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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 n ;: (,? ( 2 7 ("." 7 '7 ic 2 2-4 _ 67 e- 4.7, 1-7. x „ . - / / c t r 12 r, g eiC ,q(/) (;) ) 7 L ' f 1 er, t ,M A ■-■ V 4 1 ///, e 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.