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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. xm : \ } : ) \ ate va ( Ack � ) � # 3 xy » §� ..., . \ ■ > \ ? « w w »+ I. ? 5 ?»« m « :: « . \ } t ! 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.