PLUMBINGBUILDING
ELECTRICAL
PLUMBING
ROOFING
t
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
MIAMI SHORES VILLAGE. FLORIDA
❑ DATE ' 195
❑
PERMIT N? 5 514 Contractor's
License No.
Lot
CONTRACTOR OR BUILDER
y -.
Bl.
Signed
Work to be performed under this Permit
Subdi-
vision
Value of
Project $ +�
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 application
t 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 on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
INSPECTOR , L.
Amount of
Permit $
In consideration of the issuance to me of this permit I agree to perform the work coverer! hereunder 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 ac.
2epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Permit No
„s
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 PA's l-D_ _? N No. _ -_ ZJ =__.._
Street.
Registered Architect and /or Engineer - _ _______. —
Employing Plumber's NameT c - t u C
Location and Legal Description Lot_.__..._ _______.______ ___ — Block
Street and Number where work is to be performed- No. _ - ____
State work to be performed and purpose of building (By Floors) 2.____S -)Pic- _ ______ -!_^i L , o,e SPR , <
New Building Remodeling __ Addition______._ Repairs No. of Stories.
Size Septic Tank
Feet of Drain Tile__
Nature of Water Supply: City -Well.
Amount of Permits __._..__ - - - - -- -- __.------- - - - -_- — (Signed)_
STATE OF FLORIDA, 1
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEi ':'
APPLICATION FOR PLUMBING "' �•tiiliJl�
Type of Tank
_Dist. Feet of Tank or Drain Field from Well
_ Size of Soakage Pit
Capacity Gals
Date_. _ _ .__.._
ti
Street.. to • `� • - / .1^
Subdivision
Street
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida 'ennanent Supplement, and leas 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 per:nit, as are
licensed by Miami Shores Villaga. _
� P
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
. & , �s 1 sX
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.
CLOUTS
BATH
TUBS
SHOWER[
LAVA-
ToRice
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
R INALf
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NB
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD,
SOAKAGE
PIT
GREASE'
TRAP
SOLAR
HEATER
..
DELP
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
CONTR.
LIST
CHECK
`�„
______
Permit No
„s
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 PA's l-D_ _? N No. _ -_ ZJ =__.._
Street.
Registered Architect and /or Engineer - _ _______. —
Employing Plumber's NameT c - t u C
Location and Legal Description Lot_.__..._ _______.______ ___ — Block
Street and Number where work is to be performed- No. _ - ____
State work to be performed and purpose of building (By Floors) 2.____S -)Pic- _ ______ -!_^i L , o,e SPR , <
New Building Remodeling __ Addition______._ Repairs No. of Stories.
Size Septic Tank
Feet of Drain Tile__
Nature of Water Supply: City -Well.
Amount of Permits __._..__ - - - - -- -- __.------- - - - -_- — (Signed)_
STATE OF FLORIDA, 1
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEi ':'
APPLICATION FOR PLUMBING "' �•tiiliJl�
Type of Tank
_Dist. Feet of Tank or Drain Field from Well
_ Size of Soakage Pit
Capacity Gals
Date_. _ _ .__.._
ti
Street.. to • `� • - / .1^
Subdivision
Street
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida 'ennanent Supplement, and leas 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 per:nit, as are
licensed by Miami Shores Villaga. _
� P
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
. & , �s 1 sX
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.
Permit No
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date. .._ .J.ia'.1.3:
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 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 kcpt at
building during progress of work.
Owner's Name and Address ) • :_1! 7'S/r�
No._ � L �� . 2 Street � � . �.. �...... .
Registered Architect and /or Engineer 1 .���. A -��_
Employing Plumber's Npine N
o;_. r , -- - -- ,
__ asxeus�assr.- 8 1 1�ivaeuxsaes «maw :r. ••r•see= ••e.••
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No..- i;1, t \ a�
State work to be performed and purpose of building (By
New Building - -- __------ •..•- - -._.. Remodeling ` .._ _ Addition..._._.__ Repairs No. of Stories.
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
3 7f
Amount of Permits S (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 Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and bas 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)
c
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
matm A r r w lmection fee of $1.00 will be made when such re- inspection is made by improper notice for inspection, or faulty
CLOSETS
BATH
TUBS
SHOWER'
TORIES
SINK{
SLOP
SINKS
LAUNDRY
Tuns
URINAL{
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N {
,— ��� /yyy
FIKTUR[{
CONTR.
LIST
3
/u�
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
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date. .._ .J.ia'.1.3:
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 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 kcpt at
building during progress of work.
Owner's Name and Address ) • :_1! 7'S/r�
No._ � L �� . 2 Street � � . �.. �...... .
Registered Architect and /or Engineer 1 .���. A -��_
Employing Plumber's Npine N
o;_. r , -- - -- ,
__ asxeus�assr.- 8 1 1�ivaeuxsaes «maw :r. ••r•see= ••e.••
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No..- i;1, t \ a�
State work to be performed and purpose of building (By
New Building - -- __------ •..•- - -._.. Remodeling ` .._ _ Addition..._._.__ Repairs No. of Stories.
