applicant for this building permit does hereby certify that he derstands 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 the Act. The under signed agrees to employ only such sub - contractors, on work tq be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized
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.
acknowledgments, personally
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.
STATE OF FLORIDA,
COUNTY OF DADE.
APPLICATION FOR PLUMBING PERMIT
Permit No Date____ ! . 34l
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 r
Employing Plumber's Name ___ R! 2247
Location and Legal Description Lot_____
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building _ Remodeling Addition
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
No.
Type of Tank
No
(Signed)
_Block
/ /II Q
Size Septic Tank_
Feet of Drain Tile_____ —_ —___ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well .Size of Soakage Pit
Notary Public. State of Florida
Street) V $ 14 .
stre›
Subdivision
0 ___ Street :�_j____ __ '= — • - -___
Repairs No. of Stories
Capacity Gals._______ ......
____
Amount of Permit $_ jam____ _ ___ ____ - -__ _ (Signed)
The undersigned applicant for this building permit does hereby certify that }"understands and accepts his obligations as an employer'8f 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
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notice
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this pe
licensed by Miami Shores Village.
Plumbing Inspect
Master Plumber.
as are
t, as are
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
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
STATE OF FLORIDA,
COUNTY OF DADE.
APPLICATION FOR PLUMBING PERMIT
Permit No Date____ ! . 34l
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 r
Employing Plumber's Name ___ R! 2247
Location and Legal Description Lot_____
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building _ Remodeling Addition
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
No.
Type of Tank
No
(Signed)
_Block
/ /II Q
Size Septic Tank_
Feet of Drain Tile_____ —_ —___ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well .Size of Soakage Pit
Notary Public. State of Florida
Street) V $ 14 .
stre›
Subdivision
0 ___ Street :�_j____ __ '= — • - -___
Repairs No. of Stories
Capacity Gals._______ ......
____
Amount of Permit $_ jam____ _ ___ ____ - -__ _ (Signed)
The undersigned applicant for this building permit does hereby certify that }"understands and accepts his obligations as an employer'8f 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
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notice
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this pe
licensed by Miami Shores Village.
Plumbing Inspect
Master Plumber.
as are
t, as are
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.
Li-H4
Registered Architect and /or Engineer ______— ______________
Size Septic Tank Type of Tank
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Piu_bin' Permit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
New Building. Remodeling Addition Repairs
Amount of Permit $ ( Signed)
Date 6117/53
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 Howard Parrish _ No 1090 NE Street_ 96th
Employing Plumber's Name_ �i1f ffln__Sn�11S_tT'IB�9_i___ZIlO. NoP_.s.0_.BOR 6331 street _Coral Gables, Fla.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No. 1090 E Street 96th
State work to be performed and purpose of building (By Floors) replace solar 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
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 corn-
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.
( Signed) GIFF N INDUST ' _ = INC
/V1. $ Master Plumber.
Jot
i1 mi >a. ss = Treas.
Before nee, 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 be is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
No. of Stories
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
FOU NT' 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
100
gal.
CHECK
Permit No.
Li-H4
Registered Architect and /or Engineer ______— ______________
Size Septic Tank Type of Tank
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Piu_bin' Permit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
New Building. Remodeling Addition Repairs
Amount of Permit $ ( Signed)
Date 6117/53
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 Howard Parrish _ No 1090 NE Street_ 96th
Employing Plumber's Name_ �i1f ffln__Sn�11S_tT'IB�9_i___ZIlO. NoP_.s.0_.BOR 6331 street _Coral Gables, Fla.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No. 1090 E Street 96th
State work to be performed and purpose of building (By Floors) replace solar 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
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 corn-
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.
( Signed) GIFF N INDUST ' _ = INC
/V1. $ Master Plumber.
Jot
i1 mi >a. ss = Treas.
Before nee, 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 be is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
No. of Stories
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.
e 6)C2
Permit No fC/
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.itle..t.1.i ,
Location and Legal Description Lot
Street and Number where work is to be performed —No
/ 0 9 ® Street . - 1 [ ..._4_._.1 .
State work to be performed and purpose of building (By Floors)_ . `._ -_
New Building- _ - - -_— _ ------- .•- -• - -._ Remodeling Addition.- - -• - -_ Repairs No. of Stories. . ......
Size Septic
Feet of Drain Tile.
Nature of Water Supply: City—Well
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pere
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors em
performed under this permit; and will post or cause to be posted for inspection on the - •f the work au
required by the Act. The undersigned agrees to employ only such sub- contractors, to be
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. as.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
A
C
A L- K EA No.
