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320 NE 96 St (3)MIAMI SHORES VILLAGE, FLA. JOB ADDRESS INSPECTION ALL c/ei, TIME READY REMARKS: N? 5701 / 2 INSPECTOR DATE Permit No Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING Block_ 3 20 Size Septic Tank ........... Type of Tank_ Feet of Drain Tile -- _____._ -Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well Size of Soakage Pit (steed)- - -' ( Signed Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fir 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 ! !!__- . - - - -_� .Y �_�_ !v -- -- - _ - -- •_ --- No. Registered Architect and /or Engineer_ Employing Plumber's Name - Location and Legal Description Lot. ____. Street and Number where work is to be performed —No State work to be performed and purpose of building (By F'hoors)_ .___._____ A/F ` F L \L/ New Building —_ ___ Remodeling_ _____________ Addition______ _________. Repairs No. of Stories Street Subdivision 3 2 -0 street ! 6 S ed Notary Public, State of Florida C/Yt C C /� C� PPTi c �►;1./ 1' No.- j 7 Street____ At_A G ( 2,5 Capacity Gals. �O Cfc Pl bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, and Ilas com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors em . ;yed 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 required by the Act. The undersigned agrees to employ only such sub- contractors, on ork to b licensed by Miami Shores Village. blic notice or notices as are this permit, as are aster Plumber. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ _. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of i$1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- To/time SINKS SLOP SINKS LAUNDRY TUBS URINALS I NAS 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 SW IM•G POOL CONTR. LIST CHECK Permit No Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING Block_ 3 20 Size Septic Tank ........... Type of Tank_ Feet of Drain Tile -- _____._ -Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well Size of Soakage Pit (steed)- - -' ( Signed Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fir 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 ! !!__- . - - - -_� .Y �_�_ !v -- -- - _ - -- •_ --- No. Registered Architect and /or Engineer_ Employing Plumber's Name - Location and Legal Description Lot. ____. Street and Number where work is to be performed —No State work to be performed and purpose of building (By F'hoors)_ .___._____ A/F ` F L \L/ New Building —_ ___ Remodeling_ _____________ Addition______ _________. Repairs No. of Stories Street Subdivision 3 2 -0 street ! 6 S ed Notary Public, State of Florida C/Yt C C /� C� PPTi c �►;1./ 1' No.- j 7 Street____ At_A G ( 2,5 Capacity Gals. �O Cfc Pl bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, and Ilas com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors em . ;yed 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 required by the Act. The undersigned agrees to employ only such sub- contractors, on ork to b licensed by Miami Shores Village. blic notice or notices as are this permit, as are aster Plumber. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ _. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of i$1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty materials and /or workmanship.