PLUMBINGCLosrra
1
7 u A T H
SHOWIR•
TO:IAIII I
SINKS
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOO R
DRAIN
RKING
DIN
FOUNT'NS
1
1
TOT.-L
FIXYL RES
CONTR.
LIT
—
CHECK
1
SEPTIC
TANK
SEWER
CONN.
DRAIN
FI(LD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H
DEEP
WILL
SPRKLR.
SYSTEM
SWIM'CI
POOL
.....
I
......
COnrric.
LIST
—
--
ir-- h--..-
---!
CHICK ---
Penni: No...o?"..3.a/ig-
pltun is 1,ereby made for the approval of the detailed statement of the plans and specifications herewith subri;!...-1 for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mlz. • Shores Village, Florida,
4,-.(1 all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec. fications must be kept at
')uilding during progress of work.
John Yeats
'.)wner's Name and Address No. 1260 NE 99 Street__ .
.egict !red Architect and/or Engineer
employing Plumber's Name° ,G.Lloyd aeptis Tank Ser. N 800 NY 111
Location and Legal Description Lot Block
Street and Number where work is to be performed—No 1260 NE _29_ Street
State work to be performed and purpose of building (By Floors) ... _ ..... ......
New Building Remodeling — Addition Repairs
Size Septic Tank__ ___ Type of Tank
2 ft
Feet of Drain Tile. 00 sq. . _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of Soakage Pit
- • _ .......
Amount of Permit $
0
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
My ConimissicmExpires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Capacity Ads
(si kAtOCO
(Signed)._
Date.D.ecemb.0_29.,
StreetMiami .
Notary Public, State of Fkgida
33168
• .....
No of Stones .... .
Plumbini Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an endloyei of /oho
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent rup lement, and Iva.
.1 with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed 1 y him In e ‘ai fir e
verfcnned under this permit; and will post or cause to be posted' for inspection on the site of the work such pub': notice T. no icier .4s a?
required by the Act. The undersigned agrees to employ only such sub-contractors, • . k to be perfo •ka this .
licensed by Miami Shores Village.
MIUBA Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. perim..; ppearen
•
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 acts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re4nspection is mede•necessary by improper notice for insper.t!on, limit,
materials and/or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
n
CONTRACTOR OR BUILDER
o
MIAMI SHORES ,VILLAG, FLORIDA
DATE
PERMIT N? 1°1925
Work to be performed under this Permit
BL
Subdi-
vision
Value of
Project $
Contractor's
License No
i
Amt. of
Permit $ ,r
BY AUTHORITY
195
This permit is granted to the contractor or builder named above to conBtruct 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
❑
0 PERMIT N9
CONTRACTOR OR BUILDER/
MIAMI SHORES VILLAGE.
Bl.
8875
Subdi-
vision
FLORIDA
Work to be performed under this Permit
Sq. Ft
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
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 statii or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed: BY
INSPECTOR
DATE i 'a 195 —
Contractor's
License No
Amt. of
Permit $
In considerati of the issuange to,,d AA this ermit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict atinfOrmit ' with th pl s, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
, In accepting this peri ii I ssu a y�s sibitity f ,, all' work done by either, myself, my agent,, servant or employee.
BY AUTHORITY
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No.. __ t 015 1.— Date ti s / - ?.6./
t
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. l // qo
Owner's Nam 6/ 1r e and Address .r • I S II�_e T No.{ )-LO _ Q Street_/t r e I I YI '
Registered Architect and /or Engineer
Employing Plumber's Name C, • N __ 1L-_I__lli .___.-- _. No )Th
Block_- - - - -__ --- __.-- ____ -_ Subdivision
II
Street and Number where work is to be performed —No ___1.1 C2Sb __. _.____.____.__ Street_- _- St •
State work to be performed and purpose of building (By Floors)_...
New Building Remodeling Addition_ s 5 /
Location and-Legal Description Lot.____
Amount of Permit $
My Conunission Expires
(Signed)._
Stree
elrrP
Notary Public, State of Florida
f 'Stories
•--- -�
Size Septic Tank Type of Tank__— Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from WeIL
Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing Inspector.
The undersigned applic• for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workm s Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanent Supplement, and has com-
plied with the provision ereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this p rmit; 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) -
Master Plumber.
STATE OF FLORIDA, 1
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 far'
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 faul
aterials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N5
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
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No.. __ t 015 1.— Date ti s / - ?.6./
t
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. l // qo
Owner's Nam 6/ 1r e and Address .r • I S II�_e T No.{ )-LO _ Q Street_/t r e I I YI '
Registered Architect and /or Engineer
Employing Plumber's Name C, • N __ 1L-_I__lli .___.-- _. No )Th
Block_- - - - -__ --- __.-- ____ -_ Subdivision
II
Street and Number where work is to be performed —No ___1.1 C2Sb __. _.____.____.__ Street_- _- St •
State work to be performed and purpose of building (By Floors)_...
