Loading...
801 NE 97 St (4)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date a" /r 9 ,s Job Address gO N , , 5 2 _ Tax Folio Legal Description Historically Designated: Yes No / Tenant 19 /2- e 2A e r /2) s Master Permit # Owner's Address 80/ A), /', 9 7 V, Phone 30S- 75 - 9ooy, Contracting Co. j5 .1/9 S n . ,ie �o 0 er „„e-" -, Address 7 ? b 9 N, "- 7¢ " Qualifier PL/',r A Jer; . SS# Phone 3 o 5 - 'n — b d Yo / State # D psis-4' Municipal # O o SscF Competency # p D ,./is Ins. Co. G 4 c> Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL LUMB MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cost (value) 9,,/ Le, o ram 0 v. WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner an r Con President Date Notary as to Owner and/or Condo President My Commission E FEES: PERMIT 5 S RADON Date : i ANNA QUINONES MY COMMISSION 0 CC 602181 = EXPIRES: October 18,1899 Banded Thou Notary Public Under writers Signature of Contractor or Owner- Builder Notary as to Contractor • er- Builder My Commission Expires: ANNA QUINONES MY COMMISSION 0 CC 6031x' hut 41 WIRES: October 18,1 Bonded T.'atr !rotary Public Under. C.C.F. I - 2- o NOTARY ' BOND 3® Date TOTAL DUE _3-4 APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering Scale: Each block represents 5 feet and 1 inch = 50 feet. Notes: Plan Approved STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number DH 4015, 10/96 (Replaces HRS-H Form 4015 which may be used) (Stock Number: 5744-002-4015-6) , :', _ /2 PART II - SITE PLAN SC r = ) �.c /i i� _. < j l\� i �i r / // gnature V J , > , �< 3�. ,// 1 %: Title Not Approved Date , ( - Site Plan submitted by:- ) 7 7/ By ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT County Health Department Page 2 of 3 M APPLICATION FOR PLUMBING PERMIT c9 Permit No f) �- l Date... 7 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. Registered Architect and /or En Employing Plumber's Name Owner's Name and Address _ dock Street and Number where work is to be performed —No it, ' State work to be performed and purpose of building (By Floors) _._.____.___ New Building _ Remodeling —._- _ _.. -_ Addition Location and Legal Description Lot. Size Septic Tank- -. —_ -- of Tank — Feet of Drain Tile. -J ' ' i ^� Nature of Water Supply: City —W Amount of Permit $ STATE OF FLORIDA, j as. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Capacity Gals _Dist. Feet of Tank or Drain Field from Well. of Soakage Pit (Signed) _ ce/ street Q757— ... Street_el 5/ Repairs No. of Stories Plumbing Inspe'rtor. 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 Sdpplement, and lass 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 undersigned agrees to employ only such sub - contractors, work to be performed under ,s permit, as are licensed by Miami Shores Village. c. / J////rj/ (Signed) Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgmenta, personally appeared to me well known, and who, being by me first duly sworn, upon oath dep oses 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 saim , and that all facts therein by him stated are true. My Conuniasion Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when tral re-Inspection is mede•neoessary by Improper notice for inspection, or faulty materials and /ar worlmoanship. CLOSETS BATH TUGS SHOWERS LAVA- TORIES 6111" SLOP SINKS LAUNDRY TUSS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN SOAKAGE FIELD PIT GREASE TRAP SOLAR NEATER DEEP WELL SPRKLR. SYSTEM a WIM'O POOL cows,. ' Q /:3 r ", .-- LIST CHECK ■ M APPLICATION FOR PLUMBING PERMIT c9 Permit No f) �- l Date... 7 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. Registered Architect and /or En Employing Plumber's Name Owner's Name and Address _ dock Street and Number where work is to be performed —No it, ' State work to be performed and purpose of building (By Floors) _._.____.___ New Building _ Remodeling —._- _ _.. -_ Addition Location and Legal Description Lot. Size Septic Tank- -. —_ -- of Tank — Feet of Drain Tile. -J ' ' i ^� Nature of Water Supply: City —W Amount of Permit $ STATE OF FLORIDA, j as. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Capacity Gals _Dist. Feet of Tank or Drain Field from Well. of Soakage Pit (Signed) _ ce/ street Q757— ... Street_el 5/ Repairs No. of Stories Plumbing Inspe'rtor. 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 Sdpplement, and lass 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 undersigned agrees to employ only such sub - contractors, work to be performed under ,s permit, as are licensed by Miami Shores Village. c. / J////rj/ (Signed) Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgmenta, personally appeared to me well known, and who, being by me first duly sworn, upon oath dep oses 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 saim , and that all facts therein by him stated are true. My Conuniasion Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when tral re-Inspection is mede•neoessary by Improper notice for inspection, or faulty materials and /ar worlmoanship. __ .. .