Bloom
__Type of Tank —_ ____
Feet of Tank or Drain Field from Well.
Size of Soakage Pit
(Signed)_
(Si
/090 Street.22 e q6
9/
Subdivision
cis
.Capacity Gals._._.- ...._. __.._. _ _.._.....___....
1
Plumbing Inspector.
ations as an employer of labor
ent Supplement, and has com-
ed by him in the work to be
ie notice or notices as are
under this permit, as are
er Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ._.__......_._........_ _ ...... _._ ...............
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re - inspection is made•neoessary by improper notice for inspection, or faulty
materials and /or workmanship
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
U
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'O
POOL
CONTR.
LIST
CHECK
e 6)C2
Permit No fC/
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.itle..t.1.i ,
Location and Legal Description Lot
Street and Number where work is to be performed —No
/ 0 9 ® Street . - 1 [ ..._4_._.1 .
State work to be performed and purpose of building (By Floors)_ . `._ -_
New Building- _ - - -_— _ ------- .•- -• - -._ Remodeling Addition.- - -• - -_ Repairs No. of Stories. . ......
Size Septic
Feet of Drain Tile.
Nature of Water Supply: City—Well
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pere
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors em
performed under this permit; and will post or cause to be posted for inspection on the - •f the work au
required by the Act. The undersigned agrees to employ only such sub- contractors, to be
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. as.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
A
C
A L- K EA No.
Bloom
__Type of Tank —_ ____
Feet of Tank or Drain Field from Well.
Size of Soakage Pit
(Signed)_
(Si
/090 Street.22 e q6
9/
Subdivision
cis
.Capacity Gals._._.- ...._. __.._. _ _.._.....___....
1
Plumbing Inspector.
ations as an employer of labor
ent Supplement, and has com-
ed by him in the work to be
ie notice or notices as are
under this permit, as are
er Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ._.__......_._........_ _ ...... _._ ...............
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re - inspection is made•neoessary by improper notice for inspection, or faulty
materials and /or workmanship
JOB:
BUILDING
ELECTRICAL
PLUMBING
•
•
•
•
Inspector's Report: -
a.
• WORK
• DONE BY
•
AD:
The following is ready for Inspection:
•
• REQUESTED •
• AIL BE READY
)
AAiALALAakilLAAAAALAALAAALALAAL■ALAALAAAALAAALAL.A.ALAALALALiALiku_Au
JOB:
-BUILDING
ELECTRICAL :
PLUMBING
Inspector's Report:
•
•
•
•
•
•
•
•
•
•
•
WORK
: DONE BY:
The following is ready for Inspection:
REQUESTED
' 1
CP,J1-41-4.4.A.
•
1,7
Permit No 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 descri ed. 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.
Registered Architect and /or EngiruACME_sEpTic TANK co.
Employing Plumber's Name P-0-430X---1000- _____ No Street
Location and Legal Description Lot __ ____ _II ALEAN___E OR l D A__________ Block __ Subdivision
Street and Number where work is to be performed —No al C_______( 4' eet
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition____ Repairs No. of Stories
Owner's Name and Address
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
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 the Act. The undersigned agrees to employ only such sub - contractors, on work to be perfonned under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
ss.
�Z L
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
Date
No Street
„ Type of Tank Capacity Gals.
. Feet of Tank or Drain Field from Well
Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
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
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
1,7
Permit No 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 descri ed. 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.
Registered Architect and /or EngiruACME_sEpTic TANK co.
Employing Plumber's Name P-0-430X---1000- _____ No Street
Location and Legal Description Lot __ ____ _II ALEAN___E OR l D A__________ Block __ Subdivision
Street and Number where work is to be performed —No al C_______( 4' eet
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition____ Repairs No. of Stories
Owner's Name and Address
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
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 the Act. The undersigned agrees to employ only such sub - contractors, on work to be perfonned under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
ss.
�Z L
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
Date
No Street
„ Type of Tank Capacity Gals.
. Feet of Tank or Drain Field from Well
Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
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
Legal Lot Bi.
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 2029
DATE
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or- $asilder
Subdi-
vision
Value of
Project
r
194 =
Contractor's
License No
Amt. of
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 regula-
tions 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, eirvant or employee.
