PLUMBINGMIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Permit No 1 ._. 2-
Owner's Name and Address
y ^ /-�
-- - __ S-'___- -- •--- -•__ -- No._— ----- — Street
Registered Architect and /or ---------- - -- —_ - - -- --------- --- - --._____ ..-- .--------- -.--- -•---- - - - - -. /
Employing Plumber's Name 'Si' �1� eicr 7! 5gee re S No.__ — S'g __-__ Street4 •.
Location and Legal Description Lot_____— —.—. — Block
Street and Number where work is to be performed —No / Z 4
State work to be performed and purpose of building (By Floors)_____ _ _ _ _ . _- _
New Building __ —_ ___ Remodeling-- ____ —_ Addition__ __._._ Repairs No. of Stories_ .
Size Septic Tank
Feet of Drain Tile______ list. Feet of Tank f or Drain Field from Well
Z Gv� L C X' _ Size of Soakage Pit
Nature of Water Supply: City —Well
Amount of Permit $ - - - - 0
My Commission Expires
(Signed)
Subdivision- -- -- -- -----_-_ __ ........
z ----
9s s 2 _
Street
Type of Tank— Capacity Gals
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 5988, 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 are
required by the Act. The undersigned agrees to employ only such sub- contracto on work to be performed u r permit, are
licensed by Miami Shores Village. , , •
( Signed).. CtililA a�
Notary Public, State of Florida
1 4- 1
aster Plumber.
STATE OF FLORIDA, t is.
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 by improper notice for inspection, or faulty
materials and /or worlananship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N5
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
COHTR.
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Permit No 1 ._. 2-
Owner's Name and Address
y ^ /-�
-- - __ S-'___- -- •--- -•__ -- No._— ----- — Street
Registered Architect and /or ---------- - -- —_ - - -- --------- --- - --._____ ..-- .--------- -.--- -•---- - - - - -. /
Employing Plumber's Name 'Si' �1� eicr 7! 5gee re S No.__ — S'g __-__ Street4 •.
Location and Legal Description Lot_____— —.—. — Block
Street and Number where work is to be performed —No / Z 4
State work to be performed and purpose of building (By Floors)_____ _ _ _ _ . _- _
New Building __ —_ ___ Remodeling-- ____ —_ Addition__ __._._ Repairs No. of Stories_ .
Size Septic Tank
Feet of Drain Tile______ list. Feet of Tank f or Drain Field from Well
Z Gv� L C X' _ Size of Soakage Pit
Nature of Water Supply: City —Well
Amount of Permit $ - - - - 0
My Commission Expires
(Signed)
Subdivision- -- -- -- -----_-_ __ ........
z ----
9s s 2 _
Street
Type of Tank— Capacity Gals
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 5988, 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 are
required by the Act. The undersigned agrees to employ only such sub- contracto on work to be performed u r permit, are
licensed by Miami Shores Village. , , •
( Signed).. CtililA a�
Notary Public, State of Florida
1 4- 1
aster Plumber.
STATE OF FLORIDA, t is.
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 by improper notice for inspection, or faulty
materials and /or worlananship.
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Permit No./ 1___./_
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, whey , �erein specified or not. A copy of approved plans and specifications must be kept t
building during progress of work.
Owner's Name and Address
Registered Architect and /or En
Employing Plumber's Name.__
Location and Legal Description Lot_
Street and Number where work is to be performed— No.___— ____.___._____ _ _ _____ Street
State work to be performed and purpose of building (By Floors) _______________
New Building _-__ -- Remodeling_ — ____ -_ Addition
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply / City —Well
Amount of Permit $ 2 1 c �
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No E__ _/Ya eet
_____ Block
ci Street_
-- -
Subdivision
Repairs No. of Stories.
_Type of Tank Capacity Gals
. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed) - - — 1 - -- ----a
Date
691
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 petit, as are
licensed by Miami Shores Village.
(Signed)._
r
Master P9umbei.
STATE OF FLORIDA, t 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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWER!
LAVA-
TORIES
INK
SINKS
SLOP
SINKS
LAUNDRY
Tuns
U
CATCH
BASIN
'FLOOR
DRAIN
DRINKING
FOUNT'N6
TOTAL
FIXTURES
CoNTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LI$T
CHECK
Permit No./ 1___./_
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, whey , �erein specified or not. A copy of approved plans and specifications must be kept t
building during progress of work.
Owner's Name and Address
Registered Architect and /or En
Employing Plumber's Name.__
Location and Legal Description Lot_
Street and Number where work is to be performed— No.___— ____.___._____ _ _ _____ Street
State work to be performed and purpose of building (By Floors) _______________
New Building _-__ -- Remodeling_ — ____ -_ Addition
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply / City —Well
Amount of Permit $ 2 1 c �
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No E__ _/Ya eet
_____ Block
ci Street_
-- -
Subdivision
Repairs No. of Stories.
_Type of Tank Capacity Gals
. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed) - - — 1 - -- ----a
Date
691
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 petit, as are
licensed by Miami Shores Village.
(Signed)._
r
Master P9umbei.
STATE OF FLORIDA, t 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.
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.