Loading...
915 NE 96 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date l Z/41 Job Address - L / $ /1/6 • 9 4.1. Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant L'/Yi1//5 > P76-4 OD L L / D T 7 - Master Permit # Owner's Address q15 /l/G . 6. Phone �(of 6 D©© Contracting Co. Eow//) (i/ U OM 1 /.t Aticidress 76/ «0 P & Ali/67 Qualifier 6,86.,e-7 5 • J/. Af 5 SS# Phone 591. .3_5(0- state# C Pc 05 3* / Municipal # Competency # Ins. Co. e,"/Ale /� = Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING G%Z ELLE A CTRICA � LUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION �2 -' Gief z -&44- 3vie l ' Lc!•P -! l.J�� 1� 3 lova J 3 , J,/ • l - 167:d „ Square Ft. Estimated Cost (value) .e's 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 tractor to do the work stated. Signature of owner and/or Condo President Date ignature of Contractor or Owner - Builder Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT 7437. RADON C.C.F. APPROVED: Zoning Building Electrical I n Mechanical Plumbing ► ► Engineering Notary as to Contractor or Owner - Builder My Commission Expires: VDf 32 ) / -2 e Date Date NOTARY; BOND TOTAL DUE. (AN APPLICATTION FOR BUILDING PERMIT ;BUST ACCOMPANY THIS ADDENDUM. I: A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATTJRE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ITEM BATH TUB BIDET 0I S171YASHER 01 DRINKING FOUNTAIN FLOOR DRAIN GREASE TRAP INTERCEPTOR LAVATORY LAUNDRY TRAY CLOTHES WASHER SHOWER SINK. POT /3 COMP. SINK. RESIDENCE SINK. SLOP TENFOORARY WATER CLOSET URINAL WATER CLOSET A/C UNIT FIRE SPRINKLER AWN SPRINKLER -WELL SW IWA ING POOL WATER SERVICE SEWER CONNECT IONS UTILITY -SEWER UTILITY-WATER SEPTIC TAN( RELAY GRAINFIELD, 4' TILE/RES. PUP 3 ABANDON SEPTIC TANK SOAKAGE PIT CU. FT. CATCH 3ASIN 0ISCIARGE WELL OCK€ST ;C AREA GAIN ROOF INLET WELL SOLAR +LATER HEATER FIRE STANDPIPE PCCL PIPING LAWN SPRINKLER SYSTEM GAS ; ' �: N METER SE C1AS GAS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION UNIT FEE ITEM SWITCH OUTLETS LIGHT OUTLETS RECEPTACLES SE.RV SERVICE SIZE IN ,WS SERVICE REPAIR/1ETER CHANGE APPLIANCE CUTLETS RANGE TCP OVEN ICE TBPORARY HATER HEATER MOTORS 0- 1 HP 1- MOTORS OVER 1- 31f 1 ELECTRICAL MECHANICAL IrOTCRS OVER 3- 5 HP MOTORS OVER 5- 8 FP MOTORS OVER 8- 10 HP 40TCRS OVER 10- 25 If Kg= OVER 25-100 if MOTORS OVER 100 HP INDIRECT WASTES A/C WINDOW WATER SUPPLY TO: [ AIR =LIMNERS STRIP NEATER GENERATORS TRANSFORMERS HEATER -NEW INST GENERATORS TRANSFORNSIS HEATER - REPLACE GENERATORS TRANSFORMERS UNIT FEE ITEM SPACE HEATERS CENTRAL HEATING A/C (WINO) A/C (CENTRAL) OLCT W2AK REFRIGERATION PROCESS AND PRESS PIPING UNDERGRCJND TANKS ABOVE (MIND TANKS U.F. PRESSURE VESSELS STEAM BOILERS HOT WATER BOILERS MECHANICAL VENTILATION TRANSPORTING ASSEJeLIES ELEVATORS/ESCALATORS FIRE SPRINKLER SYSTEIS UNIT FEE SPECIAL PURPOSE CUTLETS COMERCIAL SIGN TUBES SIGN TRANSFORMERS SIGN TIME CLOCX FIXTURES 1 TELEVISION OUTLETS VIOLATION RE INSPECTION COOLING TOWERS VIOLATION RE INSPECTION 1 Permit No Amount of 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 Street._ � - - ` ` o,- =. t' Owne t_.__ / ? °ms � — e .r. ! Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot 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 STATE OF FLORIDA, I COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date..._ ._..--- -••_ - Block 1 (Signed) - -- -' --� y Capacity Gals. Size Septic Tarilsr- _--- ..- . —. - -- - -_--- - _ype 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 • The undersigned applicant for this building permit does hereby certify that he understands and accepts hii ojgations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and Ilar 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 - contractor work to be perfo and this lierinit, as are licensed by Miami Shores Village. (Sigma) 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. M Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made whin such r.- inspection fa made necessary by improper notice for inspection, er faulty materials and /or workmanship. - - -` CLOSETS BATH TUBS SHOWER{ LAVA- TORIES SIN" SINKS LAUNDRY TUGS URINAL{ CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N[ TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR H DEEP WELL SPRKLR. SYSTEM SWIM'O POOL CONTR. �- LIST CHECK Permit No Amount of 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 Street._ � - - ` ` o,- =. t' Owne t_.__ / ? °ms � — e .r. ! Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot 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 STATE OF FLORIDA, I COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date..._ ._..--- -••_ - Block 1 (Signed) - -- -' --� y Capacity Gals. Size Septic Tarilsr- _--- ..- . —. - -- - -_--- - _ype 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 • The undersigned applicant for this building permit does hereby certify that he understands and accepts hii ojgations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and Ilar 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 - contractor work to be perfo and this lierinit, as are licensed by Miami Shores Village. (Sigma) 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. M Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made whin such r.