CONTRACTOR OR BUttDBR BY AUTHORITY,,
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name
Amount of Permit
My Commission Expires
MIAMI SHARES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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
No
Location and Legal Description ___________ __ -_____ __ Subdivision- ____- - ___ /___.___A��
Street and Number where work is to be performed —No L_,l_1}_
/46 fa fa ____ Street � __�!_ljt__r '
State work to be performed and purpose of building (By Floors)
New Building_ Remodeling Addition Repairs No. of Stories____-
Type of Tank _ __Capacity Gals _________
______ —__
Size Septic Tank_
Feet of Drain Tile_
Nature of Water Supply: City —Well. Size of Soakage Pit.
Dist. Feet of Tank or Drain Field from Well
(Signed)
0
Date__.
Notary Public. State of Florida
v(2
Street �_!
Stree _? f�_2
Plu
The undersigned applicant for this building permit does hereby certify that understands and accepts his obligations as an employar6f 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 the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR. L LIST
LIST
CHECK
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name
Amount of Permit
My Commission Expires
MIAMI SHARES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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
No
Location and Legal Description ___________ __ -_____ __ Subdivision- ____- - ___ /___.___A��
Street and Number where work is to be performed —No L_,l_1}_
/46 fa fa ____ Street � __�!_ljt__r '
State work to be performed and purpose of building (By Floors)
New Building_ Remodeling Addition Repairs No. of Stories____-
Type of Tank _ __Capacity Gals _________
______ —__
Size Septic Tank_
Feet of Drain Tile_
Nature of Water Supply: City —Well. Size of Soakage Pit.
Dist. Feet of Tank or Drain Field from Well
(Signed)
0
Date__.
Notary Public. State of Florida
v(2
Street �_!
Stree _? f�_2
Plu
The undersigned applicant for this building permit does hereby certify that understands and accepts his obligations as an employar6f 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 the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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.
c C;
Location and Legal Description Lot 2± &__3
State work to be performed and purpose of building (By Floors)
Amount of Permit $_/( i,./ e' r
STATE OF FLORIDA,
COUNTY OF DADE.
Ss.
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.
Owner's Name and Address 11,S..Benfield_ No 11-10- Street
Registered Architect and /or Engineer ____ _________� -
Employing Plumber's Name , H. 0. Lasseter., � � _ No. 4646 t 11.__1.4___1_7_th_ \ e
Street and Number where work is to be performed —No 1110 __N. E. Street 9fith_
New Building X Remodeling Addition Repairs No. of Stories.____].
Size Septic Tank i► blnix Type of Tank _.P re__0Q -nOr-et. Capacity Gals. no__ _G
Feet of Drain Tile 150 Dist. Feet of Tank or Drain Field from Well .__
Nature of Water Supply: City —Well. City Size of Soa kage Pit
D ock $1_ Subdivision ___1:,
Residence
Date _________ --
My Commission Expires Notary Public, State of Florida
7 P1 bing Inspector.
The undersigned applicant for this building permit does hereby certify th a understands and accepts his obligati?, s an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Comp' d 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. i% �'
(Signed
3 Mister 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 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
3
1
2
3
1
1
IS /
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE GREASE
PIT TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
x
CHECK
.__
Permit No.
c C;
Location and Legal Description Lot 2± &__3
State work to be performed and purpose of building (By Floors)
Amount of Permit $_/( i,./ e' r
STATE OF FLORIDA,
COUNTY OF DADE.
Ss.
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.
Owner's Name and Address 11,S..Benfield_ No 11-10- Street
Registered Architect and /or Engineer ____ _________� -
Employing Plumber's Name , H. 0. Lasseter., � � _ No. 4646 t 11.__1.4___1_7_th_ \ e
Street and Number where work is to be performed —No 1110 __N. E. Street 9fith_
New Building X Remodeling Addition Repairs No. of Stories.____].
Size Septic Tank i► blnix Type of Tank _.P re__0Q -nOr-et. Capacity Gals. no__ _G
Feet of Drain Tile 150 Dist. Feet of Tank or Drain Field from Well .__
Nature of Water Supply: City —Well. City Size of Soa kage Pit
D ock $1_ Subdivision ___1:,
Residence
Date _________ --
My Commission Expires Notary Public, State of Florida
7 P1 bing Inspector.
The undersigned applicant for this building permit does hereby certify th a understands and accepts his obligati?, s an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Comp' d 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. i% �'
(Signed
3 Mister 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 notice for inspection, or faulty
materials and /or workmanship.
•
4
Owner's Name and Address
MIAMI S H m RES VILLAGE
L e t aenfts1i
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Registered Architect and /or Engineer
Employing Plumber's Name H 0. 1a!N No
Date
Marsh 3 1941
7
Permit No._ 121
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.
