351 NE 98 St (6)BUILDING ❑
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
❑ PERMIT N? 14359
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER"
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No
Amt. of
Permit $ ;
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
I►
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of 'i'a
Building
MIAMI SHORES VILLAGE, FLORIDA
❑ DATF. , ,, J
195 •
❑ PERMIT ' '? 11585 Contractor's
I License No
❑ Work to be performed under this Permit
Architect
"
Contractor
or Builder o ' * *�
Legal Lot II BL
Description
Address of v - =- _ Y.
Building ,' .
CONTRACTOR OR BUILDER
Subdi-
vision
Value of
Project $
Amt. of
Permit $
BY AUTHORITY
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the,-plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named aboie assumes the rdsponsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or dray+in'gs or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
'INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this. permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BUILDING ❑
ELECTRICAL ❑ PERMIT o
PLUMBING N. 8526
ROOFING
MIAMI SHORES VILLAGE. FLORIDA
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
Address of
Building
CONTRACTOR OR BUILDER
Bl.
Work to be performed under this Permit ='
Subdi-
vision
DATE
Sq. Ft
Value of
Project $
Contractor's ,
License No
v
Amt. of
Permit $
BY AUTHORITY
195
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed - BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BUILDING ❑
ELECTRICAL ❑ PERMIT
PLUMBING Q N9 9578
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
•
Lot
e
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Bl.
Work to be performed under this Permi
4
Subdi-
vision
BY
DATE
Sq. Ft
Value of
Project $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees. •xt
Signed (- BY
f 3 ' gNSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities, of Miami Shores Village.
In accepting this permit I assume ,responsibility for all work done by either, myself, my agent 's rvant or employee.
f1
1 ; �t � - .• 1" 1X q �p f f ^ �� ". � �.:,.f� t�d11_ f l�
Contractor's
License No
Amt. of
Permit $
AUTHORITY
195/
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Legal Lot
1
Description 1 Bl
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT xU 8567
Owner of y 4
Building ._ 4a ,
Architect
Contractor
or Builder
Work to be performed under this Permit
.7
4
Date
Contractor's
License No.
Subdi-
vision
Sq. Ft.
Value of 11 Amount of
Project $ Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether, shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or mployeetr
Signed• 4 '(INSPTOR BY
In consideration of the issuance to me of this permit I agre ,'o perform the work covered hereunder in compliance with all ordinances and regulations
pertaining theret _ nd in strict conformity with the plans, drawin s,statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting tl?'ii p snit esponsibility for all work do e•-by either, myself, my agent, servant or employee.
/CON FRACTO ILDER BY AUTHORITY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING
ELECTRICAL
• PLUMBING
Owner of
Building
CONTRACTOR OR BUILDER
PERMIT N9 4703
Work to be performed under this Permit
Architect ("
�
Contractor e -,
or Builder � � 7 w ff r .
Legal Lot Sub di
Description / o // C - / vision /2
. Address of f- F / Value of Amt. of �/ 7 ` . �--
Building �� r :/ �/ / , ( '� - / Project Permit
T his permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
� . /4, ,
6 By ` /�..s5
INSPECTOR i
•
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with rdinances andi.egplatsons''
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authont7 of Miami Shoe § - Vitfl'age.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
Signed.
Ad d s-r
BY
DATE
Contractor 8
.License No. /' /
0 9 a
AUTHORITY
194_0
4 •7
Permit No �/ s�__s 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.
Owner's Name and Address �
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEN'
APPLICATION FOR PLUMBING ° "'K WIT
/ / e >
Registered Architect and /or Engineer_ - - -- - lL -'
Employing Plumber's Name /! a ___ -(_ _ -- ___.- -� hVo._ -__.._ Street
_--. -
Location and Legal Description Lot_____ ___ _________ _- _____ _-- ...... _ -_ ____/ —J B ock_- Subdivision ......._____
Street and Number where work is to be performed- No.___ n ' 7 b"!_' i , __ Street_
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition______- Repairs No. of Stories...
