670 NE 97 Ste e., -, ; , )
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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.
Date 0' / , 7
I r
Owner's Name and Address M 0 R to � H C 1 4 E 1 , 6 - - - - H e . . . - 1 ' 0.- - -- s r , ..G. Mt nrl i
Registered Architect and A..,. -der tn 1 F (Z 1 1 OMAN
Name and address of licensed contractor. No .c+o N
Location and legal description of lot to be built on:
Lot Z 'c- slit. Lo+ 4- Block 1 rJ ° Subdivision
Street and Number where work is to be done
ln. k i?
. -. _:2 z -.e =
State work to be done and purpose of building (by floors ) �� '� lam'!
Zone cubage required ----- .- -I-74. O 0
14 :LL
6 7o N tY
and for no other purpose.
New Building V Remodeling Addition c Repairs No. of Stories
To be constructed of C 3. -.5 Kind of C `� ..7 verin r r / 1_ E
� -�
Estimated Total cost of improvements $.2.°) foundation Roof Co 0 0 O Amount of Permit $ C y s ° g -
-Plan Cubage.. 145:70-e-16- -- ; I- ads - t-- ` - /
Distance to next nearest building/it/1_0W P I 1° S E - ? C K Size of Building Lot 7 )( / 3 0
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices witthh reference to the building and its construction may
be sent to- .-1_.A RA ° J l b - NE, j o S1 l 1 1.83'' i
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 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 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 subcontractors, on work tQ be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)._
NE to St to i I
R i 1 1 1 4 0 l''i e S te,
STATE OF FLORIDA,
COUNTY OF DADE. j 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 stated are true.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman 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.
2 7
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OFFICE:
5139 S. W. 8TH ST.
LOCATION SKETCH
SURVEY OF
LOT ,"3" AA I> £ .14_"7r �`a o,t . i1 T 4
SUBDIVISION M1 A M I 5110e 10( E 5 . , 5) C °('I U N 4
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK No
PUBLIC RECORDS OF DA f-) G COUNTY. FLORIDA.
BATE: 0 ' 7 - i. 1`d. ) 8 I 1 9 5
N E 9G s7r ff�7
.40 a-la /Vl /A /v)/ F4OR-V
C. B. CO., NO. 3080 17888
THOMAS J. KELLY
CIVIL ENGINEER —LAND SURVEYOR
MIAMI, FLORIDA
SURVEY NUMBER- 57 - 1$15"
/17 E 9' 7 E,b 7
. • -t-- /c5' ' ,/ v.eA4 t/v y -
SCALE 1 "'= 2(20
Pip e
FOR. IV1 [7 I `7" `4
cp. 77 , ,,) �s s n 4 / /e3LOT DETAILS
15
i
BLOCK j®0
AT PAGE No 14
HNC1°lELI,
I HEREBY CERTIFY THAT THE ATTACHED
SKETCH REPRESENTS A RECENT SURVEY MADE
UNDER MY DIRECTION. AND IS TRUE AND COR-
RECT TO THE BEST OF MY KNOWLEDGE AND
BELIEF.
THERE ARE NO ENCROACHMENTS.
TELEPHONE
H. 1. 8 -0504
REGISTERED ENGI #3161
REGISTERED LAND SURVEYOR #8
STATE OF FLORIDA.
SCALE 1'•=-� 20
ett
,));
Owner's Name and Address /d1'
Registered Architect and /or Engineer
Disapproved Date
C
J )
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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.
State work to be done and purpose of building (by floors)
Building Insp" etoor
C 1/
Name and address of licensed contractor____t ..t3.5;/
Location and legal description of lot to be built on:
Lot Block Subdivision......
Street and Number where work is to be done (o / 0 - / 2 7,
Date c a/ , 19
Street/5f- C. =
c/.,"i es( (ai A! . IC �~ ✓
Nof /r.
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation, Roof Covering
--,
Estimated Total cost of improvements $ ' " Amount of Permit $ Z'
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
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, Permanent 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 cinder 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
i9C / C � Jiro/
f'/r/c`c'!c' -�
ate;, f i/
v
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 stated are true
Permit No 7 `� 1_ Date "c ' e( 0 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman 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.