__ —.. - - -- - -- CLO6QT0 BATH Tuota CHOW LAVA- YORIHo GINKO GLOP OIR:K0 LAUNDRY T URIgALO CATCH 15AOI FLOOR DRAIN DRI PoKI wA FOUNT w6 L ys - TOTAL FIXTURQ6 IL OT r1 Cwaca - - -�- STPTIC TANK -- - SHWQR CONN. DRAIN FIELD COAKAGS PIT CRGAOQ TRAP C3OLAR ad aAT1IR DINIP w6LL ORR KLR. SYBTRM OW IM•0 POOL Cow - LIST CMaCK APPLICATO R PLUMBING PERMIT h'ermie No.. S / Dote. /0 P — 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 Shares Village and all rules and regulations of the Building Division of Aiiami Shores Village shall be complied with, whether hwein specified or nut. A copy of approv.. • plans and specifications must be kept at building during progress of work. Owner's Name and Address 1/C� Registered Architect and /or Engineer Employing Plumber's Name Location ation and Legal Description Lot_ Street and Number where work ie to ';• performed—No 5 - `S State work to be performed and purpose of building (By I Ictiao)_Z-' _ - .. ktd4/ge:tt2 .. New Building _ _ .- . ... .......... -._ Remodeling___. ._.- Addition Size Septic Tank__ V-LQ -G 1C e t of Drain Til ®__ L? . = _fiat. Feet of Toni or Brim Mold from Well Nature of Water Supply: City — Well.! Amount of Permit (2_____—__Typo of Tai& M H M1 SNORES VILLAGE PLUMBING INSPECTION DEPARTMENT The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati ie as an employer of labor under the Florida Workmen's Compensation Act, being Section 5 , Cumpil -': General Laws of Florida Permanent Supp °,ement, and hav com- plied with the provisions thereof, and will require einbilar 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 posts far inspection on the site cf the work such public no2`.ce or notices as are required by the Act. The undersigned agrees to employ only cue2a sob-contractors, on work to be performed rends' this permit, as are b:• ?Lanni Shares Village. No.75 i - G9 21.E _ stettJ - �' /' 7 Block Siam of Soakage Pit Repairs No. of Storie0 papa t Goa. umbin`g Inspector. Mester Plum STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly atr¢ka lzot to administer oaths and take acs,.otowledguaent0, personally appeared to me well known, and who, being by me fiat duly 0eIuM, n col& o -, ewer and days that he is the.---- _.......- -- .----- • .. ...... .. ..._ _.. of the above described construction, that he has caeef � y 2z2,0.2 t f • weaving applicat o n, and that P . +d 03 r,,.: Ilea a, and that all facts therein by him stat •. are true. My Commission Ezzo2c0 matzeg l nblio, s¢cte Thatem NOTE: A re-inspection fco of O1.03 kto tom: , bi bnp r etfeo fr tiocertion, or halt/ materials nollice vur" p. D J t Ii° • Rio i O c1 Date 3- i Application is he e y 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 'a Name and Address Amount of Permit $ STATE OF FLORIDA, I COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMO1 Registered Architect and /or Engineer___— Employing Plumber's Name Location and Legal Description Lot Street and Number where work is to be performed —No ' _- 9 Street_ State work to be performed and purpose of building (By Floors) ___ New Building_ _ -- Remodeling Addition. (Signed)_ (Signed)— No. Street No._ Block Subdivision. Repairs No. of Stories . . .............. . .. Sim 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 Capacity Gals 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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are 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 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 FOU NT' NS TOTAL FI:iTURL}G CO'3TR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN PIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'6 POOL CGMTR. LuoT CHECK -- Ii° • Rio i O c1 Date 3- i Application is he e y 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 'a Name and Address Amount of Permit $ STATE OF FLORIDA, I COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMO1 Registered Architect and /or Engineer___— Employing Plumber's Name Location and Legal Description Lot Street and Number where work is to be performed —No ' _- 9 Street_ State work to be performed and purpose of building (By Floors) ___ New Building_ _ -- Remodeling Addition. (Signed)_ (Signed)— No. Street No._ Block Subdivision. Repairs No. of Stories . . .............. . .. Sim 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 Capacity Gals 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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are 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 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 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. r Owner's Name and Address__._, ; 1` Y `L' 1 ' 1 _ -- — No. _._.__.- •----- - -_._. — Street. Registered Architect and /or Engineer— _—_— _.___—__- mo t �= Employing Plumber's Name ' y " ' P @ _- — P� No..__. —. __ Street_ _ ......... Location and Legal Description Lot Block Subdivision.-.___________ __ —_ - - -- .n Street and Number where work is to be performed —No -r 0 /1/-. 9 Street State work to be performe8 and purpose of building (By Floors)__ ew Building__° _.. Remodeling — __ _ _ __ Addition. Amount of Permit 14 (Signed) _ NOTE: A re- materials and /or M MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Repairs Date 1 1.. _. Size Sepiie Tank__._ —..L :__.__._...____ _____--Type of Tank_ Feet of Drain Tile._.._/ 4) _____ . —Dist. Feet of Tank or Drain Field from Well Nature of Water Supply City Well.