PLUMBINGPermit No.__ 7 s 7
Application is hereby made for the approval of the detailed statement of the plans and specifications here
structure herein described. This application is made in compliance and conformity with the Building Ordinance o 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 Btu l iviiilllosi
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
Registered Architect and /or En i r _
Employing Plumber's Name- -- t f+`- _ No . D k et Street - - -Ai 4 )P/
Location and Legal Description Lot____ {
_____ - _- --- ___ -__ Block__ _,/ - �__l,/ Subdivision ���/ ar
Street and Number where work is to be performed—No .... _ .O__�.t Street_ 4/4 % g' `-
State work to be performed and purpose of building (By Floors)
New Building
Amount of Permit $___
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile 1'-, Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: /City -Well Size of Soakage Pit
f i
Remodeling Addition_
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)-
No. Street
Repairs
g
The undersigned applicant for this building permit does hereby certify that he - erstands and accepts his obliga : as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled a al Laws of Florida Permanent pplement, 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.
Date_.:
ed for the building or other
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknovl<ledgments, 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.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.04 will be made when such re- inspection is made necessary by improper notice for inspection, or fa Ii
materials and /or workmanship.
CLOSETS
BATH
TUSS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUGS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N/
l r
�
CONTR.
LIST
3
A-
/
4
CHECK
SEPTIC
TANK
SEWER
CONN.
._..
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
w. ._�._._.�.
CHECK
Permit No.__ 7 s 7
Application is hereby made for the approval of the detailed statement of the plans and specifications here
structure herein described. This application is made in compliance and conformity with the Building Ordinance o 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 Btu l iviiilllosi
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
Registered Architect and /or En i r _
Employing Plumber's Name- -- t f+`- _ No . D k et Street - - -Ai 4 )P/
Location and Legal Description Lot____ {
_____ - _- --- ___ -__ Block__ _,/ - �__l,/ Subdivision ���/ ar
Street and Number where work is to be performed—No .... _ .O__�.t Street_ 4/4 % g' `-
State work to be performed and purpose of building (By Floors)
New Building
Amount of Permit $___
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile 1'-, Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: /City -Well Size of Soakage Pit
f i
Remodeling Addition_
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)-
No. Street
Repairs
g
The undersigned applicant for this building permit does hereby certify that he - erstands and accepts his obliga : as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled a al Laws of Florida Permanent pplement, 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.
Date_.:
ed for the building or other
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknovl<ledgments, 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.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.04 will be made when such re- inspection is made necessary by improper notice for inspection, or fa Ii
materials and /or workmanship.
Permit No. -
Size Septic Tank
Feet of Drain Tile
Amount of Permit $
,/sie
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 speified or not. A copy of approved plans and specifications must be kept at building during the progress of work.
r 1 y
Owner's Name and Address No. S treet . -
Registered Architect and/or Engineer - - -
Employing P1grnl)er's Name — No. Street
;1-
location and Legal Description Cot Block = Subdivision
Street and Number where work is to be performed — No.
Street
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
.r`
Type of Tank Capacity Gals.
(Signed ).- f '1'C.
sr
Date
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
f- Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - Well Size of Soakage Pit
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the
Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied 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 Vilyrge.
/
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated
are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $25.00 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
FOUNTAINS
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. -
Size Septic Tank
Feet of Drain Tile
Amount of Permit $
,/sie
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 speified or not. A copy of approved plans and specifications must be kept at building during the progress of work.
r 1 y
Owner's Name and Address No. S treet . -
Registered Architect and/or Engineer - - -
Employing P1grnl)er's Name — No. Street
;1-
location and Legal Description Cot Block = Subdivision
Street and Number where work is to be performed — No.
Street
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
.r`
Type of Tank Capacity Gals.
(Signed ).- f '1'C.
sr
Date
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
f- Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - Well Size of Soakage Pit
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the
Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied 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 Vilyrge.
/
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated
are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials
and/or workmanship.
r.
„ r
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
5
Date of Application s
Name of Owner C-G� �� /
Mailing Address of Owner
Owner's Agent
Type of
Residential
Type of
Establishment
Exact Directions to Property
/ 0 0 )_
AUDIT CONTROL NO N? 240431
Y
No. Bedrooms
(each dwelling unit)
I" 1
/ t;
/
HRS-H Form 4015, Feb 85 (i7bsoletes previous editions which may not be used)
(Stock Number. 5744 - 001. 4015 -1)
Authority: Chapter 381, FS
Chapter 10D -6, FAC
Permit Application Number
9 o--,<Pc
PART I - APPLICATION---------------------------------------- ___...__._..__ - --
TOTAL FLOW =
Applicant's Signature
, q I),
S -7 40 /2.1 ` // "4 ,& Builder
Agents Mailing Address g 3 4) yt/ / 9 - 7 a--/ Telephone No 6 sm.— J rsi
Property Street Address / 0 0 fV A — 5 ? _ / ,'v Q --er TG iy4-‹
Lot No Block No. Subdivision Date Subdivided
NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BO DS DESCRIPTION
This Application is for: New System Repair Existing System
s'a
Telephone Number
- 7511- 6
Sewage Flow Sewage Flow
(Gallons per day) Based On
Heated or Cooled Area No. Dwelling Sewage Flow
(each dwelling unit) Units (Gallons per day)
ft
ft
Page 1 of 3
Permit No. 40 5 J Dam k-,tzt
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
structure herein described. TWA application is made in comphoo and conformity with the Building Ordinance of Miami
and all provisions of the; Laws of the State of Florida, all °abloom' of Miami Shores Village and all rules and regulliticius of t
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved tilos and
building during progress of work.
•
Owner's Name and Address o- No /0 0 1-
Registered Architect and/or Egineer.
Employing Plunthees 44111:4 No.
Location and Legal Description Lot_ (
Street and Number where work is to be performed—No c Soto__
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition— ____- No. of if
LAVA- LANNON/ '
TORIES TWOS MINS
terns
CONTR.
LIST
CHECK
. a
Size Septic Tank k Q 0 ._ ____Type of T - t ;.• .7;
Feet of Drib Tile_____i-g_i2 .Dist. Feet of Tank or Drain' Field from
Nature of Water Supply: City—Well. Size of Soakage Pit__
Amount of Perinit $
STATE OF FLORIDA»
COUNTY OF iitDE. I
Before ine,. the undersigned
to me well
a the ab Tbn
therein by
ho ,
My Commission Expires
MIAMI ENGINE VILLAGE
numei*INSPIIMON DEPARTMENT
APPLICATIOi FOR PWINIING
( Signed)
The undersigned applicant for this building permit does bereby certify that he and accepts his obligations
under the Florida Workmen's Compensation Act, being Section 5966, Compiled cot Matt
plied with the provisions thereof, and will require similar compliance front an or suberrettinr
performed under this permit; and will post or cause to be posted. for Inspection on die site of the work such "-
requ i re db y theA.ctTheuneruigned agrees to ezimbY only such Mth-contractors, on wo4 to be *formed
licensed by Miami libeem
(Signed)
me first duly sworn, upon oath deposes and says that he las a_
that he has carefully read the foregoing application, adirthat he did sign the same, and
Ndle, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-hispection is made necessary by improper
materials and/or workmanship.
• •
Motet Pbwrilars,
irnpection, •or
authority, a notary public, duly authorized to administer oaths and take aclmowledgments, peso* append