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PLUMBINGPermit No. ____` T LQ Owner's Name and Address Amount of Permit $ 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 Divisior 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 wor 7 • Registered Architect and /or Engineer Employing P;lglili is Name Location and Legal Description Lot_- Street and Number where work is to be performed -No 2" — G _ - - v L - - p j A treat State work to be performed and purpose of building (By Floors) _h dw y S -w•. New Building Remodeling Addition Repairs No. of Stories rimirk* co D O No.. /'2 6 Street N L 7 ' x" Block (Signed). No 3 79 / Date Street Subdivision 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 v i t w d t #"_._ Size of Soakage Pit (Signed) Plumbing Inspector. The undersigned applicant for this building perm' : oes hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, • ng Section 5986, Compiled General Laws of Florida Perinanent 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. ,oz,1114.-.6.(/ My Commission Expires Notary Public, State of Florida MwwM. STATE OF FLORIDA, COUNTY OF DADE. J 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. 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 TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURE, CONTR. UST _ __ CHECK TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM 'G POOL CONTR. LIST CHECK Permit No. ____` T LQ Owner's Name and Address Amount of Permit $ 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 Divisior 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 wor 7 • Registered Architect and /or Engineer Employing P;lglili is Name Location and Legal Description Lot_- Street and Number where work is to be performed -No 2" — G _ - - v L - - p j A treat State work to be performed and purpose of building (By Floors) _h dw y S -w•. New Building Remodeling Addition Repairs No. of Stories rimirk* co D O No.. /'2 6 Street N L 7 ' x" Block (Signed). No 3 79 / Date Street Subdivision 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 v i t w d t #"_._ Size of Soakage Pit (Signed) Plumbing Inspector. The undersigned applicant for this building perm' : oes hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, • ng Section 5986, Compiled General Laws of Florida Perinanent 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. ,oz,1114.-.6.(/ My Commission Expires Notary Public, State of Florida MwwM. STATE OF FLORIDA, COUNTY OF DADE. J 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. 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. 1111111M Pew; d of Dr Permit No 05:57 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 b 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. w / 1 /l Owner's Name and Address u 1 /4/ �Q �; •" le /je • Registered Architect and /or Epgineer / II I rr1 I in aw sC sL o �,, ig and Legal p on Lot �otr Bksllt �J Subdi State work to be performed and purpose of building (By Flom) __._ e-4 -V_Pn A r 1 et-C) • .._._ Street and Number where work is to be performed —No New Building- -_ - - -_ -- .- _....... - -._.. Remodeling__ - -. __ ._— Addition. Size Septic Tank—. Feet of Drain Tile 3OO l 1 Nature of Water Supply: City—We1L Amount of Permit $-2-fiS 9 My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (SI No. ) 24 d (Signed)__ ‘V.IV;30N, St 9T s7 Notary Public, State of Floefde Repairs No. of Stories ...... .......... -Type of Tank-- —Dist Feet of Tank or Drain Field from Well..._.__. ----._. ...-- .-- •... _---- •--- ...... _._. Size of Soakage Pit Plumbing Impector. 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 lave 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 . 9 such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work • perf • . under this permit, as are licensed by Miami Shores Village. 1/ Master Plumber. STATE OF FLORIDA, I w 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 be is the • -_ - - -...- - - of the the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be shade when such misspeotlan is asede.neoassery by improper notice far bsepection, or faulty materials and /or workmanship. CLosrrs BATH TUs• SHOWIER/ LAVA- TORNIO "KS SLOP LAUNOR URINALS CATCH /LOON DRINK! NO TOTAL CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAOt PIT G TRAP SOLAR MEATIER MCP WILL IPRKLR. a N SW IM'0 POOL CONTR. tier CHECK Permit No 05:57 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 b 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. w / 1 /l Owner's Name and Address u 1 /4/ �Q �; •" le /je • Registered Architect and /or Epgineer / II I rr1 I in aw sC sL o �,, ig and Legal p on Lot �otr Bksllt �J Subdi State work to be performed and purpose of building (By Flom) __._ e-4 -V_Pn A r 1 et-C) • .._._ Street and Number where work is to be performed —No New Building- -_ - - -_ -- .- _....... - -._.. Remodeling__ - -. __ ._— Addition. Size Septic Tank—. Feet of Drain Tile 3OO l 1 Nature of Water Supply: City—We1L Amount of Permit $-2-fiS 9 My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (SI No. ) 24 d (Signed)__ ‘V.IV;30N, St 9T s7 Notary Public, State of Floefde Repairs No. of Stories ...... .......... -Type of Tank-- —Dist Feet of Tank or Drain Field from Well..._.