1449Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 spe ' ed or ot. A copy of approved pl ns d
building during progress of work.
Owner's Name and Address
Employing Plumber's Name
Location and Legal Description Lot___
licensed by Miami Shores Village.
i
Registered Architect and /or Engineer °
C sue`
:e-t-
Street
CAOPVZI
No
' 4 " c414 ' °411 ' No
'Block Subdivision
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 '
My Commission Expires
Amount of Permit $ (Signed)
ust he kept at
Stree
Capacity Gals
Size Septic Tank Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from We1L_
Nature of Water Supply: City Size of Soakage Pit
(Signed)
Notary Public. State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as art employer of labo
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 . e
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 re
required by the Act. The under signed agrees to employ only such sub- contractors, on work to be perfed under this permit, as Mare
Master Plumber.
STATE OF FLORIDA, t
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
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURE
CONTR.
LIST
/
/
CHECK
--
SEPTIC
TANK
SEWER
CONN.
- DRAIN
IELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 spe ' ed or ot. A copy of approved pl ns d
building during progress of work.
Owner's Name and Address
Employing Plumber's Name
Location and Legal Description Lot___
licensed by Miami Shores Village.
i
Registered Architect and /or Engineer °
C sue`
:e-t-
Street
CAOPVZI
No
' 4 " c414 ' °411 ' No
'Block Subdivision
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 '
My Commission Expires
Amount of Permit $ (Signed)
ust he kept at
Stree
Capacity Gals
Size Septic Tank Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from We1L_
Nature of Water Supply: City Size of Soakage Pit
(Signed)
Notary Public. State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as art employer of labo
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 . e
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 re
required by the Act. The under signed agrees to employ only such sub- contractors, on work to be perfed under this permit, as Mare
Master Plumber.
STATE OF FLORIDA, t
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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 pot. A copy of approved plans and spewi ons,,must be kept at
building during progress of work. ¢, '',+ 1 e 0,07/ a` Y. d
Owner's Name and Address No Street
Registered Architect and /or Engineer
New Building
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
Es.
Remodeling_
Street and Number where work is to be performed —No
Employing Plumber's Name No. Street
Location and Legal Description Lot Block Subdivision
Street__„
State work to be performed and purpose of building (By Floors) y "
Addition Repairs_ _ No. of Stories__ —
Capacity Gals
Size Septic Tank Type of Tank__
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Size of Soakage Pit
(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)_
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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.
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT* NS
TOTAL
FIXTURE
I
CONTR.
LIST
''.7'
_ se -
CHECK
°
SEPTIC
TANK
SEWER
CONN.
DRAIN
, FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
ik
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 pot. A copy of approved plans and spewi ons,,must be kept at
building during progress of work. ¢, '',+ 1 e 0,07/ a` Y. d
Owner's Name and Address No Street
Registered Architect and /or Engineer
New Building
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
Es.
Remodeling_
Street and Number where work is to be performed —No
Employing Plumber's Name No. Street
Location and Legal Description Lot Block Subdivision
Street__„
State work to be performed and purpose of building (By Floors) y "
Addition Repairs_ _ No. of Stories__ —
Capacity Gals
Size Septic Tank Type of Tank__
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Size of Soakage Pit
(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)_
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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.
ELBOTIt
lnspeetrzts eportr
or
The follow .ng Is ready for Inspection:.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
Contractor's
License No.
Work to be performed under this Permit
PERMIT N9 1449
Bl.
Subdi-
vision
Value of Amt. of
Project 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. 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.
BY
AUTHORITY
•
•
The following is . ready for Inspection:
Inspector's Report;
0 /
:
:
: