80 NE 97 St (2)BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
❑ DATE 195
PERMIT N9 2648 Contractor's
License No.
C Work to be performed under this Permit_
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
/ 1 !
Bl.
Subdi-
vision
Value of
Project $
Amount of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict complianco with at. 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 c.uthorities. 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 ccntractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work coverod hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed. BY
INSPECTOR
In consideration of tho issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the—plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac•
cepting this permit I assume responsibility for all /fork done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY " _
•UILDING
LLECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder —
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 1467
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project
DATE
Contractor's
License No.
Amt. of
Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor 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 assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed: B
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work 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.
CONTRACTOR OR BUILDER" BY AUTHORITY
194__
Permit No..
Owner's Name and Address .
Registered Architect and /or Engineer
Employing Plumber's Name — _______—
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date__
{
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 must be kept at
building during progress of work.
_(Signed)
No.___ Street _
No.__________ Street_____
Location and Legal Description Lot__ —_—_— ___________—___— _ —____ Block _____________ _____________ Subdivision
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 ___ ____ ___ _.
Size Septic Tank —_ —__. —__ _______ Type of Tank . Capac ity Gals
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 employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Street
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELp
f
SOAKAGE
PIT
GREASE
TRAP
SCLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
/
CHECK
Permit No..
Owner's Name and Address .
Registered Architect and /or Engineer
Employing Plumber's Name — _______—
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date__
{
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 must be kept at
building during progress of work.
_(Signed)
No.___ Street _
No.__________ Street_____
Location and Legal Description Lot__ —_—_— ___________—___— _ —____ Block _____________ _____________ Subdivision
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 ___ ____ ___ _.
Size Septic Tank —_ —__. —__ _______ Type of Tank . Capac ity Gals
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 employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Street
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No T
Amount of Permit
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION 1FOR PLUMBING PERMIT
Employing Plumber's Name fq 1 fk we 1 � °vi e elL e P7i c
Location and Legal Description Block_
_61! -- No._ __________.L. '
( Signed
Date
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 w;th 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 Address . ------------- ____ - _-
Registered Architect and /or Engineer _
No. ___ -_-_ Street G
Street___
Subdivision
( Signed)
My Commission Expires Notary Public, State of Florida
cr. 3i. 6---)
/.
Street and Number where work is to be performed- No._______ _ _ Str eet �� ~
State work to be performed and purpose of building (By Floors)__
t � JGt/ K� e )
New Building__________ Remodeling_____ ________ Addition________._ Repairs 2/ No. of Stories.
Size Septic Tank _- _---- ____ -- Type of Tank_ Capacity Gals
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 employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em Toyed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the to of the work rc public notice or notices as are
required by tlie Act. The undersigned agrees to employ only such sub-contractot work to b pe •rm d u this permit, as are
licensed by Miami Shores Village. c/ s
'111.1.-- If C_. - aster Plumber.
Before me, the undersigned authority, a notary public, duly authorized to admini er 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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
OATH
TUBS
SHOWERS
LAVA-
TORiaS
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
Comm
LIST
CHECK
` -_
Permit No T
Amount of Permit
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION 1FOR PLUMBING PERMIT
Employing Plumber's Name fq 1 fk we 1 � °vi e elL e P7i c
Location and Legal Description Block_
_61! -- No._ __________.L. '
( Signed
Date
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 w;th 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 Address . ------------- ____ - _-
Registered Architect and /or Engineer _
No. ___ -_-_ Street G
Street___
Subdivision
( Signed)
My Commission Expires Notary Public, State of Florida
cr. 3i. 6---)
/.
Street and Number where work is to be performed- No._______ _ _ Str eet �� ~
State work to be performed and purpose of building (By Floors)__
t � JGt/ K� e )
New Building__________ Remodeling_____ ________ Addition________._ Repairs 2/ No. of Stories.
