PLUMBINGAPPLICATION FOR PLUMBING PERMIT
Permit No.._
___ ___.__ Date__.. — `i
Application is hereby made for th approval of the detailed statement of the plans and specifications herewith su muted 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 t e 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 w ., Nether herein swcified or not. A copy of approved plans and specifications mutt be kept at
building during progress of wor
appeared
NOTE: A re- inspection fee o
materials and /or wotkmanchip.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
My Commission Expires
No.
Owner's Name and Address
Registered Architect and /or Engine:r ___
Employing Plumber's Name _. _ No.
Location and Legal Description Lot____ti.! ,l� ._____ Block__ _. _._. Subdivisio
I Street and Number where work is t be performed— No.___i -__ 3 ___________ Street 9 �
State work to be performed 'and purpose of building (By Floors)
New Building_--- __ -___ -- __Y_...._ Remodeling __ Addition___ w__________ ______ Repairs _ _._ No. of Stories - -
Street
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
to me well known, and who, being � y 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.'
Notary Public, State of Florida
$ 1.00 will be made when such re- inspection is made necessary by improper notice fo i
CLOSETS
BATH
Tues
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A ii
LAVA-
TORIES
SIN 5
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
��/ ,
,/
AI a
♦
!
r/
/
CHECK
SEPTIC
TANK
SEWER
CONN.
1 DRAISI
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR J
HEATEc
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
IY
Size Septic Tank--
._.____.r Type of Tank . C:apacity Gals.._.____..._..._
__ Disc. Feet of Tank or Drain Field from Well----______ _..________._.-_-.-_-.___-_.-
.._.._.
Feet of Drain Tile___....._
Nature of Water Supply: City W
1 �__._ Size of Soakage Pit
'
...
Amount of Permit $- _ (Signed) ,
M_._____
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 w ch public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, o work to rmed under this permit, as are
licensed by Miami Shores Village.
(Signed) - — ` ....._.....__
STATE OF FLORIDA,
rotiNTY OF DADE_
Master Plumber.
,
APPLICATION FOR PLUMBING PERMIT
Permit No.._
___ ___.__ Date__.. — `i
Application is hereby made for th approval of the detailed statement of the plans and specifications herewith su muted 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 t e 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 w ., Nether herein swcified or not. A copy of approved plans and specifications mutt be kept at
building during progress of wor
appeared
NOTE: A re- inspection fee o
materials and /or wotkmanchip.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
My Commission Expires
No.
Owner's Name and Address
Registered Architect and /or Engine:r ___
Employing Plumber's Name _. _ No.
Location and Legal Description Lot____ti.! ,l� ._____ Block__ _. _._. Subdivisio
I Street and Number where work is t be performed— No.___i -__ 3 ___________ Street 9 �
State work to be performed 'and purpose of building (By Floors)
New Building_--- __ -___ -- __Y_...._ Remodeling __ Addition___ w__________ ______ Repairs _ _._ No. of Stories - -
Street
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
to me well known, and who, being � y 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.'
Notary Public, State of Florida
$ 1.00 will be made when such re- inspection is made necessary by improper notice fo i
{
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
In consideration of the
Lions pertaining them*
Village
orme4 under this Pe
Legal Lot
Deacriprti.(?
Address of t
Building
This permit is man
application hereto in strict .
with any plans, deawi
be revoked at any dine if dta reeds is
upon which this permit is '
the ordinances and
that he assumes reeponsibility
.-�- �. i � • _ a. �
IAMI SHORES VILLAGE, FLORIDA
DATE.
IT N? 2299
Subdi•
vision
Value of
Project
ed above to construct the building or to install the equipment or device described
s rtaining thereto end with the understanding that the will be pcfosced bi bon
have been submitted to and approved by the proper Municipal authorities.
with such ordinances or if the plans are changed withpuc auchorisetion. A
for or buifiger Helped above assumes the raspOnsibility for a thoionob
hereby whether shpwn on T 4f.,E-14 pup g£
or employees: ; , • . , +, E,
signed• r ,'" ' . <.,,
; — INSPECTOR
.tiork covered hereunder ip cc
c., or ap. cations submitted to
;1IIW agent. servant ot.
