PLUMBING•
Permit No._?
th submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Build' i finance 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
Application is hereby made for the approval of the detailed statement of the plans and specification
Owner's Name and Ad
Registered Architect and /or
Employing Plumber's Nam
±
Location and Legal Description Lot -
Street and Number where work is to be performed —No. / ' 7/
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
er
Nature of Water Supply: iW —Well
/ . £_.J
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.
(Signed)
(Signed) _
..Dist. Feet of Tank or Drain Field from Well
i '
~ Street___
c' 'Street
Block_ Subdivisiott�'J`
Street `--
Type of Tank__ ! .- n r '�- j � - Capacity Gals .e 0 e
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 com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors iployed 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 wor /s ch public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, o -
licensed by Miami Shores Village.
erformed under this permit, 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.
My Commission Expires Notary Public, State of Florida
Master umber.
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.
CLOSET
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT 'NS
TOTAL
FIXTURES
CONTR.
LIST
\
\
'
CHECK
L ,p G
1
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
�.. <
(
v I
T '`
CONTR.
LIST
CHECK
/
/ 1 /
J
, j.
4
•
Permit No._?
th submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Build' i finance 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
Application is hereby made for the approval of the detailed statement of the plans and specification
Owner's Name and Ad
Registered Architect and /or
Employing Plumber's Nam
±
Location and Legal Description Lot -
Street and Number where work is to be performed —No. / ' 7/
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
er
Nature of Water Supply: iW —Well
/ . £_.J
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.
(Signed)
(Signed) _
..Dist. Feet of Tank or Drain Field from Well
i '
~ Street___
c' 'Street
Block_ Subdivisiott�'J`
Street `--
Type of Tank__ ! .- n r '�- j � - Capacity Gals .e 0 e
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 com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors iployed 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 wor /s ch public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, o -
licensed by Miami Shores Village.
erformed under this permit, 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.
My Commission Expires Notary Public, State of Florida
Master umber.
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.
t ackwell Plum& a., 9 i1C ,
PHONE 7-3204 530 N. W. 54th Street
Miami, Florida 194 •••... <,
CONTRACT & SALES AGREEMENT
BLACKWELL PLUMBING CO., Inc., hereinafter designated the contractor, MO
hereinafter designated the builder, hereby agree as follow *;
1. The contractor will furnish the following:
to the property described as:
Owned by:
2. The contractor will complete the above in a workmanlike manner, for the sum of ;
3. The owner will pay -the- contractor _the sum of ; r .
4. THE TITLE AND RIGHT OF POSSESSION TO ALL FIXTURES AND EQUIPMENT FURNISHED THE OWNER HEREUNDER SHALL CONTINUE AND REMAIN VESTED
IN THE CONTRACTOR UNTIL THE ENTIRE CONTRACT PRICE, INCLUDING ANY INTEREST, COSTS, FEES OR JUDGMENTS SHALL HAVE BEEN PAID IN FULL ALL
FIXTURES AND EQUIPMENT FURNISHED HEREUNDER SHALL, AT ALL TIMES, OE CONSIDERED PERSONAL PROPERTY OF THE CONTRACTOR AND SUBJECT TO
REMOVAL BY THE CONTRACTOR AS SUCH. IN EVENT SUCH FIXTURES OR £RPMENT SHALL. BE INSTALLED IN ANY PREMISES, OR AFFIXED IN ANY MANNER
THERETO, THE SAME SHALL BE SEVERASLE AS PERSONALITY.
S. IN CASE OF DEFAULT BY THE OWNER IN THE PAYMENT OF THE CON'�ACT PRICE, OR ANY INSTALLMENT THEREOF, OR IN CASE OF FAILURE. OF THE
OWNER TO OTHERWISE PERFORM HEREUNDER, THE CONTRACTOR SHALL HA trTHE RIGHT, AT THEIR OPTION, TO DECLARE. THE ENTIRE UNPAID BALANCE OF
SAID CONTRACT DUE AND PAYABLE FORTHWITH, TOGETHER WITH INTEREST UPON THE UNPAID BALANCE, AT THE RATE OF % PER ANN ;- FROM THE
DATE OF SAID
*wax AND THE CONTRACTOR, 1N. EVENT OF SUCH DEF OS, SHALL LIKEWISE BE ENTITLED, AT THEIR OPTION, TO POSEEBBION
OF ALL FIXTUFEBtiljtk EQUIPMENT FURNISHED THE OWNER HEREUNDER, AN .*HALL HAVE A RIGHT TO ENTER UPON ANY PREMISES LAID FIXTURES
OR EQUIPMENT MAY OE I. QATE0 AND REMOVE THE SAME FORTHWITH, A 'IIE CONTRACTOR SHALL NOT EL LIABLE CRIMINALLY VILLY FOR ANY
INJURY OR DAMAGE WHATBOEVER SHALL RESULT FROM THEIR ENTRANOE r 4I ' ON SAID PREMISES AND THE REMOVAL OF SAID FIXTURES AND EQUIPMENT
THEREFROM. ` t
6. ittjus EVENT IT BEB1NE5 ,m'CESSARY FOR THE CONTRACTOR TQ THE SERVICES OF AN ATTORNEY TO EFFECT COLLECTION Of THE SAL.
