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125 NE 98 St (6)f Permit No __ _=_ _ Application i Hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th Building llI ' sion 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. Q // Owner's Name and Address- _ _ - _ _.___.--- __.____ No._�_ /{! Street _ �_C1�I° . Registered Architect and /or Engineer __ Employing Plumber's Name ___ _ No._ ___ _ __ —_ _ _ _ Street Location and Legal Description _ — _ Block ` r Subdivision_ Ai p Street and Number where work is to be performed —No / 1IQ Street _ State work to be performed and purpose of building (By Floors). _ New Building ___ -- _ _ • -. - -- .__ Remodeling_ _ -- _ -- __ _ _ _ Addition_--_ 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. ____ __ ___ _ _ _ _ __ _ Si of Soakage Pit Amount of Permit $ _ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT - (Sed)- ._+ -L.. (Signed Date `--- Repairs_ __ .. _ _ _ ___ No. of Stories _ __ .Capacity Ga:s. Pl,.mb rig In.pecto. The undersigned applicant for this building permit does hereby certify that he understands and :.cc: pts his oblif ( actions as an e nployer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppl_ment, 'n 1 I a otn plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin in the wo.k 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 no ices as are required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo under this per nit, as are licensed by Miami Shores Village. Master Plumber Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personal) 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 foregomg apphcation, and that he did sign the same, and that all .acts therein by him stated are true. My Conunission 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 U CAYC:: BASIN FLOOR DRAIN DRINKING FOU "T'N5 TOTAL F XTURES CONTR. LIST / J CHECK - _- SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP ,SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•G ••POOL CONTR. LIST / / ,. -- CHECK f Permit No __ _=_ _ Application i Hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th Building llI ' sion 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. Q // Owner's Name and Address- _ _ - _ _.___.--- __.____ No._�_ /{! Street _ �_C1�I° . Registered Architect and /or Engineer __ Employing Plumber's Name ___ _ No._ ___ _ __ —_ _ _ _ Street Location and Legal Description _ — _ Block ` r Subdivision_ Ai p Street and Number where work is to be performed —No / 1IQ Street _ State work to be performed and purpose of building (By Floors). _ New Building ___ -- _ _ • -. - -- .__ Remodeling_ _ -- _ -- __ _ _ _ Addition_--_ 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. ____ __ ___ _ _ _ _ __ _ Si of Soakage Pit Amount of Permit $ _ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT - (Sed)- ._+ -L.. (Signed Date `--- Repairs_ __ .. _ _ _ ___ No. of Stories _ __ .Capacity Ga:s. Pl,.mb rig In.pecto. The undersigned applicant for this building permit does hereby certify that he understands and :.cc: pts his oblif ( actions as an e nployer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppl_ment, 'n 1 I a otn plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin in the wo.k 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 no ices as are required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo under this per nit, as are licensed by Miami Shores Village. Master Plumber Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personal) 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 foregomg apphcation, and that he did sign the same, and that all .acts therein by him stated are true. My Conunission 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 NALS 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 a ' {/ AMI SHORES VILLAGE ' UMBING INSPECTION DEPARTMENT 4TION FOR PLUMBING PERMIT Date / 4 d tatement of the plans and specifications herewith submitted for the building or other ce and conformity with the Building Ordinance of Miami Shores Village, Florida, ^es of Miami Shores Village and all rules and regulations of the Building Division Ipecified or not. A copy of approved plans and specifications must be kept at _ No. / - Ni _ 1 ____ -- Street fsf&_ No._/ t_40_____ &la Street__19_,, . ,c-- - - - - -- ____ Block_ Block_ Subdivision work is to be performed—No-46i erformed —No.__ as _J _i2' s _ Street performed and purpose of building (By Floors) ---- -- -_ - Remodeling------------- _ --_ -_ Addition__ Repairs No. of Stories. Size Septic Tank � 9 Type of TanI' Capacity Gals. Feet of Drain Tile 34.1/- AIL," _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.______.______________._.