No. 1110 Street NA E t _ HA
1. W. 19tb s
Location and Legal Description Lot ___ —Z Block 41 subdivisionAllaid __ __�
Street and Number where work is to be performed —No m N. E. Street tt3. __________
State work to be performed and purpose of building (By Floors) Ui1de31sr
New Building Z Remodeling Addition Repairs No. of Stories 1.
Size Septic Tank Type of Tank PJ T _ - -_ -- Capacity Gals. t__ ,--
Feet of Drain Tile 110 Dist. Feet of Tank or Drain Field from Well feat
Nature of Water Supply: City —Well. i't7 Size of Soakage Pit.
Amount of Permit $
Plumbing Ins tor.
The undersigned applicant for this building permit does hereby certify ,,; he understands and accepts his obligations as an employ of labor
under the Florida Workmen's Compensation Act, being Section 5966, Co .fled General Laws of Florida Permanent Supplement, an 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed
Notary Public, State of Florida
STATE OF FLORIDA,
ss.
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
URI NALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
i
♦
'
1
at /,
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE GREASE
PIT TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
ar
CHECK
.-__. -■•■
..- ..
, ,_ „m
Owner's Name and Address
MIAMI S H m RES VILLAGE
L e t aenfts1i
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Registered Architect and /or Engineer
Employing Plumber's Name H 0. 1a!N No
Date
Marsh 3 1941
7
Permit No._ 121
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.
No. 1110 Street NA E t _ HA
1. W. 19tb s
Location and Legal Description Lot ___ —Z Block 41 subdivisionAllaid __ __�
Street and Number where work is to be performed —No m N. E. Street tt3. __________
State work to be performed and purpose of building (By Floors) Ui1de31sr
New Building Z Remodeling Addition Repairs No. of Stories 1.
Size Septic Tank Type of Tank PJ T _ - -_ -- Capacity Gals. t__ ,--
Feet of Drain Tile 110 Dist. Feet of Tank or Drain Field from Well feat
Nature of Water Supply: City —Well. i't7 Size of Soakage Pit.
Amount of Permit $
Plumbing Ins tor.
The undersigned applicant for this building permit does hereby certify ,,; he understands and accepts his obligations as an employ of labor
under the Florida Workmen's Compensation Act, being Section 5966, Co .fled General Laws of Florida Permanent Supplement, an 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed
Notary Public, State of Florida
STATE OF FLORIDA,
ss.
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 2_7 _
Application re.y marHe for the approval 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
2 .--C.--4 L / No. - - - -/ /* / Street l ��� Owner's Name and Address -- -(e�l/ 1 1 ` �/ -- l___— �/�___
Registered Architect and /or Engineer
t �r 1 AP / /
Employing Plumber's Name 0 . ___ -4. _� No „...-_-_._...1_,Z L 'L ' ee�/ . t' ' f IA ' 1
Location and Legal Description Lo _______— ___Bloat____ St>ljd'vision__—
Street and Number where work is to be performed —No / //z , ____ 4 ` ,t? ___ Street_____ __,,t,t /
State work to be performed and •purpose of building (By Floors)
New Building_ Remodeling Addition Repairs No. of Stories
Size Septic Tank_
Feet of Drain Tile_
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit S.
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank — _Capacity Gals.____________ —__
Dist. Feet of Tank or Drain Field from Well__
(Signed)
Plumb' Inspector.
The undersigned applicant for this building permit does hereby certify that he fderstands 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 the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public. State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
f l '
Date--- --' -�"
oaths and take
/ '7- '/
Master Plumber.
acknowledgments, personally
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
T UBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
D r
LL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No 2_7 _
Application re.y marHe for the approval 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
2 .--C.--4 L / No. - - - -/ /* / Street l ��� Owner's Name and Address -- -(e�l/ 1 1 ` �/ -- l___— �/�___
Registered Architect and /or Engineer
t �r 1 AP / /
Employing Plumber's Name 0 . ___ -4. _� No „...-_-_._...1_,Z L 'L ' ee�/ . t' ' f IA ' 1
Location and Legal Description Lo _______— ___Bloat____ St>ljd'vision__—
Street and Number where work is to be performed —No / //z , ____ 4 ` ,t? ___ Street_____ __,,t,t /
State work to be performed and •purpose of building (By Floors)
New Building_ Remodeling Addition Repairs No. of Stories
Size Septic Tank_
Feet of Drain Tile_
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit S.
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank — _Capacity Gals.____________ —__
Dist. Feet of Tank or Drain Field from Well__
(Signed)
Plumb' Inspector.