__. ----._. ...-- .-- •... _---- •--- ...... _._. Size of Soakage Pit Plumbing Impector. 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 lave 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 . 9 such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work • perf • . under this permit, as are licensed by Miami Shores Village. 1/ Master Plumber. STATE OF FLORIDA, I w 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 be is the • -_ - - -...- - - of the the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be shade when such misspeotlan is asede.neoassery by improper notice far bsepection, or faulty materials and /or workmanship. Applicant /CP %19 PART II - SYSTEM INSTAL Installer !� Proper tank legend: Yes No Tanks watertight: Yes No Tank size Proper tank outlet device: Yes At. No Drainfield Trench Other findings: Add Inspected Date 4pproved by: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Pe unit Number S6J T .' INSPECTION AND FINAL INSTALLATION APPROVAL Tank Manufacturer /� /if H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) Number. 5744-002-4016-0) Tank materialC, Tank level: Yes Manhole or marker to grade: Yes PART III - FINAL I STALLATION APPROVAL Absorption Bed AN APPROVED INSTALLATION DOES NOT GUARANTEE PERFORMANCE 0 gallons gallons gallons No Length width Length width Lengths ,-2. feetx 1 feet = /2 ft feet feet feet feet Length feet x feet= = ft feet feet feet feet Proper No. drainlines: Yes No feet feet feet feet Proper pipe separation: Yes No Total = ft Total = ft Distribution box level: Yes No Systems located as permitted: Yes IV No Systems including plumbing stub-outs installed at proper elevation: Yes No �/ Average depth to drainpipe invert from finished grade/ 7 inches Maximum depth:c . � L Inches Average depth of drainfield gravel ) 3 inches Minimum depth of gravel L inches Proper gravel size: Yes 1 No Gravel is suitable quality: Yes '' No Backfill or fill material as required: (Quality) Yes No (Quantity) Yes `, No Date ‘ a COt3F1TY PUBLIC HEALTH U )te: Completed copies of this form will be provided to the applicant, installer and the building department. Page 2 of 2 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 • i l ay) G - No _ 6 0 ,,,,..77E9F5 Registered Architect and /or «eeee . - J oc ROn� Le g . -�•, Lot r Street and Number where work is to be performed —No State work to be performed and purpose of buckling (By FIo s)__._._. 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 —Wells Size of Soakage Pit. Amount of Permit $ / a6-- (Signed)_S-.1. No. of Stories y1i ... Na,.� . .. Itrse._. Bloom v ubdlvWou &/ - //�t' .�s�/f Yee �� ___2 PP► ! ......!.t'!- vP, 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 Ceneral Laws of Florida Pennanent Supplement, and liav com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to he performed under this permit; and will post or cause to be posted for inspection on the site of the public notice or notices as arT• required by the Act. The undersigned agrees to employ only such sub- contractors, on work to ormed Dieu this permit, as are licensed by Miami Shores Village. ( Si STATE OF FLORIDA, 3 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 • Muter Plumber. NOTE: A re- inspection fee of $1.00 will be mad. when .snob r laspaotioa Is made - aaoaasary by Improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH TuaS aHOWERn LAVA. Tom'. LIN KS INKS BLOT LAUNDRY Tuns URINALS CATCH BAS FLOOR DRAIN DRINKI NO FOUNT' NO TOTAL •IKTURES Comm. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN PHILO SOAKAGE PIT G TRAP SOLAR HEATER DEEF WELL SPRKLR. • SW IM'O POOL CONY*. LIST CHICK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 • i l ay) G - No _ 6 0 ,,,,..77E9F5 Registered Architect and /or «eeee . - J oc ROn� Le g . -�•, Lot r Street and Number where work is to be performed —No State work to be performed and purpose of buckling (By FIo s)__._._. 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 —Wells Size of Soakage Pit. Amount of Permit $ / a6-- (Signed)_S-.1. No. of Stories y1i ... Na,.� . .. Itrse._. Bloom v ubdlvWou &/ - //�t' .�s�/f Yee �� ___2 PP► ! ......!.t'!- vP, 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 Ceneral Laws of Florida Pennanent Supplement, and liav com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to he performed under this permit; and will post or cause to be posted for inspection on the site of the public notice or notices as arT• required by the Act. The undersigned agrees to employ only such sub- contractors, on work to ormed Dieu this permit, as are licensed by Miami Shores Village. ( Si STATE OF FLORIDA, 3 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 • Muter Plumber. NOTE: A re- inspection fee of $1.00 will be mad. when .snob r laspaotioa Is made - aaoaasary by Improper notice for inspection, or faulty materials and/or workmanship.