Amt. of
Permit
with,all orb
proper mo
Subdi-
vision
Value of
Project
d a t+ to constcest the buildi
thereto and with the tr
boss submitted to and
a Ehe ., Mb ordinances r Wader
"_• d h whether
employees.
above as
plane or dyawi
) Architect
Contractor
or Builder
Legal Lot
Description
-
Address of
Building
This
applicadon
with any
at plum.
be revoked at apq
upon which thi►
the ordinances
that he am
BUILDING
ELET
PLUMBING
Owner of 1.--
Building
In co
tionr pertaining
Village. ,I'u
HOES VILLAGE, FLORI
DAT
2300
r this Permit—. + �-
f'r
Permit No.. G.
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.
Owners Name and Address_____ :_ . . t a ' i s
Registered Architect
Engineer______
Architect and /or E ® 9 ,1�
Employing Plumbers Name me e t f i� Q r � No _J "e r" S tY�et`
Location and Legal Description Lot Blorti Subdivision_.__
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By
New Building_..__ .._---- ,_-- Addition_ _ Repairs
Size Septic Tank. _ _ __ _. _ _ __.__. _ _.Type of Tank_ __
Feet of Drain Tile_______ __ __Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: ... _ ____Size of Soakage Pit_
No. of Stories.
-Capacity Gals
Amount of Permit $ ( 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 Pennanent Supplement, and bus com-
apd with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be
WE formed 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
rewired by the Act. The undersigned agrees to employ only such sub - contractors, on k • be perf � under this perm f t, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, l e
COUNTY OF DADE. f
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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or worlomanship.
Fc
CLOSETS
DATH
TUBS
SHOWERS
LAVA-
T
SINKS
SLOP
SINKf
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•N6
_. ,
er !
tc a
TOTAL
FIXTURI$
CONTP-.
L!fr,
)
7
f
�
-
SEPTIC
TANK
SEWER
CONK.
DRAIN.
FIELD
SOAKAGE
PIT.
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•O
POOL
I
_
CONTR.
LIST
•
CHECK
Permit No.. G.
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.
Owners Name and Address_____ :_ . . t a ' i s
Registered Architect
Engineer______
Architect and /or E ® 9 ,1�
Employing Plumbers Name me e t f i� Q r � No _J "e r" S tY�et`
Location and Legal Description Lot Blorti Subdivision_.__
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By
New Building_..__ .._---- ,_-- Addition_ _ Repairs
Size Septic Tank. _ _ __ _. _ _ __.__. _ _.Type of Tank_ __
Feet of Drain Tile_______ __ __Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: ... _ ____Size of Soakage Pit_
No. of Stories.
-Capacity Gals
Amount of Permit $ ( 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 Pennanent Supplement, and bus com-
apd with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be
WE formed 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
rewired by the Act. The undersigned agrees to employ only such sub - contractors, on k • be perf � under this perm f t, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, l e
COUNTY OF DADE. f
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 necessary by improper notice for inspection, or faulty
materials and /or worlomanship.
Fc
Permit No... .7
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 < <I4 No. 1a45 £'E StreeL._ 9G _
Registered Architect and /or Engineer _
Employing Plumber's Name ���� ���' N0.• . —
--- - - ----
Location and Legal Description Lot_ Block
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)_._..____... -
New Building Remodeling— _-- - - -._. _ . -_ -- Addition
Size Septic Tank_ _ _. --
Feet of Drain Tile. 36
Nature of Water Supply: City—Well.—__-__- __ -- _ - - - -- -Size of Soakage Pit
Amount of Permit $
__ ._Type of Tank__. — — -- — - . Capacity Gals.
—Dist. Feet of Tank or Drain Field from Well.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and 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, work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed
Date__ 40f_ -_ .. S- ..- -. -.— —
Repairs No. of Stories
Plumbing Inspector.
,itki c
STATE OF FLORIDA,
u.
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ...__ ................. . . .... .. ....._.._ -..
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hirn stated are true.
Notary Public, State of Florida
Mast & Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is mede.neeessary by improper notice for inspection, or faulty
materials and/or workmanship.
CLoarra
BATH
Tubs
SHOWERS
LAVA•
TORIES
SINKS •
SLOP
SINKS
LAUNDRY
Tulle
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONY'.
LIST
—
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
8 .
