20481Size Septic Tenk
Feet of Drain Tile
Amount of Permit $ L00
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
reit
Permit No 1149 441 Date— 14441J_
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 mud be kept at
building during progress of work.
Owners Name and Address ?Re52e-t'prt<<9n ttteh N 60 2
Registered Architect and /or Engineer b G petit/He ., Co. Inc .
Employing Plumber's Name iaa. 1 N
Location and Legal Description Lot Block . Subdivision.._..._..,,..
Street and Number where work is to be performed —No 6 o 2
State work to be perfonne8 and purpose of building (By Floors)
New Building Remodeling Addition Repairs____ .............. No of Stories
street.�E. 1v
street.V.WakZatua
"—' Type of Tank — Capacity
nIat. Feet of Tank or Drain Field from Well__
Nature of Water Supply: city —W4 — Size of Soakage Pit. —
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 5986, Compiled General Laws of Florida Permanent E upplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub -contractors employed ty him in the work co b
performed under this permit; and will post or cause to be posted for inspection on the site of the work such publi_ notice or noricer as arty,
required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed s -crier this ponnit, as ar
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
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 be did sign the same, and that all facts
therein by him stated are true.
NOTE: A re inspection fee of *1.00 will be mule when such miasmal= ses is made necessary by improper notice for inspection, or tangy
materials and/at workmanship.
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SEPTIC
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SEWER
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DRAIN
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: SoAKAOE
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GREASE
TRAP
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CHECK
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Size Septic Tenk
Feet of Drain Tile
Amount of Permit $ L00
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
reit
Permit No 1149 441 Date— 14441J_
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 mud be kept at
building during progress of work.
Owners Name and Address ?Re52e-t'prt<<9n ttteh N 60 2
Registered Architect and /or Engineer b G petit/He ., Co. Inc .
Employing Plumber's Name iaa. 1 N
Location and Legal Description Lot Block . Subdivision.._..._..,,..
Street and Number where work is to be performed —No 6 o 2
State work to be perfonne8 and purpose of building (By Floors)
New Building Remodeling Addition Repairs____ .............. No of Stories
street.�E. 1v
street.V.WakZatua
"—' Type of Tank — Capacity
nIat. Feet of Tank or Drain Field from Well__
Nature of Water Supply: city —W4 — Size of Soakage Pit. —
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 5986, Compiled General Laws of Florida Permanent E upplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub -contractors employed ty him in the work co b
performed under this permit; and will post or cause to be posted for inspection on the site of the work such publi_ notice or noricer as arty,
required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed s -crier this ponnit, as ar
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
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 be did sign the same, and that all facts
therein by him stated are true.
NOTE: A re inspection fee of *1.00 will be mule when such miasmal= ses is made necessary by improper notice for inspection, or tangy
materials and/at workmanship.