Capacity Gals
Size Septic Tank /� T
/
Feet of Drain Tile__) ��4k =.__ Dist. Feet stf Tank or Drain Field from Well
Nature of Water Supply: City-Well .......... -_ ______ _. ...... _- _- ______________ ___ ------Size of Soakage Pit
Amount of Permit $ ! � - - -- - - -- - - -- (Signed)_ _C yf•d =. � ��n ��
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.
(Signed)._ , 7,
Master Plumber.
STATE OF FLORIDA,
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 Conunission 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
TUBE
SHOWERS
LAVA-
TORIEB
SINK B
SLOP
SINKS
LAUNDRY
Tues
R INALB
URINALS
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
SWIM'G
POOL
CONTR.
LIST
CHECK
4 •7
Permit No �/ s�__s 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.
Owner's Name and Address �
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEN'
APPLICATION FOR PLUMBING ° "'K WIT
/ / e >
Registered Architect and /or Engineer_ - - -- - lL -'
Employing Plumber's Name /! a ___ -(_ _ -- ___.- -� hVo._ -__.._ Street
_--. -
Location and Legal Description Lot_____ ___ _________ _- _____ _-- ...... _ -_ ____/ —J B ock_- Subdivision ......._____
Street and Number where work is to be performed- No.___ n ' 7 b"!_' i , __ Street_
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition______- Repairs No. of Stories...
Capacity Gals
Size Septic Tank /� T
/
Feet of Drain Tile__) ��4k =.__ Dist. Feet stf Tank or Drain Field from Well
Nature of Water Supply: City-Well .......... -_ ______ _. ...... _- _- ______________ ___ ------Size of Soakage Pit
Amount of Permit $ ! � - - -- - - -- - - -- (Signed)_ _C yf•d =. � ��n ��
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.
(Signed)._ , 7,
Master Plumber.
STATE OF FLORIDA,
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 Conunission 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.
4 MIAMI SHORES VILLAGE
appeared
Permit No
Owner's Name and Address
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.
Size Septic Tank__
Feet of Drain Tile...
Amount of Permit $____
STATE OF FLORIDA,
COUNTY OF DADE.
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
My Commission Expires
No . Street._
Registered Architect and /or Engineer l r.G_z_!?.r':,
Employing Plumber's Name _______f_ \ e -� , , _ c'
Location and Legal Description Lot — _t^_P�-__ __4_________ _Block
Street and Number where work is to be performed —No 3 ___re`/j % —_7F
State work to be performed and purpose of building (By Floors)
New Building_____--- ___.__— ______ Remodeling __ Addition.______
di
i Street
Type of Tank — Capacity
Dist. Feet of Tank. or Drain Field from Well_____—
Date__. _ "_�-J..
Nature of Water Supply: City—Well....., 2-e Size of Soakage Pit
c r �
(. _2r2(:22 Street – ��!� ! C
Repairs —___ No. of Stories_______ .......
.(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 d sych public notice or notjces as are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be i:rform under tl]is' pe fiIt, as are
licensed by Miami Shores Village. ��; c/ �� 1
(Signed) r - + —
Master Plum r.j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
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 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
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
n
(�
Q
,/
D
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
�/
p /Aa
CHECK
4 MIAMI SHORES VILLAGE
appeared
Permit No
Owner's Name and Address
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.
Size Septic Tank__
Feet of Drain Tile...
Amount of Permit $____
STATE OF FLORIDA,
COUNTY OF DADE.
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
My Commission Expires
No . Street._
Registered Architect and /or Engineer l r.G_z_!?.r':,
Employing Plumber's Name _______f_ \ e -� , , _ c'
Location and Legal Description Lot — _t^_P�-__ __4_________ _Block
Street and Number where work is to be performed —No 3 ___re`/j % —_7F
State work to be performed and purpose of building (By Floors)
New Building_____--- ___.__— ______ Remodeling __ Addition.______
di
i Street
Type of Tank — Capacity
Dist. Feet of Tank. or Drain Field from Well_____—
Date__. _ "_�-J..
