347 NE 98 St (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 1)-2S ' Job Address 04-7 , /' Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant de d- - � Master Permit #
Owners Address
Lfa-17
Phone ,( 7S /- 31 c' O
kit / rf 30 .(/ G(/ 11 L�
Contracting Co. �,/�. 1.� um/ (.(/G�'�� �/ /N � Address y d 7 ,,b R. AA tf7,rq 1'
C 1 O Ai 7 A ,/.C Z SS# r,Phone V-3 y
Qualifier
State # (/ Municipal # Competency #S(1 ) b //6 Sens. Come 4)Lt1R y 016146/4% 6
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
MECHANICAL ROOFING PAVING FENCE SIGN
Permit Type (circle one): BUILDING ELECTRICAL
/1 /N ,k/f t J4 //
WORK DESCRIPTION
Square Ft Estimated Cost (value) 6 6 O
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/t" ondo Pr sident Date
Notary as to Owner and/or Condo President Date c�
<. Sfe�; - ":t . M ,
ietlEce, a CC4012
i' MY COMMISSION f.
� � F O F 0- AUG. 1711998 �..
FEES: PERMIT 1 7S — RADON
APPROVED:
Zoning Building
Mechanical
Signature of Contra
Notary as to Contractor or Owner - Builder
My Commission Expires:
O \t Po OFFICIAL NOTARY SEAL
� SANDRA M MONTIEL
COMMISSION NUMBER
... 'r CC401261
��„q M Y COMMISSION ION •EXP.
e OF F4
AUG, 1 990
C.C.F. ' 6r) NOTARY
der Date
Date
l/ / cr747
BOND
TOTAL DUE 5-0,
3 67
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. ,
- Ifil" street,
//2. �! No. _3 7_..__ Street//�t
Owner's Name and Address ._ - -- .._ -__w __
Registered Architect and /or Engineer . - - - - -- _ - -__ _
Employing Plumber's Name -k �'
Location and Legal Description
Street and Number where work B to be performed —No
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 Suppl 4
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
f - o.__ AEI Street- Z/1<Y°. 49 5/9° C
Subdivision-- CX L -- 5
U 7 street.... "A.LF._ 57 r)
.Type of Tank_
__Dist. Feet of Tank or Drain Field from Well
Well _ ----- _---- -_ - -.. _....._ - - -- _ _ -- -Size of Soakage Pit
a
•
Date.
Repairs No. of Stories.
Capacity Gals
CIO
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts : •bligations as an employer of labor
under the Florida Worlanen's Compensation Act, being Section 5988, Compiled `''mineral Laws of Florida - nanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all co>tractors or sub - contract.' ; 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 lag Miami Shores Village.
(Signed C.
C.
Mader 1 lumber.
STATE OF FLORIDA, I
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to adrr'nister oaths and take acknowledgments, personally appeared
to me well blown, and who, being by me first duly sworn, upon oath deposes and.sakys 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 de necessary by improper notice for inspection, or faulty
materials and /or workmanship.
L9
CLOB
fZ6'I
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
UR
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
'�/
/.1 M/
TOTAL
FIXTURES
C 2
LIST
CM=
/
/
_____#
---_
SEPTIC
TANK
SEWER
CONK.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
l
CoRTR.
LIST
- 1
_
CHECK
3 67
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. ,
- Ifil" street,
//2. �! No. _3 7_..__ Street//�t
Owner's Name and Address ._ - -- .._ -__w __
Registered Architect and /or Engineer . - - - - -- _ - -__ _
Employing Plumber's Name -k �'
Location and Legal Description
Street and Number where work B to be performed —No
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 Suppl 4
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
f - o.__ AEI Street- Z/1<Y°. 49 5/9° C
Subdivision-- CX L -- 5
U 7 street.... "A.LF._ 57 r)
.Type of Tank_
__Dist. Feet of Tank or Drain Field from Well
Well _ ----- _---- -_ - -.. _....._ - - -- _ _ -- -Size of Soakage Pit
a
•
Date.
Repairs No. of Stories.
Capacity Gals
CIO
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts : •bligations as an employer of labor
under the Florida Worlanen's Compensation Act, being Section 5988, Compiled `''mineral Laws of Florida - nanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all co>tractors or sub - contract.' ; 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 lag Miami Shores Village.
(Signed C.
C.
Mader 1 lumber.
STATE OF FLORIDA, I
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to adrr'nister oaths and take acknowledgments, personally appeared
to me well blown, and who, being by me first duly sworn, upon oath deposes and.sakys 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 de necessary by improper notice for inspection, or faulty
materials and /or workmanship.
L9
5
t J
L
J
e3
Permit No
Applical ion 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. P. 4 . CLI A-
Stobbs .. Cortst. CO.
Owner's Name and Address_ ... No. Street
Registered Architect and/or Engineer.____
Rose Septic Tank No.. 2 W; lrd Ave.
Employing Plumber's Name Street
Location and Legal Description Lot. __________— Block
Street and Number where work is to be performed—No 37 Street N.E. 98th St.
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
Nature of Water Supply: ..... _ of Soakage Pit
800 Gal.
38 Blk. Dr
Amount of Permit $
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank_
Dist. Feet of Tank or DraM Field from Well
12/51/61
Date
Subdivision
Predast Capacity Gals 800 Gal.
( Signed)_
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 permit, as are
licensed by Miami Shores Village.
ihC)-
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. a
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.
Notary PubIlc, 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.
CLOBBTO
BATH
'Nos
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
Comm.
LIST
CHB=
---,-
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW I M *0
POOL
CGMTR.
UST
CHECK
---
Permit No
Applical ion 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. P. 4 . CLI A-
Stobbs .. Cortst. CO.
