438 NE 96 St (10)BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
'Contracto
or Builder
Legal
Descriptio
Address
Building
a CONTRA C"rvet OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
PERMIT 'N° 11184
Work to be performed under this Permit
/
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 application
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 responsibility for work
done by his agents, servants or employees. ,
Jr
BY
Signed: INSP i f , . r - .. f s� r,
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, 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.
BY
DATE
Contractor's
License No
195
AUTHORITY
r
Lot
n
Bl.
Subdi-
vision
f
r
, s°'"
Value of
Project
$
Amt. of
Permit
$
r
�"
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
'Contracto
or Builder
Legal
Descriptio
Address
Building
a CONTRA C"rvet OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
PERMIT 'N° 11184
Work to be performed under this Permit
/
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 application
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 responsibility for work
done by his agents, servants or employees. ,
Jr
BY
Signed: INSP i f , . r - .. f s� r,
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, 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.
BY
DATE
Contractor's
License No
195
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE 194 _'`'
PERMIT N9 3401
Work to be performed under this Permit
Contractor's
License No.
1h,F r
P nrtll n y . 11
olr are (atii.LI C 'i. •. 1 j.::ii W of f.O jr.i:,,OrI
Board - -beiofes e wo.b ailt;Ior'i d in
this permit.
Architect_
Contractor
or Builder
Legal Lot Bl.
Description -
Address of
Building
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
application 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 responsibility for work done by his agents, servants or employees.
Signed: By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto and in strict conformity with the plans, drawings, 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.
Subdi-
vision
Value of
Project
Amt. of
Permit
CONTRACTOR OR BUILDER BY F' AUTHORITY
Permit No. -'
Application is Lereby 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 he kept 4
building during progress of work. ( ,�,�
Owner's Name and Address .
Registered Architect and /or Engineer
Employing Plumber's Nanie i t
Location and Legal Description Lot
CONTR.
LIST
CHECK
CONTR.
LIST
CHECK
Size Septic Tank______
Feet of Drain Tile_____
Nature of Water Supply: City —Well
CLOSETS
SEPTIC
TANK
BATH
Tues
SEWER
CONN.
SHOWERS
DRAIN
FIELD
LAVA-
TORIES
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
SINKS
SOAKAGE GREASE
PIT TRAP
131.oclfc
SLOP
SINKS
LAUNDR
TUBS
- — - -- — (Signed)
(Signed)
Street and Number where work is to be performed— Noerf'_ c _. Street_._
State work to be performed and purpose of building (By Floors)
A \
New Building Remodeling ____ Addition __ __ __ Repairs -,F ._ No. of Storks
URINALS
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
Type of Tank
Dist Feet of Tank or Drain Field from Well
Size of Soakage Pit.
Date. -
Street
Street
Subdivision
CATCH FLOOR DRINKING
BASIN DRAIN FOUNT'N5
Capacity Cals.
My Commission Expires Notary Public, State of Florida
TOTAL
Amount of Permit $
Plumbing I 1 pector.
The undersigned applicant for this'iitilding permit does hereby certify that he derstands and accepts his ohligatioryv!isan emp %yer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled C�,L�neral Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all gOntractors or sub - contractors employed by hint 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 an
licensed by Miami Shores Village.
Master Plumber.
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 nie 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.
FIXTURES
Permit No..____, 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 at
building during progress of work.
Owner's Name and Address ____________ — _— ___________-- _____— No. ____ —____ Street__
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed—No _______ ______— ____— _i___________ ____ Street
State work to be performed and purpose of building (By Floors)
New Building___— ______ Remodeling _______________________ Addition_.
Size Septic Tank___
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
APPLICATION FOR PLUMBING PERMIT
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, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
_Block
Repairs —___ No. of Stories
Type of Tank . _Capacity Gals.______ —____—
Dist. Feet of Tank or Drain Field from Well __—
Size of Soakage Pit _____ __ ____
___________-- �_______ —_—
(Signed) -- — -- – – -- — --
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
(Signed) – = - - - -- — - - - - --
-----------------------------
_ Master Plumber.
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.
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
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
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..____, 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 at
building during progress of work.
Owner's Name and Address ____________ — _— ___________-- _____— No. ____ —____ Street__
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed—No _______ ______— ____— _i___________ ____ Street
State work to be performed and purpose of building (By Floors)
New Building___— ______ Remodeling _______________________ Addition_.
Size Septic Tank___
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
APPLICATION FOR PLUMBING PERMIT
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, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
_Block
Repairs —___ No. of Stories
Type of Tank . _Capacity Gals.______ —____—
Dist. Feet of Tank or Drain Field from Well __—
Size of Soakage Pit _____ __ ____
___________-- �_______ —_—
(Signed) -- — -- – – -- — --
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
(Signed) – = - - - -- — - - - - --
-----------------------------
_ Master Plumber.