Nature of Water Supply: City—Well....., 2-e Size of Soakage Pit
c r �
(. _2r2(:22 Street – ��!� ! C
Repairs —___ No. of Stories_______ .......
.(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 d sych public notice or notjces as are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be i:rform under tl]is' pe fiIt, as are
licensed by Miami Shores Village. ��; c/ �� 1
(Signed) r - + —
Master Plum r.j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
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 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.
_ io A c.E-
Permit No. ____ h
Application is hereby ma a for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othel
structure herein describe . This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of th 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 al
building during progress of work. �
Owner's Name and Address- /1 1 ' G /JE - -IV No 3 o (/l% r �/°- Street ?, 1/ _ °.
Registered Architect and /or Engineer _ _ y
Employing Plumber's Name_� /_ -J_ /A.g. - 1eek. .P.Pc..2 No /--,/ Street- - - -_ _ 6 ..
Location and Legal Description Lot — Block _ _. ___ Subdivision ,
Street and Number where work is to be performed —No. ___ _. _ � _ _ _ Str ; e
1
State work to be performed and purpose of building (By Floors)_ V L-�1_y - - - - -- ..4. ?.o ,
New Building Remodeling Addition __._ _____ . _____ ......... . Repairs._ -- . ...... No. of Stories
Size Septic Tank
Feet of Drain Tile
ei
•
Amount of Permit
Type of Tank_ _ Capacity Gals.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well -_.____.Size of Soakage Pit
Date - - - -- -- -- � M C / _.. /e l j 4953
L
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 - contractor nployed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on to of the w.. sue' public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contracto , work to %. j ' or ed ..= der this permit, as are
licensed by Miami Shores Village.
aster ' umber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to admi ister 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 lac
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 f,lnl
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.
LIST
--
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No. ____ h
Application is hereby ma a for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othel
structure herein describe . This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of th 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 al
building during progress of work. �
Owner's Name and Address- /1 1 ' G /JE - -IV No 3 o (/l% r �/°- Street ?, 1/ _ °.
Registered Architect and /or Engineer _ _ y
Employing Plumber's Name_� /_ -J_ /A.g. - 1eek. .P.Pc..2 No /--,/ Street- - - -_ _ 6 ..
Location and Legal Description Lot — Block _ _. ___ Subdivision ,
Street and Number where work is to be performed —No. ___ _. _ � _ _ _ Str ; e
1
State work to be performed and purpose of building (By Floors)_ V L-�1_y - - - - -- ..4. ?.o ,
New Building Remodeling Addition __._ _____ . _____ ......... . Repairs._ -- . ...... No. of Stories
Size Septic Tank
Feet of Drain Tile
ei
•
Amount of Permit
Type of Tank_ _ Capacity Gals.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well -_.____.Size of Soakage Pit
Date - - - -- -- -- � M C / _.. /e l j 4953
L
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 - contractor nployed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on to of the w.. sue' public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contracto , work to %. j ' or ed ..= der this permit, as are
licensed by Miami Shores Village.
aster ' umber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to admi ister 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 lac
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 f,lnl
materials and /or workmanship.
,,
Permit No
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 work. )) �q�
Owner's Name and Address [ . C o w i No
Registered Architect and /or Engineer 'a . 8q C- T ' Pgj f
� ! !l I _j� 1__ !� l ! 1 !QUA -__1 -ems No.
Employing Plumber's Name C .__ Street
Location and Legal Description Lot �__________ Block A 1
Street and Number where work is to be performed —No �.
State work to be performed and purpose of building (By Floors)
New Building •� Remodeling Addition Repairs No. of Stories
STATE OF FLORIDA, ,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR. PLUMBING PERMIT
Size Septic Tank Type of, Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Amount of Permit $
(Signed)
Date 1!
Street
e.
E I
& diui�ip _ �L
Street 1111 r'-'37-
c. IRS u pit 6/ Ai G
( Signed)
My Commission Expires Notary Public, State of Florida
` ./f
Y c c
.
Capacity Gals
Nature of Water Supply: City —Well Size of Soakage Pit
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.
Master Plmnber.
