1210 NE 97 St (10)Permit No / �s
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 _______ .. - .... __ ..--- -._ -._ No._____----- __ -.__ _ Street
Registered Architect and /or Engineer r_______.___
d
Employing Plumber's Name � �� - No._ Street._
Location and Legal Description Lot __ __ __ _ — Block -____ Subdivision - - - -- _------ ____ _- _ -�
Street and Number where work is to be performed —No / a/ 8 /1/ -I-4C Street
State work to be performed and purpose of building (By Floors)_ -____
Building__ Remodeling__ ________ Addition Repairs
Size Septic Tank
0
Type of Tank
Feet of Drain Tile. ___-___1 -_- ___.Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply Cit- Well. ___ __
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMDT
Date
No. of Stories.
Capacity Gals
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 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of Che 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) _ - - _(. 11 � F .
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths ;Ind 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
OTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
ma • s and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
'rues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
ifi
TOTAL
FIXTURES
comm.
LIST
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CHECK
-
SEPTIC
TANK
SEWER
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
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HEATER
DEEP
WELL
SPRKLR.
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Permit No / �s
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 _______ .. - .... __ ..--- -._ -._ No._____----- __ -.__ _ Street
Registered Architect and /or Engineer r_______.___
d
Employing Plumber's Name � �� - No._ Street._
Location and Legal Description Lot __ __ __ _ — Block -____ Subdivision - - - -- _------ ____ _- _ -�
Street and Number where work is to be performed —No / a/ 8 /1/ -I-4C Street
State work to be performed and purpose of building (By Floors)_ -____
Building__ Remodeling__ ________ Addition Repairs
Size Septic Tank
0
Type of Tank
Feet of Drain Tile. ___-___1 -_- ___.Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply Cit- Well. ___ __
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMDT
Date
No. of Stories.
Capacity Gals
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 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of Che 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) _ - - _(. 11 � F .
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths ;Ind 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
OTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
ma • s and /or workmanship.