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
3 7f
Amount of Permits S (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 Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and bas 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)
c
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
matm A r r w lmection fee of $1.00 will be made when such re- inspection is made by improper notice for inspection, or faulty
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N° 1696
0
0
Work to be performed under this Permit
Subdi-
B1 vision
Value of
Project $
DATE 195
Contractor's
License No.
Amount of
Permit $
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
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 on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed: BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder 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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY 6 ASEPp
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 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_W_ e! _________
Registered Architect and /or
Employing Plumber's Name
Location and Legal Description
Street and Number where work
State work to be performed
New Building
7 $ Subdivision!4��Q /11
Street__
Rep
is to be performed —No 1a
and purpose of building (By Floors)._
Remodeling_ __ _ —___ Addition.
Noi ?2 315E
No._____ *.c__.4
Date 2. ^ - 2 - ^ �� s �
Street
Street__ ___7Z
97
No. of Stories.
Size Septic Tank ....... Feet of Drain Tile__
Nature of Water Supply: City-
Amount of Permit $
STATE OF FLORIDA, I 83. /
COUNTY OF DADE.
Type of Tank Capacity Gals
_Dist. 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 obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and bus 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 tlie Act. The undersigned agrees to employ only such sub- contractors, on worko be erform d under tl}js permit, as are
licensed by Miami Shores Village. ! /
•
Q (Si ! `v. ` / -�"��
Y , Master Plumber.
_Size of Soakage Pit
(Signed)-
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 , . i ' sion Expires Notary Public, State of Florida
NOTE: A on fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and/ • workmanship.
CLOSETS
BATH
Toes
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
6,,...✓'
1, D/1
/ �..
! -
Il��
v , .;,../-
/
ez-
TOTAL
FIXTURES
>
cows.
L R
3•""
/
/
.,
/
CHECK
[ f J S'
7
7 —�
ie
•
.��
SEPTIC
TANK
SEWER
CONN.
! DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
apeRft
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
n
•, 1
/d9 - J
'
—
- --
CONTR.
LIST
2/
W
CHECK
.2 tJ
- D
,f® 0
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 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_W_ e! _________
Registered Architect and /or
Employing Plumber's Name
Location and Legal Description
Street and Number where work
State work to be performed
New Building
7 $ Subdivision!4��Q /11
Street__
Rep
is to be performed —No 1a
and purpose of building (By Floors)._
Remodeling_ __ _ —___ Addition.
Noi ?2 315E
No._____ *.c__.4
Date 2. ^ - 2 - ^ �� s �
Street
Street__ ___7Z
97
No. of Stories.
Size Septic Tank ....... Feet of Drain Tile__
Nature of Water Supply: City-
Amount of Permit $
STATE OF FLORIDA, I 83. /
COUNTY OF DADE.
Type of Tank Capacity Gals
_Dist. 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 obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and bus 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 tlie Act. The undersigned agrees to employ only such sub- contractors, on worko be erform d under tl}js permit, as are
licensed by Miami Shores Village. ! /
•
Q (Si ! `v. ` / -�"��
Y , Master Plumber.
_Size of Soakage Pit
(Signed)-
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 , . i ' sion Expires Notary Public, State of Florida
NOTE: A on fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and/ • workmanship.
Permit No
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 copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address _ __ _ ____._____ No.__ - -___ _ Street.
Registered Architect and /or Engineer _-__.- -_-_...__--..__--..___._- --_ .._ ___- __-
-- _- _-- -- -- .--- �--___ - --
Employing Plumbei s Name �__ ts' — 9 No.---- - -- - - -- Street-_ -
Location and Legal Description Lot______________ __ Block_ Subdivision
Street and Number where work is to be performed -No 2 . Street_
State work to be performed and purpose of building (By Floors)___
New Building- -_- -- _---- ------ -_ --.. Remodeling Addition.._ Repairs Repairs No. of Stories
Amount of Permit $ -I-
STATE OF FLORIDA,
COUNTY OF DADE. j
3-7 -I
- —
(Signed)
Date
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
My Commission Expires Notary Public, State of Florida
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 o be performed under this permit, as are
licensed by Miami Shores Village.
(Signed). _ ������lc
Mesteras ism
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: re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty
materials or workmanship.
CLOSETS
BATH
Tugs
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
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'o
POOL
CONTR.
LIST
—
__
-
CNECK
Permit No
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 copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address _ __ _ ____._____ No.__ - -___ _ Street.
Registered Architect and /or Engineer _-__.- -_-_...__--..__--..___._- --_ .._ ___- __-
-- _- _-- -- -- .--- �--___ - --
Employing Plumbei s Name �__ ts' — 9 No.---- - -- - - -- Street-_ -
Location and Legal Description Lot______________ __ Block_ Subdivision
Street and Number where work is to be performed -No 2 . Street_
State work to be performed and purpose of building (By Floors)___
New Building- -_- -- _---- ------ -_ --.. Remodeling Addition.._ Repairs Repairs No. of Stories
Amount of Permit $ -I-
STATE OF FLORIDA,
COUNTY OF DADE. j
3-7 -I
- —
(Signed)
Date
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
My Commission Expires Notary Public, State of Florida
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 o be performed under this permit, as are
licensed by Miami Shores Village.
(Signed). _ ������lc
Mesteras ism
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: re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty
materials or workmanship.