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360 NE 97 St (5)- of
Permit No ( —
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address_._. . !._ ? - - -_ - -- � - - -- __ No.3i 0 - - -AL / - -_ Street ._ 975 7- ;
_
Registered Architect and /or Engineer __ - - -� �--- _- -- --- _ - -- ---
Employing Plumbei s Name_ /YOD�% /�''J SL% ['� 7 ice! ---- N _ jef -5 ° /V Street -L S -3 . r"
Location and Legal Description Lot. Block Subdivision
Street and Number where work is to be performed —No -76.0--4/ / 9.75 ri Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition_
Size Septic Tank______
Feet of Drain
Nature of Water Supply: City-- Well.____ _____________________.______— ____Size of Soakage Pit
Amount of Permit $ � -
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has ce n-
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 th sit of the iyork such ¢uy)lic notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractor•, o work be
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
L P.379
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank _ Capacity Gals.
7 lDist. Feet of Tank or Drain Field from Well
(Signed)-
(Signed)
Date
Repairs
My Comnnssion Expires Notary Public, State of Florida
No. of Stories . . . ... .. ...
-`y . .......
Plumbing Inspector.
under this per :nit, as are
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 inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
S
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUas
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FI %TURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
NTR.
Comm
LIST
~ — ^
CHECK
- of
Permit No ( —
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address_._. . !._ ? - - -_ - -- � - - -- __ No.3i 0 - - -AL / - -_ Street ._ 975 7- ;
_
Registered Architect and /or Engineer __ - - -� �--- _- -- --- _ - -- ---
Employing Plumbei s Name_ /YOD�% /�''J SL% ['� 7 ice! ---- N _ jef -5 ° /V Street -L S -3 . r"
Location and Legal Description Lot. Block Subdivision
Street and Number where work is to be performed —No -76.0--4/ / 9.75 ri Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition_
Size Septic Tank______
Feet of Drain
Nature of Water Supply: City-- Well.____ _____________________.______— ____Size of Soakage Pit
Amount of Permit $ � -
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has ce n-
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 th sit of the iyork such ¢uy)lic notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractor•, o work be
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
L P.379
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank _ Capacity Gals.
7 lDist. Feet of Tank or Drain Field from Well
(Signed)-
(Signed)
Date
Repairs
My Comnnssion Expires Notary Public, State of Florida
No. of Stories . . . ... .. ...
-`y . .......
Plumbing Inspector.
under this per :nit, as are
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 inspection, or faulty
materials and /or workmanship.
Village o Miami Shores
JOB
INSPECTOR DATE
ADDRESS
INSPECTION
TIME READY
REMARKS
N? 4522