__ Size of Soakage Pit ------- ---------- ------------ - ------- , Amount of Permit $ - -G - -- My Commission Expires `I ( f 7a ( Signed)_ - % Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perina nt 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 wor , to be performe4 j under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida Mastef Plumber. STATE OF FLORIDA, as. 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. 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 ............ - - -- - - -- 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 murt be kept at building during progress of work. Owner's Name and Address id' ! No._/ Registered Architect and /or En Employing Plumber's Nam State work to be performed and purpose of building (By g:oors)_ New Building -••- Remoeeling —_ .___.___- Addition Size Septic Tank- _ - ._ - - - ° -. ----- -- -__- __._Typo of Tank__ Feet of Drain Tile._._ -_ - -- - --fit. Feet of Tank or Drain Field from Well Nature of Water Supply: City -Well. _ _ .__ —_ _ _.Sizo of Soakage Pit Amount of Permit $ My CorruMseioa Ezpirea NOTE: A re-inspection fee of 31. materials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Al ®,, ©......�.,.....: Street /x, Location and Legal Description Lot Blorir Subdi S - _- Street and Number where work is to be perforred-No � � Street... fef Repairs No. of Stories (Signed) (Sed) - -- -- -- - -- - - -- The undersigned applicant for this building permit dons ILby certify that he understands and accepts his obligattonstrs an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled (General Laws of Florida Permanent Supplement, and !tar 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 undersi : ,. ed agrees to employ only such sub - contractors, on work to be performed under t permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned cutaarty, a notary pr.P lic, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me Brat duly swore, elwa ceeln deposes and says that he is the...--- .- -.. -. . ........ ......... .. . ._ _ -. of the above described constructive, that he has carefaai?y rend the foregoing application, and that he did sign the same, and that all facts therein by him stated aro true. Notary Public, State of Fkxrla Fluntl�ing Inspector.--' Master Plumber. will l k whore re.brspection is m ade • necessary by impraper notice for inspection, or faulty CLOSETS BATH TUBS SHOWERS LAMA. YORK® Py1I!'K8 SLOP SINKS LAUNDRY Tu BR t.1RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURES CONTR. LIST - CHECK SEPTIC TANK SEW.R COPQN DRAIN FIELD SOAKAGE PIT GRSASa TRAP DOLAn HEATER DAM _ WELL 8 SYSTEM SWIM'O POOL 1 CONTR. 1 LIST , CHECK 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 murt be kept at building during progress of work. Owner's Name and Address id' ! No._/ Registered Architect and /or En Employing Plumber's Nam State work to be performed and purpose of building (By g:oors)_ New Building -••- Remoeeling —_ .___.___- Addition Size Septic Tank- _ - ._ - - - ° -. ----- -- -__- __._Typo of Tank__ Feet of Drain Tile._._ -_ - -- - --fit. Feet of Tank or Drain Field from Well Nature of Water Supply: City -Well. _ _ .__ —_ _ _.Sizo of Soakage Pit Amount of Permit $ My CorruMseioa Ezpirea NOTE: A re-inspection fee of 31. materials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Al ®,, ©......�.,.....: Street /x, Location and Legal Description Lot Blorir Subdi S - _- Street and Number where work is to be perforred-No � � Street... fef Repairs No. of Stories (Signed) (Sed) - -- -- -- - -- - - -- The undersigned applicant for this building permit dons ILby certify that he understands and accepts his obligattonstrs an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled (General Laws of Florida Permanent Supplement, and !tar 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 undersi : ,. ed agrees to employ only such sub - contractors, on work to be performed under t permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned cutaarty, a notary pr.P lic, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me Brat duly swore, elwa ceeln deposes and says that he is the...--- .- -.. -. . ........ ......... .. . ._ _ -. of the above described constructive, that he has carefaai?y rend the foregoing application, and that he did sign the same, and that all facts therein by him stated aro true. Notary Public, State of Fkxrla Fluntl�ing Inspector.--' Master Plumber. will l k whore re.brspection is m ade • necessary by impraper notice for inspection, or faulty O 2- Employing Plumber's Name Size Septic Tank 7 Feet of Drain Tile_____ 3 Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. 