PLUMBINGPermit 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 heredn specified or not. A copy of approved plans and specifications mud be kept et
building during progress of work.
Owner's Name and Address
Registered Architect and/or gineer
‘?°Z
12 loyincr P
De N
„, ,, )?, 7 i.___,Z20_,.d 0
ig
P , gez_.4..eeda
s
Location and Legal ption / Block c> Subdividon
Street and Number where work is to be performed—No /4 c:C,/e7 gi;■ --'-'” Street.
State work to be performed and purpose of building (By Floors).4... ga. :sax._ a - P. 4- it re <. ,.. c. ,
2 L ....
New Building. _ Remodeling—__ .._ Ad ion. Repairs - No. of Stories — f,
Size Septic Tank__
Feet of Drain Tile.
Nature of Water Supply: City—Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/4 I L/LYN° Strept ..9Q
_Type of Tank._
__Dist. Feet of Tank oe Drain Field from Well
Size of Soakage Pit
(Signed) LEVEROCK
(Si
e /73
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 5968, Compiled General Laws of Florida Permanent Supplement, and li com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the worir to he
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 arr
required by the Act. The undersigned agrees to employ only such sub-contractors, on nder this permit, as are
licensed by Miami Shores Village.
....
Master Plumber.
STATE OF FLORIDA,
u.
COUNTY OF DADE.
Before me, the undersigned authority, • 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 We that he is the
of the above described construction, that he bas carefully read the foregoing appliattion, 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 mob rolospeedrin la macie.neamery by nproper node* for feepection, or falsity
materials and/or workmanship.
CLosa
BATH
TU•S
SHOWERS
LAVA.
TORIES
IIIN
SLOP
SINKS
LAUNDRY
Tue.
UPIINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK i NO
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHICK
.......
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE.
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
8 .
SYSTE
SWIM•0
POOL
CONTR.
LIST
CHICK
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 heredn specified or not. A copy of approved plans and specifications mud be kept et
building during progress of work.
Owner's Name and Address
Registered Architect and/or gineer
‘?°Z
12 loyincr P
De N
„, ,, )?, 7 i.___,Z20_,.d 0
ig
P , gez_.4..eeda
s
Location and Legal ption / Block c> Subdividon
Street and Number where work is to be performed—No /4 c:C,/e7 gi;■ --'-'” Street.
State work to be performed and purpose of building (By Floors).4... ga. :sax._ a - P. 4- it re <. ,.. c. ,
2 L ....
New Building. _ Remodeling—__ .._ Ad ion. Repairs - No. of Stories — f,
Size Septic Tank__
Feet of Drain Tile.
Nature of Water Supply: City—Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/4 I L/LYN° Strept ..9Q
_Type of Tank._
__Dist. Feet of Tank oe Drain Field from Well
Size of Soakage Pit
(Signed) LEVEROCK
(Si
e /73
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 5968, Compiled General Laws of Florida Permanent Supplement, and li com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the worir to he
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 arr
required by the Act. The undersigned agrees to employ only such sub-contractors, on nder this permit, as are
licensed by Miami Shores Village.
....
Master Plumber.
STATE OF FLORIDA,
u.
COUNTY OF DADE.
Before me, the undersigned authority, • 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 We that he is the
of the above described construction, that he bas carefully read the foregoing appliattion, 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 mob rolospeedrin la macie.neamery by nproper node* for feepection, or falsity
materials and/or workmanship.
p"/
0
Permit No.--------- •-- / - - - --
New Building
Amount of Permit $ `-
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby fnade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or,other
structure herein descri ed. 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. /n A, �y
Owner's Name and Address________ _- No._IQ's / .ill - t ____ 'f_, Street - q
Registered Architect and /or En ineer ..... _____ _ - -_ -�_ _ - ^ '"" 2- - - - - - - -- ,/ �` (�
Employing Plumber's Name Q _- 4.(
.(i. • C 10._ -111L_ �- ES'
Location and Legal Description Lo_______, _ __ _ _ Block_ Subdi al Street C 7 /
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) _
Remodeling _.----- ---- ---- ----- --_ --- Addition
Size Septic Tank n Type of Tank__ Capacity Gals.
e`
Feet of Drain Til _ 'k� - -= __Dist. Feet of Tank or Drain Field from Well
Nature of Water Sup y: City —Well. Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o • t! ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors nployed 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 perfo rrred under this permit, as are
licensed by Miami Shores Village.
