987 NE 96 StPermit No._ __/
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 complies} 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
Registered Architect and /or Engineer
Employing Plumber's Name___
Location and Legal Description Lot
STATE OF FLORIDA, t
COUNTY OF DADE.
ss.
•
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No
No
B lock
Date
Street
•
Street _
Subdivision
Street and Number where work is to be performed —No i Street
State work to be performed and purpose of building (By FToois
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
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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
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
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.
LI ST
•
CHECK
Permit No._ __/
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 complies} 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
Registered Architect and /or Engineer
Employing Plumber's Name___
Location and Legal Description Lot
STATE OF FLORIDA, t
COUNTY OF DADE.
ss.
•
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No
No
B lock
Date
Street
•
Street _
Subdivision
Street and Number where work is to be performed —No i Street
State work to be performed and purpose of building (By FToois
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
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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
PERMIT N? 6132
ORRCT DER
MIAMI SHORES VILLAGE, FLORIDA
DATE A, f
.
Contractor's
License No
Work to be performed under this Permit
Bl.
tew
Signed.
Subdi-
vision
BY
19.
/ g'sc
Address of ,
Building
Thl5e1 s granted • the contrac or or builder named abc e to onstruct the building or to install the equipment or device• described in the appli-
cation herefor in ict comph nce 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 re onsibility - or a thorough knowledge o the" antes and
regulations pertaining to the work covered hereby whether shown on the plans or drawl gs e state ents or specifications and )he .s mes respon-
sibility for work done by his agents, servants or employees. ; - -
Value of
Project w{=
In consideration of the issuance to me of this permit I agree to perform the work covered lfereunder 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 accepting this permit I assume responsibilit r all work done by either myself, my agent,)ervant or employee.
Amt. of
Permit
By.
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
DER
MIAMI SHORES VILLAGE, FLORIDA ,,,,��
DATE (74/ * Q 1941
ERMIT N? 6132
Work to be performed under this Permit
Owner of /--f
Building /` (.. - ,.
Architect �' ✓'
Contractor ,,, ,
or Builder L C (
Legal Lot
Description
Address of
Building
This permit granted the contractor or buil r named abo e to •nstruct the building or to install the equipment or device described in the appli-
cation herefor in . 'ct 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 resr +risibility for a thorough knowledge of t antes and
regulations pertaining to the work covered hereby whether shown on the plans or drawings qr i i • statemnts or specifications and t he es respon-
sibility for work done by his agents, servants or employees.
Signed. {, .-.
/e I a
Bl.
lr n.
Subdi-
vision
Value of
Project
BY
INSPIiGTi
Contractor's
License No.
Amt. of
Permit
mosoMIONINO
By A. i
/:'s S•
In consideration of the issuance to me of this permit I agree to perform the work covered h(reunder 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 accepting this permit I assume responsibility all work done by either myself, my agent, syirvant or employee.
€ CONTRACTOR . l ` "
AUTHORITY
•
MIAMI SHORES VILLAGE FLA.
PLUMING PERMIT
DATE 7
zi
kW-et, jA _ , ,914ti/
to install the following described p1-::ibin ; in accordance with
the laws, statutes and regulations of Miami Shores Village,
Florida and the State of Florida, governing plumbing and drain-
age work done in Miami Shores Village Florida,
ISSUED TO
FOR A L STORY
AT
41`f
FIXTURES °17
•
SEWER
SEPTIC TANK 6
TOTAL
03�
/1/,
96_4
4±et 1 10-a/ /24;tit
FIXTURES
NO.
/ 44, ,
571
Payment Received
By CA W, 4, 4,
BUILDING
r
Vil Q ge Plumbing inspector
This permit issued subject to approval of County Plumbing Inspector
r
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNTAINS
TOTAL
FIXTURES
A -244 5 -35 5M
Builder or Contractor is
Lot No.
Address
Date
ROUGH -IN INSPECTION
Ground Rough -In Rain Leader
A M P M.
Approved by
Condemned by
REMARKS
DIVISION OF PLUMBING INSPECTION
DEPARTMENT OF PUBLIC SERVICE
MIAMI, FLORIDA
I herewith submit the following plan of plumbing for approval:
Employing Plumber , /� . Work executed by
New Old ❑ Story ❑ Addition ❑ Remodeled ❑
For a
Dwelling lY Store ❑ Garage ❑ Apartment ❑ Hotel ❑ Office Bldg. ❑
Owner or Agent � �� 2� � ,��. � Address
Block No. Subdivision
9ri `)/ 1, d,
Address
Sewer Connections At center of St. ❑ At curb ❑ At property line ❑
To septic tank ❑
A charge of $1.00 will be made for correcting any inaccuracies in the foregoing information.
DO NOT WRITE IN SPACE BELOW. THIS IS FOR THE USE OF THE DIVISION OF PLUMBING INSPECTION ONLY.
Date
SEWER INSPECTION
A M P M
Approved by
Condemned by
REMARKS
Plan No. J7/ / Y" Sewer Permit No
Existing in alley ❑ Existing bldg. sewer ❑
Existing bldg. drain ❑ To dry well ❑
Date
FINAL INSPECTION
19
AM PM.