<
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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.
7 - • , 19 .-rr
Date
Owner's Name and Address ..m..A..r...+........,, A,..w...c..k....1.1 No....L.1..6 Street.....N.. ..... l. S
Registered Architect and/or Engineer
Name and address of licensed contractor WI 1 1 F e.- `I C O 3,4 . 9..-kt- 1
Location and legal description of lot to be built on:
Lot - 3 t VI. " i t Block / ‘0 g> 5 e. c. *,
Subdivision 1 a 44,. i.1.4. t T itz it- ft...%
6 7s:a 9 S f.
Street and Number where work is to be done g..e... 7 .4
State work to be done and purpose of building (by floors) ..T' 14 3 4- 01/4.1 1 7 5" 0 tx c>. f3 r.1.4 ,
. c„... e. Vs, •1 Ce._ 1 .K e ,...).- ,
and for no other purpose
New Building Remodeling
Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
"--
Estimated Total cost of improvements $ 3 0 Amount of Permit $ 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__ p,. .. i / r .a.,.., Co_ 2. 70 ALE. - a ci , f I. 'S 1- /1 t ek..ks....1
The undersigned 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 5966, Compiled General Laws of Florida, Permanent 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 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed )/b. 1 1 F . K_ Co
STATE OF FLORIDA,
COUNTY OF DADE. f
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 'thfzegoing application, and that he did sign the same, and that all facts
therein by him stated true.
Permit No ..... kr Date...,$ Read, Sworn to and Subscribed before me.
Disapproved ......
(Signed)
SS.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Notary Public, State of Florida
ding Inspector My Commission Expires
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.
•
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 ........,
Registered Architect and /or Engineer ...... ......
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Disapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date
Date ( 19.
No ._ // Street__ ? .s... e' 9
Subdivision.
State work to be done and purpose of building (by floors)
//
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of oundation Roof Covering
Estimated Total cost of improvements $ eV Amount of Permit $
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
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 5966, Compiled General Laws of Florida, Permanent 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 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village
Remarks (Signed)
Read, Sworn to and Subscribed before me.
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 stated a e.
Permit No Date
Notary Public, State of Florida
Building Inspector /. y Commission Expires
PL . NING 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.
Permit No
3v4
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
MIAMI SHORES VILLAGE
ce
ELECTRICAL INSPECTION DEPARTMENT
, APPLICATION FOR ELECTRICAL PERMIT
Registered Architect and /or Engine r
Employing Electrician'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 Floors)
New Building A Remodeling Addition Repairs No. of Stories
Overhead
Servi ce Size Feeders Conduit /.•"— Main Sw untierground
Type of Installation — Conduit Tubing B.X.L
STATE OF FLORIDA, j
COUNTY OF DADE. JI
85.
r 1
Amount of Permit $ l c .46
Block , L ..e Subdivision ?• �'
Amps Main Fuses Amps
Metal Moulding
(Signed)
Electrical 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 complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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•contractor1, on work to be performed this permit, as are
licensed by Miami Shores Village.
(Signed)
/10 7Z
Date.
Street.... / 0 F
O4 ' Aiid:Street I/
.Street
Matter Electrician.
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, and 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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
$rACE
H EATER
STRIP
HEATER
TOTAL
CONTR.
LIST
/
j �,
c /
t .3
/Y
f
`'_ /
l
. • co
1• Z S
CHECK
f '(
ENT. DIST.
SW. CAD.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
/
/ q
\`i90
- .. --._
CHECK
1.O Q,G
\su
Permit No
3v4
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
MIAMI SHORES VILLAGE
ce
ELECTRICAL INSPECTION DEPARTMENT
, APPLICATION FOR ELECTRICAL PERMIT
Registered Architect and /or Engine r
Employing Electrician'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 Floors)
New Building A Remodeling Addition Repairs No. of Stories
Overhead
Servi ce Size Feeders Conduit /.•"— Main Sw untierground
Type of Installation — Conduit Tubing B.X.L
STATE OF FLORIDA, j
COUNTY OF DADE. JI
85.
r 1
Amount of Permit $ l c .46
Block , L ..e Subdivision ?• �'
Amps Main Fuses Amps
Metal Moulding
(Signed)
Electrical 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 complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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•contractor1, on work to be performed this permit, as are
licensed by Miami Shores Village.
