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23333t ... MIAMI SHORES VILLAGE I li PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 DIVilden of Miami Shores Village shall be compiled 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 Addr Registered Architect and/or Entineer Employing Plumber's Name Amount of Permit $ Type of Tom& Size Septic Tsn' Feet of Drain Tile Nature of Water Supply: City—Well. Size of Soakage Pit Mit. Feet of Tank or Drain Field from Well under the Florida Worlaneds Compensation Act, being Section 5988, Compiled General Laws\ of Florida Permanent Su plied with the provisions thereof, and will requite similar compliance from all contractors or sub-contractors performed under this permit; and will post or cause to be posted for inspection on the of the work su Dowsed by Miami Shores Village. required by tlie Act. The undersigned agrees to employ only such sub-contractors, to (Shined) Location and Legal Description Lot Subdividon--_v Street and Number where work is to be performed—No State work to be performed and purpose of building (By )loors) New Building Remodeling—L' caPay car- Plurnbirtg Inspector. The undersigned applicant for this building permit does hereby certify that he undentands and accepts his obligations as an employer of labor IKT to be him In the wo bile notice or ces under this • Pltunber. STATE OF FLORIDA, 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 mad the foregoing application, and that he did sign the same, and that all fouls therein by him stated are true. My Commission Notary Pnbko, State of Fled& NOTE: A re-inspection fee of $1.00 will be made wheat mob relaspeado. 15 imide•neeemnry by Improper notices f Impection, er family materials and/or workmanship. CLesgra OATH Tu es 6 LAVA. Yenta* smile Stop sums LAUNDRY Tue. ....."4"4•11-11 .... _ 1,1 CATCH BASIN .---.......— FLOOR DRAIN --.....---.— DRINK! NS FOUNT'S. TOTAL ' Co pan. LIST 2_ ...—,---- CHKCIK • KW 114 '0 Poo!. Serve TANK EMIL* CONN. DRAIN FILLS SWAMIS PIT GRIEASK TRAF Soup! HEATS* DSO WELL SFRKLII. SYSTEM CONTR. LIST CHCCK t ... MIAMI SHORES VILLAGE I li PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 DIVilden of Miami Shores Village shall be compiled 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 Addr Registered Architect and/or Entineer Employing Plumber's Name Amount of Permit $ Type of Tom& Size Septic Tsn' Feet of Drain Tile Nature of Water Supply: City—Well. Size of Soakage Pit Mit. Feet of Tank or Drain Field from Well under the Florida Worlaneds Compensation Act, being Section 5988, Compiled General Laws\ of Florida Permanent Su plied with the provisions thereof, and will requite similar compliance from all contractors or sub-contractors performed under this permit; and will post or cause to be posted for inspection on the of the work su Dowsed by Miami Shores Village. required by tlie Act. The undersigned agrees to employ only such sub-contractors, to (Shined) Location and Legal Description Lot Subdividon--_v Street and Number where work is to be performed—No State work to be performed and purpose of building (By )loors) New Building Remodeling—L' caPay car- Plurnbirtg Inspector. The undersigned applicant for this building permit does hereby certify that he undentands and accepts his obligations as an employer of labor IKT to be him In the wo bile notice or ces under this • Pltunber. STATE OF FLORIDA, 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 mad the foregoing application, and that he did sign the same, and that all fouls therein by him stated are true. My Commission Notary Pnbko, State of Fled& NOTE: A re-inspection fee of $1.00 will be made wheat mob relaspeado. 15 imide•neeemnry by Improper notices f Impection, er family materials and/or workmanship.