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PLUMBINGEr. W. R. Bradford Plumbing Inspector Village of Liam! Shores Florida MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date S!'�pti_�Snbei - -- -s__ -- 1.9 63_._ Application is hereby ma lie 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 walk. Dog" Pot Shop Owner's Name and Address__N r a_a11ff11lagilt____- ---- ___ -_— No.. 12_ _R.___E.. Street__ 98th. Street Registered Architect and /or Engineer 1' ..( - L.y?l__.P113YIliail __Reply 1' __�d�1t - • - t - _IIID� Employing Plumber's Name Mid-_L 1L P nmhi rig Rep Dept No. __ a__w_ DixiArealighwa ____ Permit No. Location and Legal Description Lot__ Street and Number where work is to be performed— No.__,?12. ....-q8 t$ treet____M iaxtli ---ShOpe3,- .__F18._____ -__ State work to be performed and purpose of building (By Floors )___Set___Rat TuIh_ New Building __ Remodeling_ —_- X_ _ ____ Addition________._ Repairs Bloo>< Subdivision Size Septic Tank Feet of Drain Tile Nature of Water Supply: City — Well._ Amount of Permit $ 2.00 STATE OF FLORIDA, COUNTY OF DADE. Type of Tank _Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit (Signed)- No. of Stories. Capacity Gals 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 nctice 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. Plumbing Inspector. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Floyd J_ Chaatai n__p_f_ ri —TT13 P], in _Inc 4 , to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ master plumber 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 s Mu Gl . al Large My Commission Expires Nov. 2, 1965 My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made' necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES S INKS SLOP SINKS LAUNDRY TU88 URINALS CATCH BASIN FLOOR DRAIN DRINKI NG FOU NT' NS TOTAL FIXTURES CONTR. LIST CHECK 1 -_ 1 SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK _ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date S!'�pti_�Snbei - -- -s__ -- 1.9 63_._ Application is hereby ma lie for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of walk. Dog" Pot Shop Owner's Name and Address__N r a_a11ff11lagilt____- ---- ___ -_— No.. 12_ _R.___E.. Street__ 98th. Street Registered Architect and /or Engineer 1' ..( - L.y?l__.P113YIliail __Reply 1' __�d�1t - • - t - _IIID� Employing Plumber's Name Mid-_L 1L P nmhi rig Rep Dept No. __ a__w_ DixiArealighwa ____ Permit No. Location and Legal Description Lot__ Street and Number where work is to be performed— No.__,?12. ....-q8 t$ treet____M iaxtli ---ShOpe3,- .__F18._____ -__ State work to be performed and purpose of building (By Floors )___Set___Rat TuIh_ New Building __ Remodeling_ —_- X_ _ ____ Addition________._ Repairs Bloo>< Subdivision Size Septic Tank Feet of Drain Tile Nature of Water Supply: City — Well._ Amount of Permit $ 2.00 STATE OF FLORIDA, COUNTY OF DADE. Type of Tank _Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit (Signed)- No. of Stories. Capacity Gals 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 nctice 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. Plumbing Inspector. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Floyd J_ Chaatai n__p_f_ ri —TT13 P], in _Inc 4 , to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ master plumber 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 s Mu Gl . al Large My Commission Expires Nov. 2, 1965 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.