SYSTEM
.WIM'O
POOL
CL I T LIST
CHECK
Permit No... .7
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 < <I4 No. 1a45 £'E StreeL._ 9G _
Registered Architect and /or Engineer _
Employing Plumber's Name ���� ���' N0.• . —
--- - - ----
Location and Legal Description Lot_ Block
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)_._..____... -
New Building Remodeling— _-- - - -._. _ . -_ -- Addition
Size Septic Tank_ _ _. --
Feet of Drain Tile. 36
Nature of Water Supply: City—Well.—__-__- __ -- _ - - - -- -Size of Soakage Pit
Amount of Permit $
__ ._Type of Tank__. — — -- — - . Capacity Gals.
—Dist. Feet of Tank or Drain Field from Well.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and 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, work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed
Date__ 40f_ -_ .. S- ..- -. -.— —
Repairs No. of Stories
Plumbing Inspector.
,itki c
STATE OF FLORIDA,
u.
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ...__ ................. . . .... .. ....._.._ -..
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hirn stated are true.
Notary Public, State of Florida
Mast & Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is mede.neeessary by improper notice for inspection, or faulty
materials and/or workmanship.
Date Job Address
Legal Description
Owner/Lessee / Tenant
Owner's Address /2L-1'5 /J
Contracting Co.
Qualifier J2 o h e r 4 4 Vat) ; o r
State # C Qr C 15 . J ('°
eet/Engineer Ie )L4 (Z0i(Ogog i u
Bonding Company /a
Mortgagor I I c
WORK DESCRIP'T'ION
Signature of owner d/or Condo 'residen
0_ /_ /A, ILJ ,1
. ary as to 0 er and/or C, ndo President
My Commission Expires:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
12 /V E C/ 60 TTYce -f- Tax Folio
Municipal #
Permit Type (circle one): BUILDING ELECTRICAL
t
Historically Designated: Yes No
Master Permit # L?t3L2/9) 4i3 oZ 20
Phone (306 -7 5S - 7-
7
L I O0 kik( ( ZD Ovcr)(A c (c (
Address
Square Ft. Estimated Cost (valug O. 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.
+^,: ROSEMARIE MALONE
� •� MY COMMISSION # CC 698718
EXPIRES: November 25, 2001
-4,x... p ,,,, Bonded Nu Notary Public Undenwiters
APPROVED:
Zoning Building
Mechanical Plumbing
7 /o qg s P. 6 )J
^ s ate Signature of ontractor or Owner- uilder
ate
No as to Co actor or Owner-
My Commission Expires:
FEES: PERMIT D' RADON C.C.F. \4444S3 NOTARY
SS# `"/ 4q02_
Competency # Ins. Co.
Address (p _ iZcJe(S C i {( e, CDCa
Address
Address
ECHANICAL ROOFING PAVING FENCE SIGN
Electrical
NOW 7 //9e
ilder D afe
ROSEMARIE MALONE
MY COMMISSION B CC 698718
lit , �:
1,, EXPIRES: November 25, 2001
'•' Bonded Thru Notary Public Underwriters
BOND
TOTAL DUE
7 / /qe
Date
Engineering
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Owner's Name and Address. Qgt.a _:
Registered Architect and /or Engineer
Name and address of licensed contracto
Location and legal description of lot to be built on: h u
Lot Block Subdivision
Street and Number where work is to be done
State w k to be done and pur e of building (by floors V
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date.. - ! ‘ -
Date__ ,; / , 19‘
No --W ` S Street )\ • :.._ �:......
Disapproved � ������
(Signed)
Building Inspector \ My Commission Expires
1 4 > V AC__
3 =�
New Building Remodeling V Addition Repairs No. of Stories
To be constructed of 'nd of foundation Roof Covering
U r--, U'D
Estimated Total cost of improvements _ _ ..0__ . Amount of Permit $ L ,,..1 ,--
Zone cubage required .Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to-'Nd--- ; ,,._. 4
The undersigned applicant for this building pennit 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, Pennanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him
in the work to be performed ender this permit; and will post or cause to be posted . inspection on t ite of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such ntr t. be performed, under this
permit, as are licensed by Miami Shores Village.
Remarks ( 4-__
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 state are true.
Permit No
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
and for no other purpose.
PLANNING BOARD DATE
Chainnan Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
b2.00
50 74
Permit No
Owner's Name and Address_
Registered Architect and/or E
Employing Plumber's Name
Size Septic Tank
Feet of Drain Tile__
Nature of Water Supply: City—Well.