ANOE DUE HERE44DI191, OR THE REMOVAL OF THE PHLTIUREE ANi• ,' THE OWNSI TlHALL PAY A REASONABLE ATTORNEY'S FEE THEREFORE.
7. THE OWNER :HALL NOT BELL OR REMOVE THE FIXTURES AN0 EIEINBMENT 1O10EL,I OR ANY PORTION HEREOF WITHOUT THE WRITTEN
CONSENT OF THE CONTRACTOR AND THE OWNER WILL KEEP BRIO FIXTURES AND EQUIPMENT< SULLY INSURED FOR -.THE BENEFIT OF THE CONTRACTOR
AOAINOY 4,41ps OR 0AMAOE BY FIRE, THEFT OR OTHER CAUSES.
0. THE CON IE CR GUARANTEES ALL+ MATERIAL AND WORKMANSI I P TO A PERIOD OF ONE YEAR
9. SUBJECT TO OUR ABILITY TO SECURE AND DELIVER MATERIALS *1140
Ao opted
By
By
Dated this
(SEAL)
(SEAL)
*UILOER AND AGENT FOR OWNER
day of A.11.19
OWNER AND BUILDER
FIXTURES.
By
as follows:
4
1D. IT 145 FURTHER UNDERSTOOD AND AGREED THAT IMMEDIATELY AFTER DELIVERY OF ANY MATERIAL AND FOR FIXTURES, WHETHER THE SAME BE
INSTALLED OR IN THE PROCESS OF INSTALLATION, THE PURCHASER SHALL B£ LIABLE AND REBPONBISLE FOR ANY THEFT 014 DAMAGE DONE TO THE SAME
FROM ANY CAUSE WHATSOEVER, EXCEPTING ONLY: ACTS OF THE VENDOR, ITS AGENTS, SERVANTS OR EMPLOYi5S.
BLACKWELL PLUMBING CO., INC.
_L
(SEAL)
N
•11
BUILDINQ
ELECTRICAL
PLUMBING
Contractor <
or Builder '° " 4 'd ' {
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 7478
Work to be performed under this Permit
Owner of
Building
Architect
DATE 194.
F
Contractor's
License No.
Legal Lot Bl.
Description
Address of �,. 1 , F ` ;; ' �y Value of I Amt. of
f a r G. Project Permit
Building 4
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and 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 respon-
sibility for work done by his agents, servants or employees. ,
r :. ,
Signed: )' ,.r L L , 4.. - ...e. t, . By
INSPECTOR
In cons'. o ssuance to me of this permit I agree to perform ttfe work covered hereunder in compliance with all ordinances ancti regulations
pertaining ct conformity with the plans, drawings, statements or specifications submitted to the proper authorities of MiamtalMrpoNgage.
In accep + i- . erm' . . s � e responsibility for all work done by either myself, my agent, servant or employee.
Subdi-
vision
CONTRACTOR OR BUILDER BY AUTHORITY
Permit No .1
Size Septic Tank__ .Type of Tank__
STATE OF FLORIDA, 1
as.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
�/z g .... _ ._._.
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 , 0 . �% 0 No.
Registered Architect and /or Engineer
Employing Plumbor's Name � x..Z� ..sso...._,.......... No11F 6®. .. Btaree ..ixi .4414 4,
Location and Legal Description Lot Blor1r Subdivision
Street and Number where work is to be performed —No / 0 9 / A/
Street.
State work to be performed and purpose of building (By Floors)_— ..CAi'l_✓��fr L ao i�L.!1� .f-P;:l.:sft'.
New Building- ._.___._ _ _ Remodeling_�1 `��L� Addition..._ _ ...____... Repairs No. of Stories.
Feet of Drain Tile. _ ___ ._ _ _Dist. Feet of Tank or Drain Field from Well..._._..._
Nature of Water Supply: City —Well Size of Soakage Pit.
Amount of Permit $ `, D (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 5966, Compiled General Laws of Florida Pennanent Supplement, and liar 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 workk t o 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 oaths and take aclawwledgments, 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•neoessary by improper notice for inspection, or faulty
materials and /or worknvnnchip.
Date
Notary Public, State of Florida
Plumber.
CLOSETS
TBATH UBS
SHOWERS
TonIcs
SINKS
63 eita.t
/
SLOP
SINKS
_�
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N6
TOTAL
FIXTURES
CONTR.