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.
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
My Commission Expires
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 at
building during progress of work.
Owner's Name and Address \ ____
Registered Architect and /or Engineer
Employing Plumber's Plumber's Name ____ _ .f '_ — _ � "t s` No. /_/"; ___,___ Street__,4, fir' &✓� -' G ��._.
-1 i `= — No.= _..�_ �i — F Street'
i
Location and Legal Description Lot —_ _ fr _ _____— __ —___— _S_ ` ____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 Addition Repairs + No. of Stories
Subdivision__
Street_------_-_ --
Size Septic Tank___, ______________— ______ Type of Tank . Capacity Gals.__
Feet of Drain Tilk<< =� - -- - �'- - ---__ Dist. Feet of Tank or Drain Field from
Nature of 'Water Supply:` ity —Well —__— — .Size of Soakage Pit
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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)• f ( 1 � ' d �
Mastgy,I lumber.
Notary Public. State of Florida
STATE OF FLORIDA,
COUNTY OF DADE. ss'
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
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
- rues
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
My Commission Expires
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 at
building during progress of work.
Owner's Name and Address \ ____
Registered Architect and /or Engineer
Employing Plumber's Plumber's Name ____ _ .f '_ — _ � "t s` No. /_/"; ___,___ Street__,4, fir' &✓� -' G ��._.
-1 i `= — No.= _..�_ �i — F Street'
i
Location and Legal Description Lot —_ _ fr _ _____— __ —___— _S_ ` ____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 Addition Repairs + No. of Stories
Subdivision__
Street_------_-_ --
Size Septic Tank___, ______________— ______ Type of Tank . Capacity Gals.__
Feet of Drain Tilk<< =� - -- - �'- - ---__ Dist. Feet of Tank or Drain Field from
Nature of 'Water Supply:` ity —Well —__— — .Size of Soakage Pit
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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)• f ( 1 � ' d �
Mastgy,I lumber.
Notary Public. State of Florida
STATE OF FLORIDA,
COUNTY OF DADE. ss'
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.
BUILDING
ELECTRICAL
PLUMF3ING
Owner of
Building
Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot .B1.
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 3616
Subdi-
vision
Value of
Project
DATE
Contractor's
License No.
Amt. of
Permit
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
application 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 responsibility for work done by his agents, servants or employees.
Signed• B
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances -
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY
Permit No
Owner's Name and Address _______;'.t
Location and Legal Description Lot_
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street and Number where work is 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 . Capacity Gals.__—
r
Feet of Drain Tile`_` ' _ ' I —___ Dist. Feet of Tank or Drain Field from Well__________ Nature of Water Supply: City —Well Size of Soakage Pit
/ — -- – — -- - - -- (Signed)
(Signed)
,
Date - - - - -- .,L_----- - - 1
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.
_ Street /
r
Registered Architect and /or Engineer f
Employing Plumber's Name ______;,./
__, -. __— __ -.!_� ,, d # ' '
• — __ No. __ i _ Street_�'____rt __ 1 _ .4- r� ' t�.. -•
d/f
" __Block_
Street - – – — — — -- – - -- - - --
Notary Public. State of Florida
No. of Stories
Mastgr,,F;umber.
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed 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.
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
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
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
Owner's Name and Address _______;'.t
Location and Legal Description Lot_
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street and Number where work is 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 . Capacity Gals.__—
r
Feet of Drain Tile`_` ' _ ' I —___ Dist. Feet of Tank or Drain Field from Well__________ Nature of Water Supply: City —Well Size of Soakage Pit
/ — -- – — -- - - -- (Signed)
(Signed)
,
Date - - - - -- .,L_----- - - 1
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.
_ Street /
r
Registered Architect and /or Engineer f
Employing Plumber's Name ______;,./
__, -. __— __ -.!_� ,, d # ' '
• — __ No. __ i _ Street_�'____rt __ 1 _ .4- r� ' t�.. -•
d/f
" __Block_
Street - – – — — — -- – - -- - - --
Notary Public. State of Florida
No. of Stories
Mastgr,,F;umber.
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed 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.
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
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 3616
Work to be performed under this Permit
Bl.
Subdi-
vision
DATE
Contractor's
License No.
WARNfriC: This ('p -cfr . +,- ITA tr:rfiril■
g e ' al x aNtrioNz in
Value of i Amt. of
Project Permit
CONTRACTOR OR BUILDER BY AUTHORITY
194
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
application 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 tima 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 responsibility for work done by his agents, servants or employees.
Signed: By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto and in strict conformity with the plans, drawings, 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.