Amount of Permit $____
_ 01,_Nalaga
ngineer__
DADE GAS COMPANY
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)_ ZCi
#b4795C
Date
Subdivision
October 21 1966.
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. 1245 N3 Street. 96 Street
No. 8350 NW
Street 7 Avenue
Location and Legal Description Lot — Block
Street and Number where work is to be performed—No. 1245 N.E. 96 St. Street
State work to be performed and purpose of building (By Floors) Dryer connected to present gas installation.
New Building Remodeling Addition. Repairs No. of Stories.
Type of Tank_ Capacity Gals.
_Dist. Feet of Tank or Drain Field from 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 Worlcmen'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-contra ,ork to be performed under this permit, as are
licensed by Miami Shores Village. )
( Signed). 1
Mas_ter. lumber.
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.
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.
CLOSETS
BATH
TUBS
SH
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
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'S
POOL
DRYER
CONTR.
LIST
C HECK
X
..--■
b2.00
50 74
Permit No
Owner's Name and Address_
Registered Architect and/or E
Employing Plumber's Name
Size Septic Tank
Feet of Drain Tile__
Nature of Water Supply: City—Well.
Amount of Permit $____
_ 01,_Nalaga
ngineer__
DADE GAS COMPANY
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)_ ZCi
#b4795C
Date
Subdivision
October 21 1966.
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. 1245 N3 Street. 96 Street
No. 8350 NW
Street 7 Avenue
Location and Legal Description Lot — Block
Street and Number where work is to be performed—No. 1245 N.E. 96 St. Street
State work to be performed and purpose of building (By Floors) Dryer connected to present gas installation.
New Building Remodeling Addition. Repairs No. of Stories.
Type of Tank_ Capacity Gals.
_Dist. Feet of Tank or Drain Field from 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 Worlcmen'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-contra ,ork to be performed under this permit, as are
licensed by Miami Shores Village. )
( Signed). 1
Mas_ter. lumber.
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.
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.
Permit No r s G
Application is hereby made for th approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This ap hcation is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of th 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.
Amount of Permit $__
STATE OF FLORIDA,
COUNTY OF DADE. i
Owner's Name and Address__ ____
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot
Nature of Water Supply: City —Well .
Before me, the undersigned authori
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
• APPLICATION FOR PLUMBING PERMIT
No Street
No_________ --- _______ ___________ Street - - - - -- - - -- — -
Subdi
Block___
Street and Number where work is to be performed—No _________
______
State work to be performed and purpose of building (By Floors)
New Building Remodeling
Date _ -_ -/ 0_ ./. �_�_
Addition v" Repairs No. of Stories
Size Septic Tank �- Type of Tank___ /____'!'�"✓ Capacity Gals S'"" O
Feet of Drain Tile _ —___= - ____.______Dist. Feet of Tank or Drain Field from Well
The undersigned applicant for this building permit does hereby certify tha
under the Florida Workmen's Compensation Act, being Section 5966, Compile
plied with the provisions thereof, and will require similar compliance from all
performed under this permit; and will post or cause to be posted for inspection
required by the Act. The undersigned agrees to employ only such sub -con
licensed by Miami Shores Village.
Size of Soakage Pit
(Signe•
(Signed).
he understands and accepts his obligations as an employer of labor
General Laws of Florida Permanent Supplement, and has com-
contractors or sub - contractors employed by him in the work to be
on the site of the work such public notice or notices as are
ctors, on work to be performed under this permit, as are
Notary Public, State of Florida
Master Plumber.
ty, 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, t1at 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
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
SHOWER
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TOSS
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
-
Permit No r s G
Application is hereby made for th approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This ap hcation is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of th 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.
Amount of Permit $__
STATE OF FLORIDA,
COUNTY OF DADE. i
Owner's Name and Address__ ____
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot
Nature of Water Supply: City —Well .