LIST
tl ` "'
A
CHECK
•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
P001.
CONTR.
LIST
CHECK
Permit No .1
Size Septic Tank__ .Type of Tank__
STATE OF FLORIDA, 1
as.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
�/z g .... _ ._._.
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 , 0 . �% 0 No.
Registered Architect and /or Engineer
Employing Plumbor's Name � x..Z� ..sso...._,.......... No11F 6®. .. Btaree ..ixi .4414 4,
Location and Legal Description Lot Blor1r Subdivision
Street and Number where work is to be performed —No / 0 9 / A/
Street.
State work to be performed and purpose of building (By Floors)_— ..CAi'l_✓��fr L ao i�L.!1� .f-P;:l.:sft'.
New Building- ._.___._ _ _ Remodeling_�1 `��L� Addition..._ _ ...____... Repairs No. of Stories.
Feet of Drain Tile. _ ___ ._ _ _Dist. Feet of Tank or Drain Field from Well..._._..._
Nature of Water Supply: City —Well Size of Soakage Pit.
Amount of Permit $ `, D (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 5966, Compiled General Laws of Florida Pennanent Supplement, and liar 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 workk t o 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 oaths and take aclawwledgments, 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•neoessary by improper notice for inspection, or faulty
materials and /or worknvnnchip.
Date
Notary Public, State of Florida
Plumber.
Permit No.__.01e -
Registered Architect and /or Engineer — .. --
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 DeYoung Spr. . Co., Inc. 1091 N E . 96t St .
- - -- -_ - -_ — - - - -__ -- — - . No. _ — - -- - — -- Street . - — - - -•- -_.
Employing Plumber's Name Vickers We11 _ _ _ _ N 10836 Street_—N. W. 7 Ave.
Location and Legal Description Lot Blorti
Street and Number where work is to be performed —No 1091 `-
State work to be performe8 and purpose of building (By Floors) -- ._ _---- .- -___ --
July 2, 1972
Date — — — — --
Subdivision - - - -- ._____________-- ----•
S trom N. E. 96th St.
New Building —_ ___ Remodeling_ ___ __ -_ - -_ Addition._._ Repairs No. of Stories_ _ _ __ __ ___
Size Septic Tank__ __Type of Tank.
Feet of Drain .............. Feet of Tank or Drain Field from Well
Nature of Water Supply: _2_ _ -Size of Soakage Pit
- -- — -- - EQr_
Lawn USE:. - -- -- _
D
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
es.
(Signed)
( Signed)_.___.___. __' - "! • •
Capacity Gals
My 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-
plier 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 v k t� ke perfgiyn d under this pennit, as are
licensed by Miami Shores Village.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ ..................
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for insp. ' ` - n, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
W
SHOWERS
LAVA-
TORIES
SINKB
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHICK
Permit No.__.01e -
Registered Architect and /or Engineer — .. --
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 DeYoung Spr. . Co., Inc. 1091 N E . 96t St .
- - -- -_ - -_ — - - - -__ -- — - . No. _ — - -- - — -- Street . - — - - -•- -_.
Employing Plumber's Name Vickers We11 _ _ _ _ N 10836 Street_—N. W. 7 Ave.
Location and Legal Description Lot Blorti
Street and Number where work is to be performed —No 1091 `-
State work to be performe8 and purpose of building (By Floors) -- ._ _---- .- -___ --
July 2, 1972
Date — — — — --
Subdivision - - - -- ._____________-- ----•
S trom N. E. 96th St.
New Building —_ ___ Remodeling_ ___ __ -_ - -_ Addition._._ Repairs No. of Stories_ _ _ __ __ ___
Size Septic Tank__ __Type of Tank.
Feet of Drain .............. Feet of Tank or Drain Field from Well
Nature of Water Supply: _2_ _ -Size of Soakage Pit
- -- — -- - EQr_
Lawn USE:. - -- -- _
D
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
es.
(Signed)
( Signed)_.___.___. __' - "! • •
Capacity Gals
My 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-
plier 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 v k t� ke perfgiyn d under this pennit, as are
licensed by Miami Shores Village.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ ..................
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for insp. ' ` - n, or faulty
materials and /or workmanship.
4-s
Permit No --
Amount of Permit $
Size Septic Teak .-- .------- - - - - -- — - - -- - T ype of Tank___
Feet of Drain Tile._. — - - -- _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— WeIL_ _-- _----- _ -__ -- - - -__.— ..._Size of Soakage Pit
fJ�
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
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. ,1" p /�
Owner's Name and Address �, _ W/� /' ' __._. No. � ��/ Street.. e 'll!`f� / - S �OIpZ
Registered Architect and /or eer r-- -
Employing Plumber's Name. ._, .cam ..(;) No, // / � .Z02' eL••.r��,l,,s. /.. .--2�� '
Location and Legal Description Lot_ Block Subdivision__- --_.___
Street and Number where work is to be performed —No / ./1 4- ' - -��/,, �. Street -
State work to be performed and purpose of building (By Floors)_—._.. & iv ' a/ St / ir S %,1- .- ..... - .