Owner's Name and Address_ ... No. Street
Registered Architect and/or Engineer.____
Rose Septic Tank No.. 2 W; lrd Ave.
Employing Plumber's Name Street
Location and Legal Description Lot. __________— Block
Street and Number where work is to be performed—No 37 Street N.E. 98th St.
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
Nature of Water Supply: ..... _ of Soakage Pit
800 Gal.
38 Blk. Dr
Amount of Permit $
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank_
Dist. Feet of Tank or DraM Field from Well
12/51/61
Date
Subdivision
Predast Capacity Gals 800 Gal.
( Signed)_
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 permit, as are
licensed by Miami Shores Village.
ihC)-
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. a
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.
Notary PubIlc, 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.
.emit No._
Application is hereby nw.i.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 Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kcp
building during progress of w
Owner's Name and Address... t/_ _ 1 C e % d-' C A/ No._ Street
Registered Architect and /or Eng' eer_.__._______
Shell c 6e /�� �, �y_ c 10._ o- 2i tit/ / �-
Employin s Name - -. e... C ` � �• _ : _._ — Street�_g C 4
Location and Legal Description Lot._.__ _ _______ _._______ Block_ _ Subdivision
Street and Number where work is to be performed -No 7 '' `x'. _. St `Z ___^
State work to be performed and purpose of building (By Floors)... 1
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank.
Date
reet
New Building .- __ -__- Remodeling__________- _ -_._. Addition_------- •-- -- ---- - ----- Repairs No. of Stories. _
Size Septic Tank______ ...... _ -__
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City -Well.
Capacity Gals.
__Size of Soakage Pit
(Signed).
My Commission Expires Notary Public, State of Florida
mbing nspecto
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent S •p'-ment, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe • - y im 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 ; publ otice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be rmed der 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•necessary by improper notice for inspection, or faulty
materials and /or worlananship.
'''S.
CLOOaT6
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
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
SW IM'O
POOL
CONTR.
LICIT
CHECK
.emit No._
Application is hereby nw.i.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 Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kcp
building during progress of w
Owner's Name and Address... t/_ _ 1 C e % d-' C A/ No._ Street
Registered Architect and /or Eng' eer_.__._______
Shell c 6e /�� �, �y_ c 10._ o- 2i tit/ / �-
Employin s Name - -. e... C ` � �• _ : _._ — Street�_g C 4
Location and Legal Description Lot._.__ _ _______ _._______ Block_ _ Subdivision
Street and Number where work is to be performed -No 7 '' `x'. _. St `Z ___^
State work to be performed and purpose of building (By Floors)... 1
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank.
Date
reet
New Building .- __ -__- Remodeling__________- _ -_._. Addition_------- •-- -- ---- - ----- Repairs No. of Stories. _
Size Septic Tank______ ...... _ -__
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City -Well.
Capacity Gals.
__Size of Soakage Pit
(Signed).
My Commission Expires Notary Public, State of Florida
mbing nspecto
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent S •p'-ment, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe • - y im 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 ; publ otice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be rmed der 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•necessary by improper notice for inspection, or faulty
materials and /or worlananship.
'''S.
42.50
Permit No Z (4_
MIA IA SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLIC :TION FOR PLUMBING PERMIT
Date January 22, 196
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_- D s_.. - .___.. . No. 3 J' — 98 Street
Registered Architect and /or Engineer ..... _______ - ------ ------ -- --- .__ -- — " Der.
Employing Plumber's Name DADE GAS COMPANY No..6940-_ 2 Street
Location and Legal Description Lot__ Block Subdivision
-
Street and Number where work is to be 4 performed— No.... 8 St
..� 7_ NO ��_ _ - Street
State work to be performed and purpose of building (By Floors)--- _----------------- ___ -._
New Building Remodeling —___ __-___ - -- Addition Repairs
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $ 2 °5O
STATE OF FLORIDA, t se.
COUNTY OF DADE. Q
__ -.— (Signed)_
(Signed)._
My Conunission Expires Notary Public, State of Florida
No. of Stories.... ......... ......
Type of Tank Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accep is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori 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" : er this permit, as are
licensed by Miami Shores Village.
M er 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 'necessary by improper notice for inspection, or faulty
materials and /oar worknannchip.
CLOBa TB
BATH
TUBS
SHOWERS
O
LAVA-
TORIES
SINKS
N
SLOP
SINKS
LAUNDRY
TUBS
INALS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
LOGS
TOTAL
FIXTURES
CoNTR.
LIST
2
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LOOT
--
-
CHECK
42.50
Permit No Z (4_
MIA IA SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLIC :TION FOR PLUMBING PERMIT
Date January 22, 196
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_- D s_.. - .___.. . No. 3 J' — 98 Street
Registered Architect and /or Engineer ..... _______ - ------ ------ -- --- .__ -- — " Der.
Employing Plumber's Name DADE GAS COMPANY No..6940-_ 2 Street
Location and Legal Description Lot__ Block Subdivision
-
Street and Number where work is to be 4 performed— No.... 8 St
..� 7_ NO ��_ _ - Street
State work to be performed and purpose of building (By Floors)--- _----------------- ___ -._
New Building Remodeling —___ __-___ - -- Addition Repairs
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $ 2 °5O
STATE OF FLORIDA, t se.
COUNTY OF DADE. Q
__ -.— (Signed)_
(Signed)._
My Conunission Expires Notary Public, State of Florida
No. of Stories.... ......... ......
Type of Tank Capacity Gals
_Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accep is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori 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" : er this permit, as are
licensed by Miami Shores Village.
M er 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 'necessary by improper notice for inspection, or faulty
materials and /oar worknannchip.