The undersigned applicant for this building permit does hereby certify that he fderstands 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 the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public. State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
f l '
Date--- --' -�"
oaths and take
/ '7- '/
Master Plumber.
acknowledgments, personally
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date - ^ 3 r5 C- Job Address \ Ck \.,_ q( S\ Tax Folio - /
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant WQ.A \ �►�9 vCxl■t, l jk► Master Permit # "t 0
Owner's Address k O �� .- t \ a. \ Phone �^
Contracting Co. \ \ \ ` 1`► Address " ` \ 0 -\)) Zz-
Qualifier - 72.3 .� . 0 - , � rJ‘\ `�a� SS# ' .1
Z-Z 5A•\
State # \ Municipal # 1 \V� Competency1 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION C‘ItIN \
APPROVED:
Zoning
Mechanical
Square Ft. Estimated Cost (value) .. 0.
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 PROPERTY (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, ROOF 1 G and CAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurst: and that all ' ork will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -n: \ ed contr : • to do the work stated.
Signature of owner and/or Condo President Date Signa 1 o' ontr• or Owner- Builder Date
C---2--7_,Kit--a.),)7? Yy? e rt,I.,
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder
My Commission Expires: My Commission Expires:
FEES: PERMIT 3.§: RADON
C.C.F. NOTARY 6s BOND
Electrical
Date
TOTAL DUE 4/6
Engineering
ITEM
BATH T1)3
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
1141T
FEE
BIDET
'
LIGHT CURETS
CENTRAL HEATING
OIS WASHER
RECEPTACLES
A/C (WINO)
.
OIS?DSAL
SERVICE TEWORARY
A/C (CENTRAL)
ORINKING FOUNTAIN
SERVICE SIZE IN AWS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/1¢7ER GANG'
REFRIGERATION
GREASE TRAP
APPLIANCE CURETS
PROCESS APO PRESS PIPING J
I UTERCEPTCR
_
RANGE TCP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GRCUPO TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSIME VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 FP
MEGAN I CAL VENTILATION
SINK. RESIDENCE
MOTORS OVER 5- 8 NP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 NP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 FP
FIRE SPRINKLER SYSTtE}I6 • E
1
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
_
A/C WINDOW
REINSPECTION
WATER SLPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
► f
HEATER- REPLACE
GENERATORS TRANSFCAM¢RS
r +
1
LAWN SPRINKLER -HELL
SPECIAL PURPOSE
-_
I
SWIMMING POOL
CUTLETS COMMERCIAL
WATER SERVICE
SIGN TIKES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY
SIGN T CLOCK
UTILITY -WATER
FIXTLRES
SEPTIC TANK
,ANNA
RELAY
TELEV IS ION CURETS
ORAINFIELO, 4' TILE/RES.
-+
VIOLATION
?LIP 3 ABANDON SEPTIC TA
TAW
RE I NSPECT I0H
SOAKAGE PIT CU. FT.
CATCH BASIN
0 I SCiARGE WELL
l I
DOMESTIC WELL
AREA GAIN
ROOF INLET
{ J
SOLAR MATER HEATER
FIRE ST:141P!PE
1
PCCL ?APING
F
LAN ZF INKLER S'STE4
I
GAS ; :E
I 1
ME E. SET (GAS)
SET (GS)
_
I
GAS ?IPA%
( £P'LICATTION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A RASTER PERMIT SFAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
Architect
Contractor
or Builder
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑
ELECTRICAL ❑ PERMIT N? 14844
PLUMBING
ROOFING ❑ Work to be performed under this Permit
Owner of
Building ., r ; Sok L, ,. ,. a..;i °O
Legal Lot II BL Subdi-
Description vision
Address of Value of
Building 1, ;:ur - Project $
DATE
/2 195 :
Contractor's
License No
Amt. of
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.
CONTRACTOR OR BUILDER
Signed • ' •••• ti 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Owner/Lessee / Tenant
Qualifier
State #(30.07 Municipal #
Square Ft.
ary as to Own- an• •r
4 y Commission xpires:
FEES: PERMIT
• - PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 719 (‘ A Tax Folio
h4
Date
OFFICIAL NOTARY SEAL
GLADYS J VILLAR
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MYCOM YIIffiION I7 fP. 12tJ
APPROVED:
Zoning Building
Mechanical
1
Plumb
Legal Description
Mich .e l/e- Sa4 c1/ev--
Owner's Address /ay° &# �-'
Contract Co. L :e 4/ v / , ire Z
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMB
WORK DESCRIPTION iCJ. 4 ,�/Zef2.14P0
wner and/or Condo President Date
,5 54. �7 /y -
we — 3-20
o.