___ . Size of Soakage Pit Capacity Gals. 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 8988, Compiled General Laws of Florida Permanent Supplement, and bus 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. �l l Master Plumber. STATE OF FLORIDA, I se. COUNTY OF DADE. No. of Stories. Expires Notary Public, State of Fkrida 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 sarse, and that all facts therein by him stated are true. fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty p• CLOUT* TueB rues S HOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY rues U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS ]5/ ' a ,s, .r,, TOTAL FIXTURES COs. LIST o �/ / .. ,e' y SEPTIC TAM SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP `S'OCAIr HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL 1,4/4„V, . CONTR. LIST // / ,'/ murex / \ / //, ' , ll; Ai- - _ 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. r Owner's Name and Address__._, ; 1` Y `L' 1 ' 1 _ -- — No. _._.__.- •----- - -_._. — Street. Registered Architect and /or Engineer— _—_— _.___—__- mo t �= Employing Plumber's Name ' y " ' P @ _- — P� No..__. —. __ Street_ _ ......... Location and Legal Description Lot Block Subdivision.-.___________ __ —_ - - -- .n Street and Number where work is to be performed —No -r 0 /1/-. 9 Street State work to be performe8 and purpose of building (By Floors)__ ew Building__° _.. Remodeling — __ _ _ __ Addition. Amount of Permit 14 (Signed) _ NOTE: A re- materials and /or M MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Repairs Date 1 1.. _. Size Sepiie Tank__._ —..L :__.__._...____ _____--Type of Tank_ Feet of Drain Tile._.._/ 4) _____ . —Dist. Feet of Tank or Drain Field from Well Nature of Water Supply City Well.___ . Size of Soakage Pit Capacity Gals. 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 8988, Compiled General Laws of Florida Permanent Supplement, and bus 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. �l l Master Plumber. STATE OF FLORIDA, I se. COUNTY OF DADE. No. of Stories. Expires Notary Public, State of Fkrida 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 sarse, and that all facts therein by him stated are true. fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty p• eki� ca . r9 Permit No.___; New Building Amount of Permit $ Application is hereby mdde for the approval of the detailed statement of the plans and specifications her yh sub ed for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of iami 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. Owners Name end Address Registered Architect and /or Enginee Employing Plumber's Name �f - Size Septic Tank_ -- --- Feet of Drain Tile)./_ Nature of Water Supp : City— Well.___ STATE OF FLORIDA, I COUNTY IF • DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _ (Signed)_ (Signed) No. _3/23 Street - ._ l Location and Legal Description Lot__ ___ . Block__._.__ Street and Number where work is to be performed —No _d 6 / State work to be performed and purpose of building (By Floors)_____ ___ _____________ Street Date. Remodeling— _- ----------- _-__ -___ Addition-- •-- _-- •--- •----- --. --- Repairs No. of Stories - - .---- _ - •-------- ------ Type of Tank Capacity Gals _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit 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 Pennanent 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 undersigned agrees to employ only such sub - contractors, on work to be 2erformed under this permit, as are licensed by Miami Shores Village. Subdivision 72 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 Yix 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. CLOSET° BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE INALS 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.___; New Building Amount of Permit $ Application is hereby mdde for the approval of the detailed statement of the plans and specifications her yh sub ed for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of iami 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. Owners Name end Address Registered Architect and /or Enginee Employing Plumber's Name �f - Size Septic Tank_ -- --- Feet of Drain Tile)./_ Nature of Water Supp : City— Well.___ STATE OF FLORIDA, I COUNTY IF • DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _ (Signed)_ (Signed) No. _3/23 Street - ._ l Location and Legal Description Lot__ ___ . Block__._.__ Street and Number where work is to be performed —No _d 6 / State work to be performed and purpose of building (By Floors)_____ ___ _____________ Street Date. Remodeling— _- ----------- _-__ -___ Addition-- •-- _-- •--- •----- --. --- Repairs No. of Stories - - .---- _ - •-------- ------ Type of Tank Capacity Gals _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit 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 Pennanent 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 undersigned agrees to employ only such sub - contractors, on work to be 2erformed under this permit, as are licensed by Miami Shores Village. Subdivision 72 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 Yix 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.