(Signed)-- (
(Signed) __-__
ILA
Repairs_._ No. of Stories.
Date
STATE OF FLORIDA,
se. •
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
• My Commission Expires
NOTE: A re- inspection fee of $LOO will be made when such re- inspection is made necessary . by improper notice for inspection, or faulty
materials and /or workmanship.
Master Plumber.
CLU6@T'8
BATH
TUBS
J
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LICIT
1
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
_
CHECK
p"/
0
Permit No.--------- •-- / - - - --
New Building
Amount of Permit $ `-
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby fnade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or,other
structure herein descri ed. 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. /n A, �y
Owner's Name and Address________ _- No._IQ's / .ill - t ____ 'f_, Street - q
Registered Architect and /or En ineer ..... _____ _ - -_ -�_ _ - ^ '"" 2- - - - - - - -- ,/ �` (�
Employing Plumber's Name Q _- 4.(
.(i. • C 10._ -111L_ �- ES'
Location and Legal Description Lo_______, _ __ _ _ Block_ Subdi al Street C 7 /
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) _
Remodeling _.----- ---- ---- ----- --_ --- Addition
Size Septic Tank n Type of Tank__ Capacity Gals.
e`
Feet of Drain Til _ 'k� - -= __Dist. Feet of Tank or Drain Field from Well
Nature of Water Sup y: City —Well. Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o • t! ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors nployed 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 perfo rrred under this permit, as are
licensed by Miami Shores Village.
(Signed)-- (
(Signed) __-__
ILA
Repairs_._ No. of Stories.
Date
STATE OF FLORIDA,
se. •
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
• My Commission Expires
NOTE: A re- inspection fee of $LOO will be made when such re- inspection is made necessary . by improper notice for inspection, or faulty
materials and /or workmanship.
Master Plumber.
BUILDING ❑
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
DATE �'
n PERMIT IT? 12656
I ...l
n Work to be performed under this Permit
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
Value of
Project $
Contractor's
License No
Amt. of
Permit $
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
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 • -e.,
BY
INSPECT& _"
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Permit No. ._.
Registered Architect and /or Eng neer
Employing Plumber's Name
APPLICATION FOR PLUMBING PERMIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address • \-1-.) `^' No Street
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) _
New Building Remodeling Addition _________________________ Repairs
No . Street
Block . ___ Subdivision
M. • e 4 - - Street _
Size Septic Tank Type of Tank_ Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from WeIL
O d 0 0 __Size of Soakage Pit
Nature of Water Supply: City —Well
Amount of Permit $
(Signed)
(Signed)-
Date
No. of Stories
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 arc
licensed by Miami Shores Village. •
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 appeare
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 fat.
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 such re- inspection is made necessary by improper notice for inspection, or faul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURE!
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
/
T
1 , o d
Permit No. ._.
Registered Architect and /or Eng neer
Employing Plumber's Name
APPLICATION FOR PLUMBING PERMIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address • \-1-.) `^' No Street
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) _
New Building Remodeling Addition _________________________ Repairs
No . Street
Block . ___ Subdivision
M. • e 4 - - Street _
Size Septic Tank Type of Tank_ Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from WeIL
O d 0 0 __Size of Soakage Pit
Nature of Water Supply: City —Well
Amount of Permit $
(Signed)
(Signed)-
Date
No. of Stories
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 arc
licensed by Miami Shores Village. •
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 appeare
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 fat.
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 such re- inspection is made necessary by improper notice for inspection, or faul
materials and /or workmanship.