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 workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CiLIST
LIST
2
c! �j
2
/
1
- --
CHECK
SEPTIC
' TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
,,
Permit No
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 work. )) �q�
Owner's Name and Address [ . C o w i No
Registered Architect and /or Engineer 'a . 8q C- T ' Pgj f
� ! !l I _j� 1__ !� l ! 1 !QUA -__1 -ems No.
Employing Plumber's Name C .__ Street
Location and Legal Description Lot �__________ Block A 1
Street and Number where work is to be performed —No �.
State work to be performed and purpose of building (By Floors)
New Building •� Remodeling Addition Repairs No. of Stories
STATE OF FLORIDA, ,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR. PLUMBING PERMIT
Size Septic Tank Type of, Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Amount of Permit $
(Signed)
Date 1!
Street
e.
E I
& diui�ip _ �L
Street 1111 r'-'37-
c. IRS u pit 6/ Ai G
( Signed)
My Commission Expires Notary Public, State of Florida
` ./f
Y c c
.
Capacity Gals
Nature of Water Supply: City —Well Size of Soakage Pit
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.
Master Plmnber.
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 workmanship.
•
PHONE 7 -2477
CEV
CoNTK, `= PS'PE'YJ rP
McG UIR E PLUMBING INC. •
85 N. E. 62nd STREET
MIAMI, FLORIDA
M,r, Cowed
3Si E 71 ,5
iLo7 1/9 684,DCK 684 C SEc
/y1 l i•P1 1 SHE
•- Jv
• a - w. .
244 V.
D °som
e LT .
CO
•• 0 •
•
RAI:PH McGUIRF
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the det2iled 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_C
Registered Architect and /or Engineer
Employing Plumber's Name____Y i s
Location and Legal Description Lot
Feet of Drain Tile
Nature of Water Supply: — Well
Amount of Permit $ 5 _
ss.
New Building Remodeling Addition
(Signed)
Date M 1 45
No Street 33
No. Street _3l -
Size Septic Tank Type of Tank Capacity Gals
`` Block S ubdiyi� n
ss ��
Street and Number where work is to be performed— No._ _ !r? 5 k) E.. Street C D j "
State work to be performed and purpose of building (By Floors) "' W e Lk. (4 _� 71 .4' ""
Repairs No. of Stories
Dist. Feet of Tank or Drain Field from Well
ILL° Size of Soakage Pit
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.
(Signed) 141' (� �� t - � JQ / -)34
( Master 'lumber.
STATE OF FLORIDA,
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
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U RINALS
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
SWIM'G
POOL
CONTR.
LIST
CHECK
0
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the det2iled 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_C
Registered Architect and /or Engineer
Employing Plumber's Name____Y i s
Location and Legal Description Lot
Feet of Drain Tile
Nature of Water Supply: — Well
Amount of Permit $ 5 _
ss.
New Building Remodeling Addition
(Signed)
Date M 1 45
No Street 33
No. Street _3l -
Size Septic Tank Type of Tank Capacity Gals
`` Block S ubdiyi� n
ss ��
Street and Number where work is to be performed— No._ _ !r? 5 k) E.. Street C D j "
State work to be performed and purpose of building (By Floors) "' W e Lk. (4 _� 71 .4' ""
Repairs No. of Stories
Dist. Feet of Tank or Drain Field from Well
ILL° Size of Soakage Pit
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.
(Signed) 141' (� �� t - � JQ / -)34
( Master 'lumber.
STATE OF FLORIDA,
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.
building during progress of work.
Owner's Name and Address
MIAMI SNORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLIC,' TION FOR PLUMBING PERMIT
Permit No Date ? 7
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
Registered Architect and /or Engineer_____
Employing Plumber's Name L_ol't_eetc. C _fto._
Location and Legal Description Lot ________
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
No. .C/
street ocv S S
Street__
—Block Subdivision
3 S I Street Fs
1C) A I e 6
Repairs °'' No. of Stories .........
_...
