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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 SWIM'G POOL CONTN. LIST .-- CHECK 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.