Approved by
Condemned by
REMARKS
THIS SPACE FOR ELEVATION SKETCH
In alterations to existing work show the old work in red ink and the new in black ink. Letter each stack to
correspond with the opening shown in floor plan or ground plan on opposite page.
A PERSPECTIVE SKETCH
PROVIDED THE WORK C:
F
W
Sketch position of building and lot lines in square (which represents an entire city block), showing on whi
street the building and lot faces; also show exact location of "Y" in street and position of lateral or sept
tank. Show sewer and any change in direction same may make. The purpose of this plan is to have an adcura e
layout of all underground pipes for future references.
WEST
NORTH
A
EAST
Remarks :
NORTH
SOUTH
1
WILL BE SUFFICIENT
: BE CLEARLY SHOWN
THIS SPACE FOR PLAN SKETCH
Show location of stacks and horizontal drains inside building, lettering each opening to correspond with the
stock connections as shown on the elevation sketch on opposite page. Where ground work is concealed, draw
floor plan of building showing location of walls, partitions, columns, etc., and the location of all horizontal
soil and waste pipes, in reference to same.
DATE
ISSUED TO
FIXTURES
SEWER
to install the following described plurihing, in accordance'with
the laws, statutes and rcgalatiolis of Miami Shores Village,
Florida and the State of Florida, governing plumbing and drain-
age work done in Miami Shores Village, Florida,
FOR A 1 STORY
AT
SEPTIC TANK
TOTAL 4
Village Plumbing in`s`pector
MIAMI SHORES VILLAGE FLA.
PLUMBING PERMIT
FIXTURES
By
NO.
Payment Received
ka 571
BUILDING
This permit issued subject to approval of County Plumbing Inspector
I"11:1 ::xi SYSTI
(7, STATTaff, LNO:.
..F4e . .
Vrr er 1
•-• Addy: - - • RGlia°16.'1)t'l
•• • . •
/Araytrao.3.1.1.7 HYLJ O1 o e Bg
• .
03 icr- A d&ros s
(Ir.. 0:171.-Ilt_Qr.
Addres s S*.
. • • • •
q 6
connoctin
or_ opt Sewer ) S elpt rilan
, • •
je11 - ..ttalre S .. ez4
mak° nruirAng & layout on This Shoot Below, Mark Old Plum'KnE.: in Red Par:
N.
Pr
DATE
AT
FIXTURES 2 i
SEWER
SEPTIC TANK
TOTAL cl;
' 7?
Village TIUMFIRFInsper
MIMI SHORES VILLAGE FLA.
PLUMBING PERMIT
r
FIXTURES
/ 4
. •
•
NO.
Payment Received
By , I • /
571
-.0
•
7 .
to install the following aescribed plumbing, in accordance'with
the laws, statutes and regulations of Miami Shores Village,
Florida and the State of Florida, governing plumbing and drain-
age work done in Miami Shores Village. Florida.
FOR A / STORY 4
BUILDING
This permit issued subject to approval of County Plumbing Inspector
❑ MIAMI SHORES VILLAGE, FLORIDA
Date 19
BUILDING
ELECTRICAL ❑
PLUMBING .0 PERMIT N° 9681
ROOFING ❑
D
Owner of
Building
Architect
Contractor •
or Builder 4" .:i` ,.? �.� ,.;... c� .
Legal Lox 11
Description 11 B1
Address of ..
Building / +� t 7 ' °7
Work to be performed under this Permit
Contractor's
License No.
Subdi-
vision
Sq. Ft.
Value of 11 Amount of {
Project $ 11 Permit $ ca{
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 applica-
tion 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 oh the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants o , employees. , /
Signed• ►ice (INSPECTOR) BY
In consideration of the issuance to me of this per I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plan , 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 a gent, servant or employee.
CONTRACTOR or BUILDER BY AUTHORITY
Permit No. _14_t / __ --
New Building -- - - - -_. Remodeling
Amount of Permit $
STATE OF FLORIDA,
sa
COUNTY OF DADE.
My Commission Expires
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 herem 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 th- 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_ _ e )4_
•__
Registered Architect and /or Engineer ..
Employing Plumber's Name 1143A-Yk1- - -t eeg.
_ti A No._
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). _ _ '
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
- — - No. -- 121_ Street. E9Gr
Addition____ _ _ _.. ____ __._ Repairs. L/ _ ._. No. of Stories
(Signed)_
Date
Capacity Gals.
SY
1 Street..
Subdivision 4- //��
Street -. _ 9 t?. 4)
t 4.
Pll.mb'ng In pecto.
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, ,ind I as com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contra a ployed 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 ork sue • public notice or no' ices as are
required by the Act. The undersigned agrees to employ only such sub - contra on work • • be o: - - nder this per nit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledge: eats, personal) 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 .acts
therein by him stated are true.
Notary Public, State of Florida
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 worlcmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
F'% TURFS
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWING
POOL
.