Size Septic Tank _- _---- ____ -- Type of Tank_ Capacity Gals
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 employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em Toyed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the to of the work rc public notice or notices as are
required by tlie Act. The undersigned agrees to employ only such sub-contractot work to b pe •rm d u this permit, as are
licensed by Miami Shores Village. c/ s
'111.1.-- If C_. - aster Plumber.
Before me, the undersigned authority, a notary public, duly authorized to admini er 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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
MIAMI SHORES VILLAGE, FLORID;
PERMIT N9 1628
Work to be performed under this Permit
Architect____
Contractor
or Builder
Legal Lot Bl.
Description
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor 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 assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed: By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work 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 assumelresponsibility for all work done by either myself, my agent, servant or employee.
Subdi-
vision
Value of
Project
DATE
Contractor
License No._
Amt. of
Permit
CONTRACTOR OR BUILDER BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
MIAMI SHORES VILLAGE, FLORIDA
DATE 194
PERMIT N? 3453
Work to be performed under this Permit_
BI.
/
Subdi-
vision
Contractor's
License No.
may , ro;d
,0 Ro fIr=lpr ;
1c co.P.::;:it
• fc b A.; 1 0—
tffis peumt
Address of Value of Amt. of
Building Project Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor 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 pro-per 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 assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed: By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions pertain2g 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,bry either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot Bt.
Description
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor 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 assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed- By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and rre
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper a ities of Miamj.S r
Village. Iv :accepting this permit I assume. responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 19
Contractor's
License No.
PERMIT N9 3453
Work to be performed under this Permit
4
11
7�1
3�1 di-
iion
Value of
Project
BY AUTHORITY
Amt. of
Permit
Permit No..
Application is hereby made for the approval of the detailed statement of the plans and specifications herewyth subrtritted 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 must be kept at
building during progress of work.
Owner's Name and Address‘,/ �:_'_ f ___ � "� '` `^ No . !_t 1_ 2
-- -- ____ -. Serest_ r
Registered Architect a /or, Ln Weer -___ �___- __�___ No � � _- -_��-- _.= 1 �
Employing Plumber's Name Street
._L x _:____ _____
Location and Legal Description Lot--_ ______ _ ________________Block_
Street and Number where work is to be performed—No ______ __ ______________ ___________ _______ Street____
State work to be performed and purpose of building (By Floors)
New Building Remodeling __ Addition Repairs No. of Stories___
Size Septic Tank_
Feet of Drain Tile_____ _ _ _ — — Dist. Feet of Tank or Drain Field from Well__________
Nature of Water Supply: City—Well. of Soakage Pit
Amount of Permit $_
APPLICATION FOR PLUMBING PERMIT
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 5966, Compiled General Laws of Florida Pernianent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, du'y 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 he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Type of Tank . Capacity Gals._______________ — _____
_(Signed)
(Signed
Date - - - -- —
Subeivision__—
Notary Public, State of Florida
Master Plumber.
NOTE: A re inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
Permit No..
Application is hereby made for the approval of the detailed statement of the plans and specifications herewyth subrtritted 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 must be kept at
building during progress of work.
Owner's Name and Address‘,/ �:_'_ f ___ � "� '` `^ No . !_t 1_ 2
-- -- ____ -. Serest_ r
Registered Architect a /or, Ln Weer -___ �___- __�___ No � � _- -_��-- _.= 1 �
Employing Plumber's Name Street
._L x _:____ _____
Location and Legal Description Lot--_ ______ _ ________________Block_
Street and Number where work is to be performed—No ______ __ ______________ ___________ _______ Street____
State work to be performed and purpose of building (By Floors)
New Building Remodeling __ Addition Repairs No. of Stories___
Size Septic Tank_
Feet of Drain Tile_____ _ _ _ — — Dist. Feet of Tank or Drain Field from Well__________
Nature of Water Supply: City—Well. of Soakage Pit
Amount of Permit $_
APPLICATION FOR PLUMBING PERMIT
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 5966, Compiled General Laws of Florida Pernianent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, du'y 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 he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Type of Tank . Capacity Gals._______________ — _____
_(Signed)
(Signed
Date - - - -- —
Subeivision__—
Notary Public, State of Florida
Master Plumber.