1 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Location and Legal Description Lot.____ �____. _ ____ Block. _ Street and Number where work is to be performed —No � ' ``� ( Signed)_. (Signed). pplice.tion is hereby r.lac:e 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 ipiiami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at hui.'ding during progress of work. �+ J , � OwLe:'s Name and Address - Street Registered Architect and /or Engineer p___ -. �� t 'Y__ : -__._ Street•- 2 Subdivision Street State work to be performed and purpose of building (By Floors)__-.__________- New Building _ _.. Remodeling____ _______ Addition__._ Repairs No. of Stories ......................... e of Tank__ Capacity Gals ._Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit My Commission Expires Notary Public, State of Florida Plu g Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Sup ment, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed b him in the work to be performed uLlder 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 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•neoessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SNOWF!RS LAVA. TORIES 6 1NK5 SLOP SINKS LAUNDRY TUBS URINAL, CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST C!4ICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM 'G P001. CONTP.. LIST CHECK - -- — O 2- Employing Plumber's Name Size Septic Tank 7 Feet of Drain Tile_____ 3 Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. 1 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Location and Legal Description Lot.____ �____. _ ____ Block. _ Street and Number where work is to be performed —No � ' ``� ( Signed)_. (Signed). pplice.tion is hereby r.lac:e 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 ipiiami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at hui.'ding during progress of work. �+ J , � OwLe:'s Name and Address - Street Registered Architect and /or Engineer p___ -. �� t 'Y__ : -__._ Street•- 2 Subdivision Street State work to be performed and purpose of building (By Floors)__-.__________- New Building _ _.. Remodeling____ _______ Addition__._ Repairs No. of Stories ......................... e of Tank__ Capacity Gals ._Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit My Commission Expires Notary Public, State of Florida Plu g Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Sup ment, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed b him in the work to be performed uLlder 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 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•neoessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No.. C ' ) Amount of Permit $ STATE OF FLORIDA, I a. COUNTY OF DADE. 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_ ....)........-. ......-.4.... 1_ __._____________ No._....±L . i'- '' 4treet... - i 1 - : ----. , - , ' . . , ,-. Registered Architect and/or Engineer - — — ............ -------- ........ Employing Plumber's Name N . .1(7lt. ty st riot .f...-i--Y. Location and Legal Description Lot_ .. / g Block--L-7 —__ • Subdivision__. .._ , Street and Number where work is to be performed-NO . ' 1 'I 1 ''' '1. ' ' ' ; Street. - State work to be performed and purpose of building (By Floors)_-.____ New Building Remodeling--- Addition. Repairs.. Feet of Drain Tile _Dist Feet of Tank or Draill Field from Well Nature of Water Supply: City-Well. Size of Soakage Pit A . (Signed)- ' Plumbing Inspector. gi No. of Stories. .Capacfty Gab The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli lions as an employer of labor under the Florida Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Penn ent 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 Cr 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 perform -under this permit, as are licensed by Miami Shores Village. Mut& Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared tc 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 bas 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 inch re-inspection is made.necessary by improper notice for inspection, or faulty materials and/or workmanship. CLosrm BATH TUBS SHOWERS LAVA. TORISS S SLOP SINK S LAUNDRY Tuns URINALS CATCH BAS IM N FLOOR DRAIN DRINKING FOUNT' NS VI) Al , , ' ; k ,, d TOTAL FIXTURES LIST ' t f i . • ? a .............. SEPTIC TANK SEWER DRAIN . ID Poo FIE SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM' 0 POOL tc: • ,..-...,...... corm'. Lin ¥ i maw( Permit No.. C ' ) Amount of Permit $ STATE OF FLORIDA, I a. COUNTY OF DADE. 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_ ....)........-. ......-.4.... 1_ __._____________ No._....