New Building Remodeling Addition_ s 5 /
Location and-Legal Description Lot.____
Amount of Permit $
My Conunission Expires
(Signed)._
Stree
elrrP
Notary Public, State of Florida
f 'Stories
•--- -�
Size Septic Tank Type of Tank__— Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from WeIL
Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing Inspector.
The undersigned applic• for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workm s Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanent Supplement, and has com-
plied with the provision ereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this p rmit; 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) -
Master Plumber.
STATE OF FLORIDA, 1
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 far'
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 faul
aterials and /or workmanship.
e.- 0 SeT
CL-osTr
Ftue
Architect
Contractor_,
or Builde
Legal Lot
Description
Address of j�
Building
BI.
gve
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑
ELECTRICAL. 1 i PERMIT N? 11746
PLUMBING
ROOFING 1 Work to be performed under this Permit__
Owner of i tow Building
Subdi-
vision
Value of
Project $
BY
DATE
195
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 applfcat qn
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked a
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 pei'tei
granted is the understanding that the contractor or builder named above assumes the responsibili for a thorough knowledge of the ordinances aid regulation
pertaining to the work covered hereby whether shown on the plans or draw or i he state ts or specifications and that he ass , s sibility for work'
done by his agents, servants or employees.
Signed. BY
IN 'ECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all or mances 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 'ther, myself, my agent, servant or employee.
�* e PLma#'c..
CONTRACTOR OR BUILDER
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
El
Architect
Contractor
or Builder
Legal Lot BL
Description
Address of
Building 1 t � ry . 1 `� .
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT 'N ?. 12548
❑ Work to be performed under this Permit
•
Subdi-
vision
Value of
Project $
If •
DATE / 2
Contractor's
License No
Amt. of
Permit
BY " AUTHORITY
195
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. 1'
Signed• t 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
•
'
Permit No 7 ti"
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
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
V
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
Date .l
t ___1 No Street
Registered Architect and /or Engineer _
Employing Plumber's Name 3 ' i ' ' No ' : Street
Location and Legal Description Lot__ _L '' r, L 1 W iS 19' _ Block " Z.- Subdivision
Street and Number where work is to be performed —No /'' Street w, / '
State work to be performed and purpose of building (By Floors)
.
New Building Remodeling Addition Repairs No. of Stories
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
( 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. � I ;
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
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
4)''
s, •p: ,.
e'/ .
f, eA,;.
TOTAL
FIXTURES
CONTR.
LIST
/
CHECK
..� D
` r � `
°� ,•"
•
)
� `
7 J
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT •
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
' C 4
° /,•:: ,,
r
1
CONTR.
LIST
/
!
rl
f.
^
.,
°-�
CHECK
Permit No 7 ti"
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
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
V
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
Date .l
t ___1 No Street
Registered Architect and /or Engineer _
Employing Plumber's Name 3 ' i ' ' No ' : Street
Location and Legal Description Lot__ _L '' r, L 1 W iS 19' _ Block " Z.- Subdivision
Street and Number where work is to be performed —No /'' Street w, / '
State work to be performed and purpose of building (By Floors)
.
New Building Remodeling Addition Repairs No. of Stories
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
( 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. � I ;
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
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 Date
Application is hereby made for the approval of the detailed statement of the plans 4nd 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. 4
Owner's Name and Address -4 )' ' $ 4 •0 -'T ` ' r t' � No Street
Registered Architect and /or Engineer
Employing Plumber's Name
Size Septic Tank___
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
ll
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No._ ___ 0 ! • _1_- r Street
State work to be performed and purpose of building (By Floors)
New Building ____ Remodeling Addition_ _ Repairs No. of Stories
Type of Tank ®�
No � - Street
Capacity Gals'
Feet of Drain Tile / 0 t` ) s Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $ (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
perforned 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) 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 he is the
of the above described construction, that he has carefully read the fo regoing 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
r
Master Plumber.
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
SOLAR
HEATER
DEEP •
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
•
CHECK
•
Permit No Date
Application is hereby made for the approval of the detailed statement of the plans 4nd 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. 4
Owner's Name and Address -4 )' ' $ 4 •0 -'T ` ' r t' � No Street
Registered Architect and /or Engineer
Employing Plumber's Name
Size Septic Tank___
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
ll
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No._ ___ 0 ! • _1_- r Street
State work to be performed and purpose of building (By Floors)
New Building ____ Remodeling Addition_ _ Repairs No. of Stories
Type of Tank ®�
No � - Street
Capacity Gals'
Feet of Drain Tile / 0 t` ) s Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $ (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
perforned 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) 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 he is the
of the above described construction, that he has carefully read the fo regoing 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
r
Master Plumber.