Size Septic Tank Type of Tank .. Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — ____ Size of Soakage Pit - -
Amount of Permit $
(Signed)
umbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio a: an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent S ..lement, and Ilas com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors - ... ed 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 wor
required by the Act. The undersigned agrees to employ only such sub - contractors work to
licensed by Miami Shores Village.
(Si
My Commission Expires Notary Public, State of Florida
is notice or notices as are
er this permit, as are
Master Plumber.
STATE OF FLORIDA,
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 necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
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
SWIM'G
POOL
CONTR.
LIST
-
CHECK
building during progress of work.
Owner's Name and Address
MIAMI SNORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLIC,' TION FOR PLUMBING PERMIT
Permit No Date ? 7
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
Registered Architect and /or Engineer_____
Employing Plumber's Name L_ol't_eetc. C _fto._
Location and Legal Description Lot ________
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
No. .C/
street ocv S S
Street__
—Block Subdivision
3 S I Street Fs
1C) A I e 6
Repairs °'' No. of Stories .........
_...
Size Septic Tank Type of Tank .. Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — ____ Size of Soakage Pit - -
Amount of Permit $
(Signed)
umbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio a: an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent S ..lement, and Ilas com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors - ... ed 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 wor
required by the Act. The undersigned agrees to employ only such sub - contractors work to
licensed by Miami Shores Village.
(Si
My Commission Expires Notary Public, State of Florida
is notice or notices as are
er this permit, as are
Master Plumber.
STATE OF FLORIDA,
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 necessary by improper notice for inspection, or faulty
materials and /or workmanship.
..'er..4it No 'Z 1/4-1
Application is hereby mlo+.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 kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Location and Legal Description Lot. ____.__ ........ — .._____..... ___ / ______ Block
Employing Plumbers Name
Street and Number where work is to be performed —No._
State work to be performed purpose of building (By Floors)
New Building _ !� Remodeling __________ Addition Repairs No. of Stories. _ ..
Size Septic Tank
Nature of Water Supply: City —Well
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.- __ - -- - _. /' Street_ - -1 k
No.
(Signed)._ _
( Signed) - -- - - ----
/ Street__
L
Date
ti ri ,- T undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig� i
N t' Glider the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman 7 G yp with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em
r forrned under this permit; and will post or cause to be posted for inspection on the site of the work such
, by the Act. The undersigned agrees to employ only such sub- contractors, on work / t6)be
/licensed by Miami Shores Village.
Subdivision
Street
My Commission Expires Notary Public, State of Florida
Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
/ Plumbing Inspector.
ns as an employer of labor
Supplement, and has c'om-
oyed by him in the work to be
publ, notice or notices as are
under this permit, as are
Master Plumber.
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.
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 workmanship.
CLOSE TG
BATH
TUBS
SHOWERS
LAVA.
TORIES
SI
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
,�
■
TOTAL
FIXTURES
4
.3
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
/ I"'�
L)i�Q
r
�R.�°�
CONTR. R.
� �� � �
4
4 Z,v�
_ - - - --
CHECK
..'er..4it No 'Z 1/4-1
Application is hereby mlo+.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 kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Location and Legal Description Lot. ____.__ ........ — .._____..... ___ / ______ Block
Employing Plumbers Name
Street and Number where work is to be performed —No._
State work to be performed purpose of building (By Floors)
New Building _ !� Remodeling __________ Addition Repairs No. of Stories. _ ..
Size Septic Tank
Nature of Water Supply: City —Well
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.- __ - -- - _. /' Street_ - -1 k
No.
(Signed)._ _
( Signed) - -- - - ----
/ Street__
L
Date
ti ri ,- T undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig� i
N t' Glider the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman 7 G yp with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em
r forrned under this permit; and will post or cause to be posted for inspection on the site of the work such
, by the Act. The undersigned agrees to employ only such sub- contractors, on work / t6)be
/licensed by Miami Shores Village.
Subdivision
Street
My Commission Expires Notary Public, State of Florida
Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
/ Plumbing Inspector.
ns as an employer of labor
Supplement, and has c'om-
oyed by him in the work to be
publ, notice or notices as are
under this permit, as are
Master Plumber.
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.
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 workmanship.