New Building Remodeling Addition- ..__.__ Repairs No. of Stories
Capacity Cals.
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his otgations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) — //
"" aster Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac 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 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, er faulty
materials and/or workmanship.
TOTAL
FIXTURES
CLOSETS
BATH
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUB*
URINAL/
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEEM
$WIM'O
POOL
CONTR.
I /
-
LIST
CHECK
4-s
Permit No --
Amount of Permit $
Size Septic Teak .-- .------- - - - - -- — - - -- - T ype of Tank___
Feet of Drain Tile._. — - - -- _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— WeIL_ _-- _----- _ -__ -- - - -__.— ..._Size of Soakage Pit
fJ�
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
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. ,1" p /�
Owner's Name and Address �, _ W/� /' ' __._. No. � ��/ Street.. e 'll!`f� / - S �OIpZ
Registered Architect and /or eer r-- -
Employing Plumber's Name. ._, .cam ..(;) No, // / � .Z02' eL••.r��,l,,s. /.. .--2�� '
Location and Legal Description Lot_ Block Subdivision__- --_.___
Street and Number where work is to be performed —No / ./1 4- ' - -��/,, �. Street -
State work to be performed and purpose of building (By Floors)_—._.. & iv ' a/ St / ir S %,1- .- ..... - .
New Building Remodeling Addition- ..__.__ Repairs No. of Stories
Capacity Cals.
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his otgations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) — //
"" aster Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac 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 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, er faulty
materials and/or workmanship.
CLOB [TB
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SINK•
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LAUNDRY
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BASIN
FLOOR DR INKING
DRAIN FO UNT•NB
I
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CONTA.
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CHECK
- -
SEPTIC
TANK
SEWER
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DRAIN
FIELD
SOAKAGE
PIT
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TRAP
SOLAR
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WELL
SPRKLR.
SYSTEM
SWIM'O
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CONTR.
LIST
-
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—
CHECK
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om.__ _
Penni; Nu.
Amount of Permit $
4'j
STATE OF FLORIDA, }
ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date..
(signed)_ ‘•7
3 -r-OA_ _
:Ippllcaii,.11 i, hereby nu or the approval of the detailed statement of the plans and specifications herewith subr.itr. ,d for the building or other
;-tructurc herein describes his application is made in compliance and conformity with the Building Ordinance of Mi.:. ! Shores Village, Florida,
and all provisions of '" .vs of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic , of the Building Division
of Miami Shores V ,shall be complied with, whether herein specified or not. A copy of approved plans and spec fications must be kept at
Building during progie.,> of work. �^
'.)wner's Name and Address —-No /Q ee
e/ Strt_. . . ` ` q‘ v
r
.egist -red Architect and /or Engineer n , � / / / G/
m 1 n Plu bar's N e ./�!7 � NO..__... l�� (... street !Y-7� �T.
ppylg
f / ' I d Legal Des ption Lot. it Block -_7r[_G —� — rn S ubdivfaion--4(.4t..r 14 C C
Street and Number where work is to be performed —No ! j street... q651
... .- ... --_ -__ -.
State work to be performed and purpose of building (By Floors). ___.__ -? i
New Building Remodeling—__ — __ ... ___ Addition..._____ Rep
No of Stones
Size Septic Tank__.,__ -.-__•- ....... _--_— _--- - - - - -- •_...Type of Tank— Capacity ^.als. - - _..
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
Mast 31. P1t rY
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as on a n;lloyer of lobo
under the Florida Workrnen's Compensation Act, being Section 5966, Compiled General La of Florida Permanent Cum lement, and ha. •'ori•
t.lied with the provisions thereof, and will require similar compliance from all contractor ors b- contractors employed 1 • in ' •AI rk c b
performed under this permit; and will post or cause to be posted' for inspection on the site the work su pub': noti x no icer 45 a:
requ'red by the Act. The undersigned agrees to employ only such sub- contractors work to be formed ' . this ,r:rl.rii, i.. as .
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, perimat ; , pp.arn.
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 pgFysku�Un� be has carefully read the foregoing application, and that be did sign the same, and tint all acts
therein by him stated are , STATE OF FLORIDA
MY COMMISSION EXPIRES APRIL 16, 1S88
My Gl
NOT_ E: A re- inspection fee of $1.00 will be made when sue m
s re-inspection is ade•neoessary by improper notice, for ir�sperton, tlr fruit)
materials and /or workmanship.