1201 NE 98 St (2)Permit No Date
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. A� j ,4
Owner's Name and Address ` r � G ` e - s--z - - — No.__ __I .2 Gl.-- - -_ - -_ Street / ? efy
Registered Architect and /or Engineer ..... _________ .... ___._._— _.______—
Employing Plumber's Name sP- ` -_A__V S No.___-- 7 j_1 - -2 r StreeL.A ' cf -7 _ --
APPLICATION FOR PLUMBING PERMIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Location and Legal Description Lot_______
Street and Number where work is to be performed —No
___ -__ Block._ Subdivision
? O L Street 4l 9,.%)-
State work to be perfonmea and purpose of building (By Floors) _----- _------ ____ -_
New Building Remodeling _-- _--- ..---------- -_ -__- Addition____ Repairs No. of Stories. _ .._ . ............ ..
Size Septic Tank
Feet of Drain Tile_____
Nature of Water Supply: City —Well
Amount of Permit $
Type of Tank_ Capacity Gals
Dist. Feet of Tank or Drain Field from Well
—__ Size of Soakage Pit
(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.
My Commission Expires
(Signed).
STATE OF FLORIDA, I ee.
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.
Notary Public, State of Florida
Master Plumber.
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.
TOTAL
FIXTURES
CLOSETS
BATH
TUBS
SHOWERS
R OW
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
—.-
-
_�--
CONTR.
L IST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW MUG
CLIP.
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414 z
CHICK
Permit No Date
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. A� j ,4
Owner's Name and Address ` r � G ` e - s--z - - — No.__ __I .2 Gl.-- - -_ - -_ Street / ? efy
Registered Architect and /or Engineer ..... _________ .... ___._._— _.______—
Employing Plumber's Name sP- ` -_A__V S No.___-- 7 j_1 - -2 r StreeL.A ' cf -7 _ --
APPLICATION FOR PLUMBING PERMIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Location and Legal Description Lot_______
Street and Number where work is to be performed —No
___ -__ Block._ Subdivision
? O L Street 4l 9,.%)-
State work to be perfonmea and purpose of building (By Floors) _----- _------ ____ -_
New Building Remodeling _-- _--- ..---------- -_ -__- Addition____ Repairs No. of Stories. _ .._ . ............ ..
Size Septic Tank
Feet of Drain Tile_____
Nature of Water Supply: City —Well
Amount of Permit $
Type of Tank_ Capacity Gals
Dist. Feet of Tank or Drain Field from Well
—__ Size of Soakage Pit
(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.
My Commission Expires
(Signed).
STATE OF FLORIDA, I ee.
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.
Notary Public, State of Florida
Master Plumber.
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.