- inspection fa made necessary by improper notice for inspection, er faulty materials and /or workmanship. Permit No.. ..'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 whether herein specified or not. A copy of approved plans and specifications must be kept et building during progress of work. � r � C 2 6 7. / Street. — It MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT LP No Owners Name and Address Registered Architect and /orcngineer /�, 1P, AI tgel Employing Flumber s Name Location and Legal Description Lot Street and Number where work is to be performed-No i -- S ..,. .lb. State work to be performed and purpose of building (By Floors)-_._.-. 1.1.x. 4-420Q New Building..__.._ .. Remodeling .- —__ Addition...---_ —..__ Repair Size Septic Tank__ _Type of Tanit --- -- --- • - _ - - - -. Feet of Drain Tile __Dist Feet of Tank or Drain Field from Well. Nature of Water Supply: City-Well. Size of Soakage Pit. /.ta Dee ... 2_4 �!= ` 1 Subdivldon No. of Stories Capacity Cals._._..._... -- _ - -.._ ..__.._ (Signed)_T� Plumbing Inspector. The undersigned applicant for this building perinit 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 has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work t 1pP performed under this permit; and will post or cause to be posted' for inspection on the site of the work • h public notice or notices as err required by the Act. The undersigned agrees to employ only such orb -contr .. work to this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, } as. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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 be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when mob rwlarpmtb it made by improper nodes for impaction, or faulty materials and /or workmanship. CLosr y. BATH Tugs SHOW[RI LAVA• TORI[s SINK[ SLOP SINKS LAUNDRY rues URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N11 TOTAL FIXTURES Corms. LIST CHECK + SEPTIC TANK S[W[R CONN. DRAIN FIELD SeAKAGI PIT G TRAP SOLAR HATER D[IIIP WILL SPRKLR. SYSTEM SW IM•0 POOL CONTR. LIST r- CHICK Permit No.. ..'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 whether herein specified or not. A copy of approved plans and specifications must be kept et building during progress of work. � r � C 2 6 7. / Street. — It MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT LP No Owners Name and Address Registered Architect and /orcngineer /�, 1P, AI tgel Employing Flumber s Name Location and Legal Description Lot Street and Number where work is to be performed-No i -- S ..,. .lb. State work to be performed and purpose of building (By Floors)-_._.-. 1.1.x. 4-420Q New Building..__.._ .. Remodeling .- —__ Addition...---_ —..__ Repair Size Septic Tank__ _Type of Tanit --- -- --- • - _ - - - -. Feet of Drain Tile __Dist Feet of Tank or Drain Field from Well. Nature of Water Supply: City-Well. Size of Soakage Pit. /.ta Dee ... 2_4 �!= ` 1 Subdivldon No. of Stories Capacity Cals._._..._... -- _ - -.._ ..__.._ (Signed)_T� Plumbing Inspector. The undersigned applicant for this building perinit 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 has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work t 1pP performed under this permit; and will post or cause to be posted' for inspection on the site of the work • h public notice or notices as err required by the Act. The undersigned agrees to employ only such orb -contr .. work to this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, } as. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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 be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when mob rwlarpmtb it made by improper nodes for impaction, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT e Permit No Date......._2z.t 1 2—:Z_3_ 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 confomilty 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. Os•ner• s Name and Address Miami. and12 r ia 1 P1 b q ...Kwark e S id e 11C e 9 l& E . 96th street Registered Architect and/or Engineer Employing ritiLmbee N ame 13„.c2se Sptic Tap lc, Co, P • ° P__°140..344 1 s Location and Legal Description Lot_ Block Street and Number where work is to be performed—No 915 N. E.. 96th street State work to be performe8 and purpose of building (By Floon)___ New Building Remodeling — Addition. Repairs Size Septic Tank_ _Type of Tank__ Feet of Drain Tile. Feet of Tank or Drain Field from Well.____ .... ..... Nature of Water Supply: City—Well. Size of Soakage Pit_ Amount of Permit $ STATE OF FLORIDA, } . ss COUNTY OF DADE. ( .----,--- F-- / . (Signed)._ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Peri ent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors el Capacity No. of Stories . loyed by him in the work to be performed under this perma; 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. 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. