16603 MIAMI SHORES V I LLAG E
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
T'
ar
Permit No../ D ` (-
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 an 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
/1
building during progress of work ) :
Owner's Name and, Address
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City Well
STATE OF FLORIDA,
COUNTY OF DADE. e.
Type of Tank
My Commission Expires
New Building Remodeling_ Addition
0
Dist. Feet of Tank or Drain Field from Well
The undersigned applicant for this building permit does hereby to
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.
NOTE: A re- inspection fee of $1.00 will be made when such
materials and /or workmanship.
(' 'Street
Repairs
k-' %No Street
Registered Architect and /or Engineer y d
Employing Plumber's Name � ' t 4' �� Flo. Street
Location and Legal Description Lor liloe
Street and Number where work is to b4 performed —No a ? r
State work to be performed and purpose of building (By Floors)
Block
Subdivision
Capacity Gals.
Size of Soakage Pit.
No. of Stories
Amount of Permit $ (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
Before me, the undersigned. authority, a notary public, duly
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
sor
re- inspection is made necessary by improper notice for inspection, or faulty
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
',. TORIES
SINKS
SLOP -
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR -.
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
Comm.
LIST
CHECK
-.
SEPTIC.
TANK
SEWER
-_. CONN.
DRAIN
FIELD
, SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL.
" SPRKLR.
SYSTEM
SWIM'0
POOL
CONTR.
LIST
CHECK
3 MIAMI SHORES V I LLAG E
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
T'
ar
Permit No../ D ` (-
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 an 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
/1
building during progress of work ) :
Owner's Name and, Address
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City Well
STATE OF FLORIDA,
COUNTY OF DADE. e.
Type of Tank
My Commission Expires
New Building Remodeling_ Addition
0
Dist. Feet of Tank or Drain Field from Well
The undersigned applicant for this building permit does hereby to
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.
NOTE: A re- inspection fee of $1.00 will be made when such
materials and /or workmanship.
(' 'Street
Repairs
k-' %No Street
Registered Architect and /or Engineer y d
Employing Plumber's Name � ' t 4' �� Flo. Street
Location and Legal Description Lor liloe
Street and Number where work is to b4 performed —No a ? r
State work to be performed and purpose of building (By Floors)
Block
Subdivision
Capacity Gals.
Size of Soakage Pit.
No. of Stories
Amount of Permit $ (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
Before me, the undersigned. authority, a notary public, duly
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
sor
re- inspection is made necessary by improper notice for inspection, or faulty
MING
cLECFRICAt
pLL71�iNTG
PERMIT N° 1660
Owner of
Building
Architect
Contractor
or Builder
Legal
-- Description
ONTRACTOOR IRTIET
MIAMI SHDRES VILLAGE, FLDRIDA
Subdi•
_vision - -
DATE p , ;
Contractor's
'1.icense_N
�.F
Work to be performed under this Permit
Address of w E Value of Amt. of
_ Building ° -; _ _' Project ( Permit
This t is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application �or 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 assn es the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans o'draa 'atom in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed' ay By
INSPECTOR
In consideration of the issuance to me of this permit I. agree to perform,thework 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.
n piectpr's Report:
•
'WORK
DONE
REQ;13'E8 `ED
ol1owing 4 ,.s ready or Ir spect1on: i;l