Historically Designated: Yes No
Master Permit # 30 /3
Phone 75; --- �
Address
SS #, Phone ' Z.74/
Competency #
Address
Address
Address
ECHANICAL ROOFING PAVING FENCE SIGN
4/L
149 4
Estimated Cost (value) 1 2-6 0
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 PROPERTY (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.
•
_
e of Contr. t. • Owner- Builder
t1F ,WALNOTARYSEAL
.� %w J �IILLAR
cto or ' r � l�i►� ND. CC7141t)3 �/�
�tP ��' ! 4�,+1i �2ti'. MAR 1,2002
Sias
)1' otary as to/
My Co
ontr
ssion
RADON C.C.F. ! ' 2, V NOTARY
Electrical
Ins. Co.
BOND 3D° 0 v
TOTAL DUE
6 r / / -c-c?
Date
- /x-90
Date
Engineering
STATE OF FLORIDA •
DEPARTMENT OF HEALTH AND
ONSITE SEWAGE DISPOSAL SYS
CONSTRUCTION PERMIT
Authority: Chapter 381, F
CONSTRUCTION PERMIT FOR:
[I'] New System [/ - -1 Existing System f Holding Tank [ A Temporary /Experimental
Cy] Repair [AI [ „Il Other(Specify)
APPLICANT:
//.
PROPERTY STREET ADDRESS:
LOT:
PROPERTY ID #:
0
T
H
E
R
BLOCK:
L
D FILL REQUIRED: [
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
4�y
SUBDIVISION:
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD -6, FAC
REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS
EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY
PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A
BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH
MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
SYSTEM DESIGN AND SPECIFICATIONS
za p
T ['`'f'( f) ] ALL GPD( SEPTIC TANK/ ROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
LO
A [ ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK 1250 GALLONS]
K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ]
D SQUAREST 'PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND
I CONFIGURATION: [ ] TRENCH [ =r' BED [ ]
N
F LOCATION OF BENCHMARK: f f. 5 C " " er 0 �t k
I ELEVATION OF PROPOSED SYSTEM SITE [ ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /RF)rRENCE PAINT
E BOTTOM OF DRAINFIELD TO BE [ 4 (, e [INCHES/37] [ABOVE, FLOW] BENCHMARK /REFERENCE POINT
] INCHES EXCAVATION REQUIRED: [3C)] INCHES
PERMIT #
REHABILITATIVE SERVICES DATE PAID
TEM
FEE PAID $
RECEIPT #
S & Chapter 1OD -6, FAC
[SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
[OR TAX ID NUMBER]
AGENT:
TITLE:
HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744-001- 4016 -0)
(" C_
TITLE: '` __._ ? 7/, _ _.
CPHU
EXPIRATION DATE: r FJ tf-
Page 1 of 2
type of per: rit, if "Other" specify type in blenii.
6: ?:: :CAN?: : ?:op erty owner'3 fu!'. name.
DNS :':Icnhone ;umber for cppiicent or agent.
?.operty owner's !egaliy authorized representative.
bon or street .sailing address for applicant or agent.
SU3Dt'/ SION or
3: 2 character id number for properly. (CPHU may require property cppraicer ED t) or section /taanrhip /rrngc /percel number)
S"S :3?r.. J SICNr Aiv
Alt: Minimum specification; from Chaplet 10D-6, I?AC.
:D,:/ Minitmm specifications from Chapter 10D -6, IFAC.
}'; H3 Other specifications, such as operating permit requirements, !ow- volume flush toilets, variance pi-evicos.
31': :Var.re of individual providing specifications. :f designed by a registered engineer must be sealed.
A: ?P OVED 3l': County Public Health Unit (CPHU) personnel reviewing and approving permit.
DA73 :SSJED: Date permit is issued by CPHU.
DATE: On.: year from dcte issued if the system has not been installed. Permits for system repairs become vcid 90 days from the date
issued.
BUILDING
ELECTRICAL :
PLUMBING
Inspector's Report:
••
AD. ///0)/( ?i•
: WORK
: DONE BY:
: REQUESTED
The following is ready for Inspection:
• 0--t.-1" .
. .
. .
. .
. .
. .
. .
. .
. 0?-,r/ •
. .
. .
•
• •
IND
: WILL BE READY
/0
/a ct-44-1