29290Permit Na D Date �S 1 �.�
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Application '' ereby made for the approval of the detailed statement of the plans and specifications herewith eubm ed for the building or other
structure hen t `:; bed. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisi . a 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 a shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during p of work. c n
S�c,�e s \ �-S� ; �-- (,O2 W ' E_ r b S -
Owner's Name and Ad &ens. '� ..._.� Street.
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block ...h/ . Subdivision-10
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....
Stu Septic Ta *ti Type of Tan
Feet of Drain Tile .._ ._ - Wise. Feet of Tank or Drain Field from Well
Nature of Water Supply: City Well Size of Soakage Pit.
Amount of Permit $ l! `5 P
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 5988, Compiled General Laws of Florida Permanent Supplement, and liar com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to he
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 err
required by the Act The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Villages
STATE OF FLORIDA, f ens.
COUNTY OF DADE.
Before u ndersigned authority a dui auto odzed to administer oaths and take aclmowledgments, personally appeared
to me well known, and who, being by me&it duly sworn, upon oath deposes and says that he is Ills_ , . __ ' - ..... . - -
of the a described construction, that - has carefully mead the foregoing application, and that he did sign ilse seism, and that all facts
therein drs W FLORIDA f
flY CONNISSIOI EX► MT 11,10!*
-
...Capacity
Notary FuL& ate of Florkta
NOTE: A re- inspection fee of $1.00 will be made when as& siispaoMon Is made. aseeemsy by bumper sugar for-inspection, or faulty
materials and /era workmanship.
Plumbing Inspector.
Plumber.
CLOUTS
BATH
Tull
SHOWERS
LAVA.
loam
SINKS
SLOP
aINKa
LAUNDRY
TYaa
UR1NALe
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT 'Nf
TOTAL
R1
CONTR.
LIST
CNKCK
SEPTIC
TANK
SWIM
CONN.
DRAIN
FIELD
SOAKAGU
PIT
GREASE
TRAP
SOLAR
MuATUR
DUMP
WELL
SPRKLR.
SYaTUM
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POOL
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LIST
.----
CHUCK
Permit Na D Date �S 1 �.�
wIlifl
� r � .,_
Application '' ereby made for the approval of the detailed statement of the plans and specifications herewith eubm ed for the building or other
structure hen t `:; bed. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisi . a 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 a shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during p of work. c n
S�c,�e s \ �-S� ; �-- (,O2 W ' E_ r b S -
Owner's Name and Ad &ens. '� ..._.� Street.
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block ...h/ . Subdivision-10
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....
Stu Septic Ta *ti Type of Tan
Feet of Drain Tile .._ ._ - Wise. Feet of Tank or Drain Field from Well
Nature of Water Supply: City Well Size of Soakage Pit.
Amount of Permit $ l! `5 P
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 5988, Compiled General Laws of Florida Permanent Supplement, and liar com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to he
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 err
required by the Act The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Villages
STATE OF FLORIDA, f ens.
COUNTY OF DADE.
Before u ndersigned authority a dui auto odzed to administer oaths and take aclmowledgments, personally appeared
to me well known, and who, being by me&it duly sworn, upon oath deposes and says that he is Ills_ , . __ ' - ..... . - -
of the a described construction, that - has carefully mead the foregoing application, and that he did sign ilse seism, and that all facts
therein drs W FLORIDA f
flY CONNISSIOI EX► MT 11,10!*
-
...Capacity
Notary FuL& ate of Florkta
NOTE: A re- inspection fee of $1.00 will be made when as& siispaoMon Is made. aseeemsy by bumper sugar for-inspection, or faulty
materials and /era workmanship.
Plumbing Inspector.
Plumber.
10
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