601 NE 96 St (4)Date [_ _� __ -S�2 l7 ... -__ -- -. -.
Application i- hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herein described. This application is made in comphance 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 th Building Di ''sion
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_ 12.13.__ c _ No._______— _______— - -__— Street ! 1 C
Registered Architect and /or Engineer - - -__ �___ -- ___ -- -- - -- _ - _ --- • ----- _ -- --_ - _-
Employing Plumbei s Name _ � _.C79 _ t k �_._ No._ as Wi.9_ _ .__ _ Street. -t :_- &:)1 _.a 69 L V bLKta1
Permit No _______ _ ______ - --
Location and Legal Description Lot•__ —_____ _.— __._.____ _ —._. _.— Block_- -
Street and Number where work is to be performed —No
State w o r k to b e performed and purpose of building (By F l o o r s )- - - - - - - - --
New Building -- Remodeling_ -_ -_• _ - -. -- _ -.- -- Addition____ _ _ _ -- -- -- -.._ Repairs.
Size Septic Tank___ _ . _. _. _. _ -- - -- - Type of Tank -•___ -_- _ - _Capacity Gals.
Feet of Drain Tile__ - __ -- _ - -- - -• - - -- W e l l of Water Supply: City —Well. __ Size of Soakage Pit 5 ._x .0 X_ .
Amount of Permit $ _.
STATE OF FLORIDA, }
as.
COUNTY OF DADE.
MIAMI SHORES' 'VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
- (Signed)- _
Pl.:mb'ng In:pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oli gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and 1 as , om••
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin: in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site t ork such public notice or no ices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on wok e perfo. ed uIJler this per nit, as are
licensed by Miami Shores Village.
(Signed)_.
Street_ (pO1 ?1..96 SIre- q'71'
No. of Stories -
s
Subdivision_
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 •acts
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 /car workmanship.
CLOSETS
TUBS
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuba
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT 'NS
TOTAL
F XTURE8
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
X
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
`-
CONTR.
LIST
CHECK
Date [_ _� __ -S�2 l7 ... -__ -- -. -.
Application i- hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herein described. This application is made in comphance 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 th Building Di ''sion
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_ 12.13.__ c _ No._______— _______— - -__— Street ! 1 C
Registered Architect and /or Engineer - - -__ �___ -- ___ -- -- - -- _ - _ --- • ----- _ -- --_ - _-
Employing Plumbei s Name _ � _.C79 _ t k �_._ No._ as Wi.9_ _ .__ _ Street. -t :_- &:)1 _.a 69 L V bLKta1
Permit No _______ _ ______ - --
Location and Legal Description Lot•__ —_____ _.— __._.____ _ —._. _.— Block_- -
Street and Number where work is to be performed —No
State w o r k to b e performed and purpose of building (By F l o o r s )- - - - - - - - --
New Building -- Remodeling_ -_ -_• _ - -. -- _ -.- -- Addition____ _ _ _ -- -- -- -.._ Repairs.
Size Septic Tank___ _ . _. _. _. _ -- - -- - Type of Tank -•___ -_- _ - _Capacity Gals.
Feet of Drain Tile__ - __ -- _ - -- - -• - - -- W e l l of Water Supply: City —Well. __ Size of Soakage Pit 5 ._x .0 X_ .
Amount of Permit $ _.
STATE OF FLORIDA, }
as.
COUNTY OF DADE.
MIAMI SHORES' 'VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
- (Signed)- _
Pl.:mb'ng In:pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oli gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and 1 as , om••
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin: in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site t ork such public notice or no ices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on wok e perfo. ed uIJler this per nit, as are
licensed by Miami Shores Village.
(Signed)_.
Street_ (pO1 ?1..96 SIre- q'71'
No. of Stories -
s
Subdivision_
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 •acts
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 /car workmanship.
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