Before me, the undersigned authori
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
• APPLICATION FOR PLUMBING PERMIT
No Street
No_________ --- _______ ___________ Street - - - - -- - - -- — -
Subdi
Block___
Street and Number where work is to be performed—No _________
______
State work to be performed and purpose of building (By Floors)
New Building Remodeling
Date _ -_ -/ 0_ ./. �_�_
Addition v" Repairs No. of Stories
Size Septic Tank �- Type of Tank___ /____'!'�"✓ Capacity Gals S'"" O
Feet of Drain Tile _ —___= - ____.______Dist. Feet of Tank or Drain Field from Well
The undersigned applicant for this building permit does hereby certify tha
under the Florida Workmen's Compensation Act, being Section 5966, Compile
plied with the provisions thereof, and will require similar compliance from all
performed under this permit; and will post or cause to be posted for inspection
required by the Act. The undersigned agrees to employ only such sub -con
licensed by Miami Shores Village.
Size of Soakage Pit
(Signe•
(Signed).
he understands and accepts his obligations as an employer of labor
General Laws of Florida Permanent Supplement, and has com-
contractors or sub - contractors employed by him in the work to be
on the site of the work such public notice or notices as are
ctors, on work to be performed under this permit, as are
Notary Public, State of Florida
Master Plumber.
ty, 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, t1at 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
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. 1 ___
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sii 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 r' t h $
Registered Architect and /or Engineer
Employing Plumber's Name /3r! r Atit4
Location and Legal Description Lot
Street and Number where work is to be performed —No
New Building __. Remodeling — ____..- -_-____ -- Addition
Amount of Permit $__
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date.
No. --__ 2_ ti --- Street_ N 7'
_ ---� 41 l4o.___ -- Street
— U
Bloch Subdivision________
strel // IZ 9 ( V
State work to be performed and purpose of building (By Floors)_._ ___ the Lit/
(Signed)_
Repairs__ 1,0.
Capacity Gals.
No. of Stories.
1 , T
Size Septic Tank ___ ,�. Type of Tank
2 a
Feet of Drain Tile_____ g !'! t. 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 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 ib1ic notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contract OS, on work to be d under this permit, as are
licensed by Miami Shores Village.
(Signed) -- ' -• - - -- -- �--- - - - - -- -- - - -x.. .... ---- --
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 necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
Tues
S
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TWIG
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NE
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
CHICK
Permit No. 1 ___
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sii 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 r' t h $
Registered Architect and /or Engineer
Employing Plumber's Name /3r! r Atit4
Location and Legal Description Lot
Street and Number where work is to be performed —No
New Building __. Remodeling — ____..- -_-____ -- Addition
Amount of Permit $__
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date.
No. --__ 2_ ti --- Street_ N 7'
_ ---� 41 l4o.___ -- Street
— U
Bloch Subdivision________
strel // IZ 9 ( V
State work to be performed and purpose of building (By Floors)_._ ___ the Lit/
(Signed)_
Repairs__ 1,0.
Capacity Gals.
No. of Stories.
1 , T
Size Septic Tank ___ ,�. Type of Tank
2 a
Feet of Drain Tile_____ g !'! t. 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 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 ib1ic notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contract OS, on work to be d under this permit, as are
licensed by Miami Shores Village.
(Signed) -- ' -• - - -- -- �--- - - - - -- -- - - -x.. .... ---- --
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 necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING E] MIAMI SHORES VILLAGE FLORIDA
Date_6 0 17 19�r' /�
ELECTRICAL ❑
PLUMBING PERMIT N° 8076
ROOFING ❑
❑ Work to be performed under this Permit
9, .
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
/0.0.4 _Air., 6
Lot 11
11 BI
/,1s_ vie 9G .-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 applica-
tion 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 emRloyees. ,
e f �IrirN[/
(INSPECTOR) BY � •
agree to perform the work covered hereunder in compliance with all ordinances and regulations
Signed a
In consideration of the issuance to me of this permi
pertaining thereto and in strict conformity with the plans, iawings, 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.
•
CONTRACTOR or BUILDER
Subdi-
vision
Sq Ft
Value of I Amount of ?
Project $— 11 Permit $
BY
Contractor's
License No.
AUTHORITY
Permit No.... _.__.
O (%
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
_... ..__
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 air
building during progress of work.
Owners Name and Address At..g.„..._„eiluee_a_c_ No.__ l.____.___ StreetA
____
Registered / or Engineer
. . _._______ -
Employing Plumber's Name
Location and Legal Descriptio Lot__________ __.___.______..__Block_w _________ __.___.___� S -- Street and Number where work `s to be performed —No
;'" Street
-.