NOTE: A re inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Dad'
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 must be kept at
building during progress of work.
Owner's Name and Address No. v ' Street
Registered Architect and /or Engineer
Employing Plumber's Name No Street
Location and Legal Description Lot } Block Subdivision __ /
/ \ `
Street and Number where work is to be performed —No ; ., Street
State work to be performed and purpose of building (By Floors)
/
New Building Remodeling Addition Repairs No. of Stories
Capacity Gals
Size Septic Tank Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit.
Amount of Permit $_ (Signed)
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 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 he c:id sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Notary Public, State of Florida
Master Plumber.
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
F IELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Dad'
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 must be kept at
building during progress of work.
Owner's Name and Address No. v ' Street
Registered Architect and /or Engineer
Employing Plumber's Name No Street
Location and Legal Description Lot } Block Subdivision __ /
/ \ `
Street and Number where work is to be performed —No ; ., Street
State work to be performed and purpose of building (By Floors)
/
New Building Remodeling Addition Repairs No. of Stories
Capacity Gals
Size Septic Tank Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit.
Amount of Permit $_ (Signed)
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 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 he c:id sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Notary Public, State of Florida
Master Plumber.
Permit No..
My Commission Expires
MIAMI SHORES VI LLAG E
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING 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 Stare 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 plants and specifications must be kept at
building during progress of work.
Owner's Name and Address __ _ No.______ __ - Street
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lbt._ -_ Block
Street and Number where work is to be performed —No. _
State work to be performed and purpose of building (By Floors)
New Building X, Remodeling
No'
Addition Repairs
Size Septic Tank__. __ /_ __ Type of ank
Feet of Drain Tile ( ,rt __ _ ______ __ Dist. Feet of Tan's or Drain Field from Well
Nature of Water Supply: City - -- Well.____ Size of Soakage Pit.
Amount of Permit $ (Signed) __
The undersigned applicant for this building permit does hereby certify that he understands and accepts hi .s obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida Pzrmanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public duly authorized to administer oaths anc!. 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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Date
Street
Subdivision
Street
No. of Stories
Capacity Gals.
Notary Public, State of Florida
P umbing Inspector.
Master Plumber.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
Permit No..
My Commission Expires
MIAMI SHORES VI LLAG E
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING 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 Stare 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 plants and specifications must be kept at
building during progress of work.
Owner's Name and Address __ _ No.______ __ - Street
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lbt._ -_ Block
Street and Number where work is to be performed —No. _
State work to be performed and purpose of building (By Floors)
New Building X, Remodeling
No'
Addition Repairs
Size Septic Tank__. __ /_ __ Type of ank
Feet of Drain Tile ( ,rt __ _ ______ __ Dist. Feet of Tan's or Drain Field from Well
Nature of Water Supply: City - -- Well.____ Size of Soakage Pit.
Amount of Permit $ (Signed) __
The undersigned applicant for this building permit does hereby certify that he understands and accepts hi .s obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida Pzrmanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public duly authorized to administer oaths anc!. 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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Date
Street
Subdivision
Street
No. of Stories
Capacity Gals.
Notary Public, State of Florida
P umbing Inspector.
Master Plumber.
JOB: AD:
BUILDING
ELECTRICAL
PLUMBING
•
•
•
•
The following is ready for Inspection: ,.
Inspector's Report: -
WORK
DONE BY
REUESTED WILL BE READY
Permit No
building during progress of work. l
Owner's Name and Address
Registered Architect and /or Engineer
/
Employing Plumber's Name
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.
N
Date
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 must be kept at
' Street-- z/
/'1,
Location and Legal Description Lot_ Block Subdivision
Street and Number where work is to be performed —No / _Z _ Stre i / -:
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories _ __
Capacity Gals
Size Septic Tank Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
STATE OF FLORIDA,
COUNTY OF DADE.