/
Permit No -tJ%
7;r - - - -
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
o/
Application is hereby made for the approval of the detailed statement of the plans and specifications her h submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordi . nce 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_ 7.4. 7 � No Street
Registered Architect and /or Engineer
Employing Plumber's Name ��l_t_!,�� 4.f No.
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)
New Building Remodeling Addition
Size Septic Tank 7 e Type of Tank Capacity Gals ,0 0 -
Feet of Drain Tile
Nature of Water Supply: City —Well Size of Soakage Pit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Dist. Feet of Tank or Drain Field from Well
( Signed)
Street
Da
o Y 4Z Street 7f
(Signed) •
My Commission Expires Notary Public, State of Florida
Subdivisio
Repairs No. of Stories
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.
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
.11411LMR
HEATER
? , .
DEEP,
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
- .1 " �
CONTR.
LIST
/
/
1
CHECK
/
Permit No -tJ%
7;r - - - -
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
o/
Application is hereby made for the approval of the detailed statement of the plans and specifications her h submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordi . nce 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_ 7.4. 7 � No Street
Registered Architect and /or Engineer
Employing Plumber's Name ��l_t_!,�� 4.f No.
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)
New Building Remodeling Addition
Size Septic Tank 7 e Type of Tank Capacity Gals ,0 0 -
Feet of Drain Tile
Nature of Water Supply: City —Well Size of Soakage Pit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Dist. Feet of Tank or Drain Field from Well
( Signed)
Street
Da
o Y 4Z Street 7f
(Signed) •
My Commission Expires Notary Public, State of Florida
Subdivisio
Repairs No. of Stories
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.
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
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 6708
Work to be performed under this Permi
1
Legal Lot / , B < Subdi-
Description -' /, vision
Address of
Building L-
This permi is granted to the co actor or b . ilde named above to construct the building or to install the equipment or device described in the appli-
cation 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 responsib 'ty for a thorough knowledge of th dinances and
regulations pertaining to the work covered hereby whether shown on the plans or awings or in th t ements or spec cations aid that :he sumes respon-
Al Signed: S . L1 By?
• v SPE OR
In consideration of the issuance to me of this permit I agree to perform' the work covered hereunder in compliance witl ordinances4IndyeglaWions
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miam VfIlage.
In a ing this permit I responsibility .for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
sibility for work done by his agents, servants or employees.
DATE
Contractor's
License
19419
Value of
Project
BY
Amt. of
Permit
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
f ! d�'ir r
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 6708
Work to be performed under this Permit / c` .q-,•
Owner of
Building
(%rtt
Bl.
e f._
Subdi-
vision
DATE ,' ` 194
Value of
Project
Contractor's
License NQ.
This permit is granted to the contractor or budder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 is inances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the sta €ments or specifications and he uines respon-
sibility for work done by his agents, servants or employees.
Amt. of
Permit
Signed. s' /d 4 . L By sf�
'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 accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
{ �,A.., _1..1.
CONTRACTOR OR BUILDER BY AUTHORITY
Permit No -I 7 7 , Date..._..l.._�_ :.�8 .......— ._._._
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. No. /nl VP
Registered Architect and /or Engineer
£tn loyi 's N e Ore J 07/C 1 ��Y 1 1ki�vs- ._... NO./.PJ -.._.. emmer....... 8121101144161 6'S:: �Q . .p�;�. • .-
Location and Le Description Lot S W as' / Y Mork v� SubdivWon�.l�
Street and Number where work is to be performed —No /2 VP Street
State work to be performed and purpose of building (By Floozs)__.__ _.._ — __
New Building ..__._— _.._.....-....._.. Remodeling— _.__._._____ Addition
Size Septic Tank___
Feet of Drain Tile. JO o 4
Nature of Water Supply: City—Well.
Amount of Permit $—t"
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Repairs
-Type of Tank - -_- — •--- _ - -• -•
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit.
Capacity Cat...._..._...__
(signed)_ t<Y6 -4n
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 5968, Compiled General Laws of Florida Pennanent Supplement, and has com-
plied with the provisions thereof. and will require Itirnilar compliance from all contractors or sub- contractors employed by him in the worse 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 ere
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)
street_Xt • 99 Sr
No. of Stories.