(Signed)
/10 7Z
Date.
Street.... / 0 F
O4 ' Aiid:Street I/
.Street
Matter Electrician.
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, and 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 1 Q' t
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
Amount of Permit $ °
STATE OF FLORIDA,
COUNTY OF DADE. J
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING ro ;kMOT
... Street_
Registered Architect and /or Engineer _ ___ t - _
Employing Plumber s' Names 0 ___ No.__ _ Street--
Location and Legal Description Lot_ - _!7 A.! - _.!-4.! . Block___1 0 i2 Subdivisios - � - •
_i '7
Street and Number where work is to be performed —No N. C 7 '7 - street
State work to be performed and purpose of building (By Floors) __.____
New Building - Remodeling _ Addition
Slze 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
Capacity Gals
&kJ
(Signed)_
Repairs No. of Stories
The undersigned applicant for this building permit does hereby certify that he understands and accept is 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
o -
.i
(Signed)_._ , Z Z
/Master Plumber.
DateI5.1.e _ t _ 7
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
Plumb - Spector.
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
SHO
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U RNL
I AS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
2,
/
/
2
/'
i—.
�,
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 1 Q' t
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
Amount of Permit $ °
STATE OF FLORIDA,
COUNTY OF DADE. J
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING ro ;kMOT
... Street_
Registered Architect and /or Engineer _ ___ t - _
Employing Plumber s' Names 0 ___ No.__ _ Street--
Location and Legal Description Lot_ - _!7 A.! - _.!-4.! . Block___1 0 i2 Subdivisios - � - •
_i '7
Street and Number where work is to be performed —No N. C 7 '7 - street
State work to be performed and purpose of building (By Floors) __.____
New Building - Remodeling _ Addition
Slze 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
Capacity Gals
&kJ
(Signed)_
Repairs No. of Stories
The undersigned applicant for this building permit does hereby certify that he understands and accept is 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
o -
.i
(Signed)_._ , Z Z
/Master Plumber.
DateI5.1.e _ t _ 7
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
Plumb - Spector.
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.
'Me Goa 05m Vii (7,7 u.
Cv' BN\Cu o F,;1DA
At7
Permit No._ i5
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 Engine
Employing Plumber's Name
Amount of Permit $ —
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING i`'twMIT
..........
Location and Legal Description Lok_. 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.
4 `d=_ No.
(Signed)._
No._____------ -- .- -•_— Street
Size Septic Tank of Tank
Feat of Drain Tile___ —___� !. ' - . / eet of Tank or Drain Field from Well
(Signed)- -- //{ `Z
Date
My Commission Expires Notary Public, State of Florida
Street-.
Subdivision- - - -._- ----------_-___---
Street
Repairs No. of Stories_ _
Capacity Gals.
Nature of Water Supply: City — Well.-_.______ ....... _ ....... _______ ......... -.__.___Size of Soakage Pit
f
umbing 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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, I
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 $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
U RINALS
CATCH
BASIN
FLOOR
DRAIN
ORINKI NG
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
CHUCK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
CONTR.
LIST
_
CHECK
.tea
At7
Permit No._ i5
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 Engine
Employing Plumber's Name
Amount of Permit $ —
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING i`'twMIT
..........
Location and Legal Description Lok_. 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.
4 `d=_ No.
(Signed)._
No._____------ -- .- -•_— Street
Size Septic Tank of Tank
Feat of Drain Tile___ —___� !. ' - . / eet of Tank or Drain Field from Well
(Signed)- -- //{ `Z
Date
My Commission Expires Notary Public, State of Florida
Street-.
Subdivision- - - -._- ----------_-___---
Street
Repairs No. of Stories_ _
Capacity Gals.
Nature of Water Supply: City — Well.-_.______ ....... _ ....... _______ ......... -.__.___Size of Soakage Pit
f
umbing 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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, I
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 $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.