103 NE 99 StPermit No
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Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other r .
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.
Yfess g4A/DOLA
Owners Name and Address
Size Septic Tank.
Feet of Drain Tile.
STATE OF FLORIDA, }
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floor,)_ _ __....
New Building - . Remodeling__.._..._....._... Addition.
No
F N& Street.9/
Registered Architect and /or E eer
Employing Plumber's Name 02 0 1 K..._ CLL ieicLiaz ENc• No..l_.LLj(d:Stteet_�_? v/dE / � / 44M9 /LA
Location and Legal Description Lot. Bl Subdhtion
Street and Number where work is to be performed — Z 15 Al Street Tegket-e-E
of Water Supply: City —Well. Size of Soakage Pit
Amount of permit $ ._.4• (Signed)._
(Signed) E/ t
Repairs No. of Stories.
_Type of Tank_.__
•
Feet of Tank or Drain Field from Well
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o igations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, 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.
/005D 4 / 6 AVe.
Date.. / . - . / ''7 . 7
FiegAce
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.
Notary Public, State of Florida
mate NOTE: r w ikmc t on fee of $1.00 will be made when such re- inspection it made'neoe,sary by improper notice for inspection, or faulty
CLOSRi
BATH
TUBE
S NOWBRE
LAVA•
TORIES
"
SLOP
SINKS
LAUNDRY
T uns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT'
TOTAL
FI[TURES
CONTR.
LIST
CHECK
•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'
POOL
CONTR.
LIST
X /
CHECK
A
6 , oo
Permit No
dr
{
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other r .
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.
Yfess g4A/DOLA
Owners Name and Address
Size Septic Tank.
Feet of Drain Tile.
STATE OF FLORIDA, }
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floor,)_ _ __....
New Building - . Remodeling__.._..._....._... Addition.
No
F N& Street.9/
Registered Architect and /or E eer
Employing Plumber's Name 02 0 1 K..._ CLL ieicLiaz ENc• No..l_.LLj(d:Stteet_�_? v/dE / � / 44M9 /LA
Location and Legal Description Lot. Bl Subdhtion
Street and Number where work is to be performed — Z 15 Al Street Tegket-e-E
of Water Supply: City —Well. Size of Soakage Pit
Amount of permit $ ._.4• (Signed)._
(Signed) E/ t
Repairs No. of Stories.
_Type of Tank_.__
•
Feet of Tank or Drain Field from Well
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o igations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, 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.
/005D 4 / 6 AVe.
Date.. / . - . / ''7 . 7
FiegAce
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.
Notary Public, State of Florida
mate NOTE: r w ikmc t on fee of $1.00 will be made when such re- inspection it made'neoe,sary by improper notice for inspection, or faulty