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of *1.00 will be made when such re-inspection is made by improper notice for inspection, or faulty materials and/or workmnship. CLOSETS BATH Tues SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUGS URINALS CATCH BASIN ASIN FLOOR DRAIN DRINK I NO FOUNT' NS FIXTURES CONTR. LIST _ CHECK --- SEPTIC SEWER TANK CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW I M •0 POOL C EIST • 1050U/113 CHECK 1 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT e Permit No Date......._2z.t 1 2—:Z_3_ 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 confomilty 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. Os•ner• s Name and Address Miami. and12 r ia 1 P1 b q ...Kwark e S id e 11C e 9 l& E . 96th street Registered Architect and/or Engineer Employing ritiLmbee N ame 13„.c2se Sptic Tap lc, Co, P • ° P__°140..344 1 s Location and Legal Description Lot_ Block Street and Number where work is to be performed—No 915 N. E.. 96th street State work to be performe8 and purpose of building (By Floon)___ New Building Remodeling — Addition. Repairs Size Septic Tank_ _Type of Tank__ Feet of Drain Tile. Feet of Tank or Drain Field from Well.____ .... ..... Nature of Water Supply: City—Well. Size of Soakage Pit_ Amount of Permit $ STATE OF FLORIDA, } . ss COUNTY OF DADE. ( .----,--- F-- / . (Signed)._ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Peri ent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors el Capacity No. of Stories . loyed by him in the work to be performed under this perma; 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. 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. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of *1.00 will be made when such re-inspection is made by improper notice for inspection, or faulty materials and/or workmnship. APPLICATION FOR PLUMBING PERMIT 4 7 / Date..._ ' z 3 Permit No - — - .... - - - r` -- — — Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building OT 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. g j � 1 a 1t ' No. Street- (` Owner's /�'r1 s Name and Address �/ / �� /L � '� t. Registered Architect and /or Engineer /'v°91 CA; Gr R �exit -- .-- -. .... p sr � ! 1 a Cif+/. �r � -f , �'' /t .......w -• -- - Employing Plumber's Name A /A/Ii.. r,/ -l� �A- -./ti R �i J P P- No ,.m..,....s.,,....� Eltreet...� .� - .<.....,.........._ ,..,.. G 6T Location and Legal Description Lot 0--�. Blo 4 r7 `7 Su'bdivWon. _ C._L — Street and Number where work is to be performed —No 91 ` State work to be performed and purpose of building (By Floors) _— .___..._.. N Building t Remodeling___ Addition.- .______ Repairs No. of Stories / Size Septic Tank_ ___L € f1-= _.-Type of Tank-__ Feet of Drain _.- - , _Dist. Feet of Tank or Drain Field from Well Tile. � ____...r Nature of Water Supply: •Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, D is. COUNTY OF DADE. `/- The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig .t'ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5088, 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 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT (signed_ - —_ - (Sigma Street 9 Capacity Gals._- _..._.Y. . Notary Public, State of Florida Plumbing Inspector. Muter 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 be 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'neoessary by improper notice for inspection, or faulty materials and /or workmanship. CLOUTS BATH Tuns SHOWER• LAVA- TORIES 61NK• SLOP SINKS LAUNDRY Tints URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N• Di, "� i. TOTAL FIxTUR[• CONTR. LI•T 3' L it CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGI PIT G TRAP SOLAR H DEEP WELL BPRKLR. SYSTEM SWIM'O POOL. CONTR. 1 _ LIST CHECK APPLICATION FOR PLUMBING PERMIT 4 7 / Date..._ ' z 3 Permit No - — - .... - - - r` -- — — Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building OT 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. g j � 1 a 1t ' No. Street- (` Owner's /�'r1 s Name and Address �/ / �� /L � '� t. Registered Architect and /or Engineer /'v°91 CA; Gr R �exit -- .-- -. .... p sr � ! 1 a Cif+/. �r � -f , �'' /t .......w -• -- - Employing Plumber's Name A /A/Ii.. r,/ -l� �A- -./ti R �i J P P- No ,.m..,....s.,,....� Eltreet...� .� - .<.....,.........._ ,..,.. G 6T Location and Legal Description Lot 0--�. Blo 4 r7 `7 Su'bdivWon. _ C._L — Street and Number where work is to be performed —No 91 ` State work to be performed and purpose of building (By Floors) _— .___..._.. N Building t Remodeling___ Addition.- .______ Repairs No. of Stories / Size Septic Tank_ ___L € f1-= _.-Type of Tank-__ Feet of Drain _.- - , _Dist. Feet of Tank or Drain Field from Well Tile. � ____...r Nature of Water Supply: •Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, D is. COUNTY OF DADE. `/- The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig .t'ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5088, 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 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT (signed_ - —_ - (Sigma Street 9 Capacity Gals._- _..._.Y. . Notary Public, State of Florida Plumbing Inspector. Muter 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 be 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'neoessary by improper notice for inspection, or faulty materials and /or workmanship. 0