±L . i'- '' 4treet... - i 1 - : ----. , - , ' . . , ,-. Registered Architect and/or Engineer - — — ............ -------- ........ Employing Plumber's Name N . .1(7lt. ty st riot .f...-i--Y. Location and Legal Description Lot_ .. / g Block--L-7 —__ • Subdivision__. .._ , Street and Number where work is to be performed-NO . ' 1 'I 1 ''' '1. ' ' ' ; Street. - State work to be performed and purpose of building (By Floors)_-.____ New Building Remodeling--- Addition. Repairs.. Feet of Drain Tile _Dist Feet of Tank or Draill Field from Well Nature of Water Supply: City-Well. Size of Soakage Pit A . (Signed)- ' Plumbing Inspector. gi No. of Stories. .Capacfty Gab The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli lions as an employer of labor under the Florida Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Penn ent 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 Cr 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 perform -under this permit, as are licensed by Miami Shores Village. Mut& Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared tc 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 bas 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 inch re-inspection is made.necessary by improper notice for inspection, or faulty materials and/or workmanship. - -' CLOSETS BATH Tu•• SHOW[R LAVA. TORIaa a1NK• SLOP SINK• LAUNDRY Tuve URINALS CATCH SAWN FLOOR DRAIN DRINK NO FOUNT' NS TOTAL PIETURES CONTK. LIST CHECK — SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR HEATER DEEP WELL S . SYST[M SWING POOL CONTR. LIST CHECK .- 1 Permit No if 4 7 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 et building during progress of work. p Owners Name and Address NF 4 R Architect and /or Engineer EMP)0Ying Plumber's Iloralc■t T 1t i1a Z S P Na. . .....1trNt.._� a / Sub i�vision ' / Street . tu why a BI L to be performed —No C Str .7.7...722>___ e S 0 -,7%A !fi _ � �+ State te work to be performed and purpose of building (By Floors)._._ . �r _._. —._..— ` t. � ... MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No New Building..__._ _ _.._.........._.. Remodeling._____ -__.... ____ Addition.. _ Repairs 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 Amount of Permit 4 (Signed) _ / Gj e � z Street / .Y 5/ 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 hav com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worx to ,e performed under this permit; and will post or cause to be posted' for inspection on the site of the work public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, op -work to .�' - = oy this permit, as are licensed by Miami Shores Village. No. of Stories (Si Master Plumber. — STATE OF FLORIDA, 1 µ COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer aths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath depose. and says that he is the -_ - . - •-- • - •-- -..... _ _ of the 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 Commisaian Expires Notary Public, State of Florida NOTE: A re- inspection fee of 41.00 will be made wises moll eedospeodos Is soade•oeoewry by improper notice for impection, or faulty materials and /Or worlonaoshap. Installer STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Applicant /1"0/i4 R Permit Number c5 ' / 5 7 ' f� .2,5" - , 98 L rk /54 7 PART II - SYSTEM INSTALLATION INSPECTION AND FINAL INSTALLATION APPROVAL /)7/t/ 7?//7,,Z /)/4/J /- /57/• /c " Manufacturer P Tank material Propertank legend: Yes Tankswatertight: Yes Proper tank outlet device: Length Width feet feet feet feet feet feet Total = No Yes L ' No Drainfield Trench ft Total = Systems located as permitted: Yes V No Systems including plumbing stub -outs installed at proper elevation: Yes No fr Average depth to drainpipe invert from finished grade: � f l' inches lit 1 A depth of drainfield gravel I "� - inches Minimum depth of gravel• _ inches Proper gravel size: Yes V No Backfill or fill material as required: (Quality) Yes I Other findings Inspected by: F iII - N LINS'J Date -1- �' �`� pproved by: HRS —H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744 -002- 4016.0) Tank size �s ��� gallons gallons gallons Manhole or marker to grade: Yes No Length feetx feet= /C ft Length Width feet feet Length .2 C feet x 4, feet = 1i 7 ft feet feet feet feet Proper pipe separation: Yes V No 3 ft Distribution box level: Yes No /V� No .A77 Proper No. drainlines: Yes No Maximum depth Gravel is suitable quality: Yes 1 (Quantity) Yes Absorption Bed No AN APPROVED INSTALLATION DOES NOT GUARANTEE PERFORMANCE Tank level: Yes No No Inches Date J Note: Completed copies of this form will be provided to the applicant, installer and the building department. 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