CONTR.
LIST
--
CHECK
Permit No. _14_t / __ --
New Building -- - - - -_. Remodeling
Amount of Permit $
STATE OF FLORIDA,
sa
COUNTY OF DADE.
My Commission Expires
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 herem 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 th- 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_ _ e )4_
•__
Registered Architect and /or Engineer ..
Employing Plumber's Name 1143A-Yk1- - -t eeg.
_ti A No._
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). _ _ '
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
- — - No. -- 121_ Street. E9Gr
Addition____ _ _ _.. ____ __._ Repairs. L/ _ ._. No. of Stories
(Signed)_
Date
Capacity Gals.
SY
1 Street..
Subdivision 4- //��
Street -. _ 9 t?. 4)
t 4.
Pll.mb'ng In pecto.
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, ,ind I as com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contra a ployed 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 ork sue • public notice or no' ices as are
required by the Act. The undersigned agrees to employ only such sub - contra on work • • be o: - - nder this per nit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledge: eats, personal) 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 .acts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or worlcmanship.
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address 997 ti, - 9 5 Tax Folio %/ 3 ' /1' 3 S
Legal Description ' /3 /1' It 27 /9 se
Date
/ Lessee / TenantOk/it Master Permit IP
Owner's Address 987 A:", 05/ Phone 78- 58O
Contracting Co. ,/ /t/1° .S Address „��/0 cLU ' 6 c
Qualifier 2 (//. 0/9 Ai$ Phone
State # Municipal # Competency # 22 Ins .Co .
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAI(PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION „ /OJ/ /f A44ti jL e. 7541 ,es26I,tce416'. l/7
Square Ft. Estimated Cost(value)
$7 0'e/i W
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 he above -named contractor to do the work state
Signat rs of owner and /or Condo President
Date:
Notjry as to Owner and /or Condo President
My Commission Expires: NOTARY PUBLIC, STATE OF FLORIDA
MY COMMISSION EXPIRES APRIL 16. 1992
BONDED IHRU STEMBLER -ADAMS 8 SWEET
** * * * * * * * * *
FEES: PERMIT " RADON
APPROVED:
C.C.F. .5
Signature of Contractor or Owner- Builder
Date:
Not
My
y a to Contractor or Owner - Builder
ommission
* *
NOTARY
Fire
ExpiI5v PUBLIC. STATE OF FLORIDA
MY COMMISSION EXPIRES APRIL 16. 1992
BONDED IHRU STEMBBER -ADAMS i SWEET **
* *
TOTAL DUE t
Other
Zoning Building Electrical
Mechanical Plumbing .X ^L% )1Rfi ri ng
Permit No..igQ 7‘71
Street and Number where work L to be performed —No
State work to be performed and purpose of building (By
New Building..__._ _ _.---- ...... -•_ -. Remodeling
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 Dopy of approved plans and specifications must be kept at
building during progress of work
Owner's Name and Address
Registered Architect and /or En ' .�.. -
5 5p o g Plumber's Narpe 1
/ Location a dd Legal Description Lot
Addition
Repairs
Size Septic Tank.-_ Type of Tantr
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 :---2 / " ®r
(Signed)
No. ` 7 Street . 0 -
9i 7/
1/2s/re-
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 5988, Compiled General Laws of Florida Permanent Supplement, and have mm-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worm 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 err
required by the Act. The undersigned agrees to employ only such sub - contr a' •, k to under this permit, as are
licensed by Miami Shores Village. _
(Si
No. of Stories....
Master Plumber.
STATE OF FLORIDA, 1
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 be 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 snob re•laspeodon V made.neoaesery by improper aotloe for dapectlon, er flaky
materials and /or workmanship.
CLOacTS
BATH
Tulle
iNOW[Ra
LAVA•
Tema.
SINKS
SLOT
SINK
LAUNDRY
Tuea
URINAL/
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIATUR[S
CONTR.
LIST
CHECK
+
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT •
G
TRAP
SOLAR
NEATER
our
WILL
6
SYSTEM
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Permit No..igQ 7‘71
Street and Number where work L to be performed —No
State work to be performed and purpose of building (By
New Building..__._ _ _.---- ...... -•_ -. Remodeling
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 Dopy of approved plans and specifications must be kept at
building during progress of work
Owner's Name and Address
Registered Architect and /or En ' .�.. -
5 5p o g Plumber's Narpe 1
/ Location a dd Legal Description Lot
Addition
Repairs
Size Septic Tank.-_ Type of Tantr
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 :---2 / " ®r
(Signed)
No. ` 7 Street . 0 -
9i 7/
1/2s/re-
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 5988, Compiled General Laws of Florida Permanent Supplement, and have mm-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worm 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 err
required by the Act. The undersigned agrees to employ only such sub - contr a' •, k to under this permit, as are
licensed by Miami Shores Village. _
(Si
No. of Stories....
Master Plumber.
STATE OF FLORIDA, 1
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 be 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 snob re•laspeodon V made.neoaesery by improper aotloe for dapectlon, er flaky
materials and /or workmanship.