State work to be performed an purpose of building (By Floors) 1 # 1,1 ' 4,10 !PAILII 1 W
New Building_____ _-__ -__-_1. --__ Remodeling Addition Repairs _- ...... _____ No. of Stories-_____--. -
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
l
SEPTIC
TANK
SEWER
CONN
RAIN
IELO
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
k
CHECK
Size Septic Tank- Type of Tank Capacity Gals.___._.....
_- .- _...- ..._.- - .–....._--__---.---_-_-_ _.___ r________.. _
Feet of Drain Tile_-- Dist. Feet of Tank or Drain Field from Well
_.-- _-__---_-.. ........ _- ---_ -- ___: _.._.-_ .4
Nature of Water Supply: City Well Size of Soakage Pit.
— ________
Amount of Permit $_._ (Signe +' Amy
..r_. .c:�_.. _.
robing Inspector.
The undersigned applicant for this building permit does hereby certi at 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 thereolf, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; asd will post or cause- to be posted for inspection on the site of the work such public notice or , • +` - as are',
required by the Act. The unde signed agrees to employ only such sub - contractors, on war to be rmed under his as , a re
licensed by Miami Shores Villaste.
(Signed) s i.-4.
- __
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersign authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally'
appealed----- —
._._._. _... .._– — — _ – -- -- - - - -- _–
to well known, and who, bei by me first duly sworn, upon oath deposes and says that he is the
me
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. r
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 f atty
materials and /or workmanship.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sui 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 l shall be complied w . , . hether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress 'Of wo
Owner's Name and Address
Registered Architect and /or Eng neer
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work to be performed —No.
State work to be performed and purpose of building (By Floors)
New Building_.._ _____ Remodeling Addition Repairs
Size Septic Tank- - — Type of Tank
Amount of Permit $ _ o t
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof,
performed under this permit; and
required by the Act. The under
licensed by Miami Shores Village.
NOTE: A re- inspection fee
materials and /or workmanship.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
PPLIG'ATION FOR PLUMBING PERMIT ,{
Date
B ock
P
and will require similar compliance
will post or cause to be posted for
signed agrees to employ only such
.(Signed)
(Signed)
No
No.
Feet of Drain Tik___..�_ �._.___.__._�. Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City Well. Size of Soakage Pit
� Ks
Street
Subdivisio
Street
- Capacity Gals.
Notary Public. State of Florida
No. of Stories__- .._.__.
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has corn-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the w b public notice or notices as are
sub-contractors, o work t / armed under this permit, as are
fr/ii{/
Master Plumber.
STATE OF FLORIDA, k
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.
of $ 1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fa
CLOSETS
BATH
Tues
ER .
LAVA-
TORIES
SINS
SLOP
SINKS
LAUNDRY
TUDS
URINALS CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
r
, t
rf
{'
s
/ SOAKAGE,
i
`
r r. `
Iipp-r
• j
1
CHECK
SEPTIC
TANK
SEWER
CONN.'S.
DRAIN
FIELD
PIT
GREASE
TRAP
SOLAR >
HEATER'
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sui 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 l shall be complied w . , . hether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress 'Of wo
Owner's Name and Address
Registered Architect and /or Eng neer
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work to be performed —No.
State work to be performed and purpose of building (By Floors)
New Building_.._ _____ Remodeling Addition Repairs
Size Septic Tank- - — Type of Tank
Amount of Permit $ _ o t
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof,
performed under this permit; and
required by the Act. The under
licensed by Miami Shores Village.
NOTE: A re- inspection fee
materials and /or workmanship.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
PPLIG'ATION FOR PLUMBING PERMIT ,{
Date
B ock
P
and will require similar compliance
will post or cause to be posted for
signed agrees to employ only such
.(Signed)
(Signed)
No
No.
Feet of Drain Tik___..�_ �._.___.__._�. Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City Well. Size of Soakage Pit
� Ks
Street
Subdivisio
Street
- Capacity Gals.
Notary Public. State of Florida
No. of Stories__- .._.__.
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has corn-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the w b public notice or notices as are
sub-contractors, o work t / armed under this permit, as are
fr/ii{/
Master Plumber.
STATE OF FLORIDA, k
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.
of $ 1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fa