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755 NE 97 St (6)MIAMI SHORES VILLAGE, FLA. JOB � „ 4 5 - 7.4*- ADDRESS 6 N2 1258 INSPECTION TIME READY REMARKS: CLOSETS 1 BATH TUBS SHOW [RS LAVA• TORIES SINK{ SLOP SINK• LAUNDRY Tuns URINAL{ CATCH BASIN FLOOR DRINKING DRAIN FOUNT'NS TOT..I. PIRA RES CONTR. T - - LI CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAOS PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL I . C O►rrR. LIST __ _ .,--. CHUCK Perini: Nu.■.. 24___ 'Avner s Name and Address..__g.�_.ALth �/ J04 r2°� .egict.tred Architect and /or Engine _ �`. W Engineer Amount of Permit 3 .5 l7 STATE OF FLORIDA, b es. COUNTY OF DADE. • MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT o . (Signed) _ (Signed)._ Date , is liereby made for the approval of the detailed statement of the plans and specifications herewith subr.w...•i for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi. ••f Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic - of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec fications must be kept at ',wilding during progress of work. �. /Vr treet_! 15 1, .3651 7 :mploying Plumber's Name 1110.- •.,, n,,.,, ,.: BQtee & ..<.. <..<. >... - <. Location and Legal Description Lot_ Bloch -7 � Subdivlaion.__..._. _ Street and Number where work is to be performed —No _7;____ 5 S �r 1 Street State work to be performed and purpose of building (By Floors) __. ... _ ..... _____ ..... _ New Building Remodeling__ _ - _ Addition Repairs No of Stones Size Septic Tank_ - - -_ •---- _- ...-- •- •- .----- .---- -_ -_ -- -Type of Tank__ Capacity r Feet of Drain Tile. __Dist. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well..____ __...__ .- __. -__. —_ ._ -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 endloyei of tabu) under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Cum lement, and liar onil. ;.lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed 1 y him in : Is 'XI 0, a b•- performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publ: notice -: no icer is a requ'red by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed ? this ,):rl.ti, :.t rar . licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclawwledgntents, per;or.e: ; . ppearesa 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 mat all acts therein by hin, stated are true. ~ My Cc mission Expires Notary Public, State of Fkntda NOTE: A re inspection fee of $1.00 will be made when such ro•inapee ioo le mads•neeessary by improper notice for Insperton, or mutt) materials and /ce workmanship. MIAMI SHORES VILLAGE, FLA. / JOB �� (i/// ADDRESS 7/ INSPECTION TIME READY l REMARKS: P IN TOR __ SEC _ r . 7 N2 1280 DATE et-v.,'