STATE OF FLORIDA, µ
COUNTY OF DADE. j
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 ei Florida
3a.9 - 3c - /3 1 2,7
Master Plumber.
NOTE: A re- inspection fee of 0.00 will be mad. when sash roliaspootfosi >. oada'aaoassary by improper moth for Impaction, or faulty
materials and /or warl®anship.
CLO•Ra
BATH
Twits
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N•
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
$PRKLR.
SYSTEM
SW IM'O
POOL
CONTR.
LIST
CHECK
Permit No -I 7 7 , Date..._..l.._�_ :.�8 .......— ._._._
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. No. /nl VP
Registered Architect and /or Engineer
£tn loyi 's N e Ore J 07/C 1 ��Y 1 1ki�vs- ._... NO./.PJ -.._.. emmer....... 8121101144161 6'S:: �Q . .p�;�. • .-
Location and Le Description Lot S W as' / Y Mork v� SubdivWon�.l�
Street and Number where work is to be performed —No /2 VP Street
State work to be performed and purpose of building (By Floozs)__.__ _.._ — __
New Building ..__._— _.._.....-....._.. Remodeling— _.__._._____ Addition
Size Septic Tank___
Feet of Drain Tile. JO o 4
Nature of Water Supply: City—Well.
Amount of Permit $—t"
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Repairs
-Type of Tank - -_- — •--- _ - -• -•
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit.
Capacity Cat...._..._...__
(signed)_ t<Y6 -4n
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 5968, Compiled General Laws of Florida Pennanent Supplement, and has com-
plied with the provisions thereof. and will require Itirnilar compliance from all contractors or sub- contractors employed by him in the worse 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 ere
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)
street_Xt • 99 Sr
No. of Stories.
STATE OF FLORIDA, µ
COUNTY OF DADE. j
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 ei Florida
3a.9 - 3c - /3 1 2,7
Master Plumber.
NOTE: A re- inspection fee of 0.00 will be mad. when sash roliaspootfosi >. oada'aaoassary by improper moth for Impaction, or faulty
materials and /or warl®anship.
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT
Applicant Perr it F umbg� 7 � c=, / 7
PART II - SYS M IN
E STALLATION INSPECTION AND FINAL INNSTALLATIO APPROVAL-
Installer a 7
Proper tank legend: Yes/ /di No
Tanks watertight: Yes
Proper tank outlet device:
Other findings
Inspected by
Ye
No
Drainfield Trench
Length Width Length Width Length 3 5-feet x..12. feet =Y420 ft
30c,
feet feet feet feet Length feet x feet= ft
feet feet ! 1 feet feet Proper No. drainlines: Yes y No
feet feet * feet feet Proper pipe separation: Yes 3. No
Total = ft Total = ft Distribution box level: Yes No 1/
Systems located as permitted: Yes ice' No
Systems including plumbing stub -outs installed at proper elevation: Yes b No
\ Average depth to drainpipe invert from finished grade: / � inches IV depth 2 7 Inches
7 Average depth of drainfield gravel: j J � inches Minimum depth of gravel. - inches
Proper gravel size: Yes 7 No � ! Gravel is suitable quality: Yes '' No
Backfill or fill material as required: (Quality) Yes No (Quantity) Yes No
Tank Manufacturer /v /14
Tank material Tank level: Yes No
Tank size• gallons gallons gallons
Manhole or marker to grade: Yes Al No
PART III FINAL IN TALLATION APPROVAL -
Date pproved by:
Absorption Be
AN APPROVED INSTALLATION DOES NOT GUARANTEE PERFORMANCE
Date /_
COUNTY PUBLIC HEALTH UNIT
Note: Completed copies of this form will be provided to the applicant, installer and the building department.
HRS —H Form 4016, Jan 86 (Replaces Feb 85 edition which may be used)
(Stock Number: 5744-002-4016-4) Page 2 of 2