Amount of Permit $— (Signed)
Before me,
SS.
(Signed)
My Commission Expires Notary Public, State of Florida
Master Plumber.
Id
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 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No
building during progress of work. l
Owner's Name and Address
Registered Architect and /or Engineer
/
Employing Plumber's Name
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.
N
Date
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 must be kept at
' Street-- z/
/'1,
Location and Legal Description Lot_ Block Subdivision
Street and Number where work is to be performed —No / _Z _ Stre i / -:
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories _ __
Capacity Gals
Size Septic Tank Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
STATE OF FLORIDA,
COUNTY OF DADE.
Amount of Permit $— (Signed)
Before me,
SS.
(Signed)
My Commission Expires Notary Public, State of Florida
Master Plumber.
Id
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 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
• MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. Date
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 must be kept at
building during progress of work.
No. -X Street
Owner's Name and Address
Registered Architect and/or Engineer
Employing Plumber's Name
Location and Legal Description Lot Block
fif
Street and Number where work is to be performed—No. / - ' Str
State work to be performed and purpose of building (By Floors)
New Building Remodeling
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City Well
Amount of Permit $ —
/ ,)
( No.—
Subdivision
Addition
Type of Tank
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)
(Signed)
Repairs
My Commission Expires Notary Public. State of Florida
No. of Stories
Capacity Gals,
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob[igations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
4
Master Plumber.
STATE OF FLORIDA,
SS.
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 read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and/or workmanship.
CLOSETS
BATH
Tues
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
, -
joe
CHECK
• MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. Date
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 must be kept at
building during progress of work.
No. -X Street
Owner's Name and Address
Registered Architect and/or Engineer
Employing Plumber's Name
Location and Legal Description Lot Block
fif
Street and Number where work is to be performed—No. / - ' Str
State work to be performed and purpose of building (By Floors)
New Building Remodeling
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City Well
Amount of Permit $ —
/ ,)
( No.—
Subdivision
Addition
Type of Tank
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)
(Signed)
Repairs
My Commission Expires Notary Public. State of Florida
No. of Stories
Capacity Gals,
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob[igations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be
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 are
required by the Act. The under signed agrees to employ only such sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
4
Master Plumber.
STATE OF FLORIDA,
SS.
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 read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and/or workmanship.
Permit No '
Amount of Permit $ (/
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
• APPLICATION FOR PLUMBING 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 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
building during progress of work.
Owner's Name and Address ;', No.
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot ' L __L_L r Block
State work to be performed and purpose of building (By Floors)
-7—
The undersigned applicant for this building permit does hereby ce
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.
STATE OF FLORIDA, k
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
SS.
My Commission Expires
No.
(Signed)
\•
'
(Signed)
Street and Number where work is to be performed —No Street__
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
therein by him stated are true.
Date
'
o .. Street
Subdivision
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank. Capacity Gals
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.
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
authorized to administer oaths and take acknowledgments, personally
Notary Public. State of Florida
Master Plumber.
the same, and that all facts
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
-.—
CONTR.
LIST
/
..,
..:--
n
n
' ./
a- - _
CHECK
s
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
v
CHECK
Permit No '
Amount of Permit $ (/
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
• APPLICATION FOR PLUMBING 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 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
building during progress of work.
Owner's Name and Address ;', No.
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot ' L __L_L r Block
State work to be performed and purpose of building (By Floors)
-7—
The undersigned applicant for this building permit does hereby ce
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.
STATE OF FLORIDA, k
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
SS.
My Commission Expires
No.
(Signed)
\•
'
(Signed)
Street and Number where work is to be performed —No Street__
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
therein by him stated are true.
Date
'
o .. Street
Subdivision
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank. Capacity Gals
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.
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
authorized to administer oaths and take acknowledgments, personally
Notary Public. State of Florida
Master Plumber.
the same, and that all facts
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.