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366 NE 99 St (3)Permit No NX L Amount of Permit 8 / 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 ordinance of Miami Shares Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether Benin 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 . _ �yi� M/Pim P , e e Avis, ,- t l I D /v = % 1 b Gov 1 s� -�� Na.- ,�.. ........ Iwmt.,4 , !�.. ✓- Location and'Legal Descrlptoa Lot Bloom Subdlxddon 6 6 Street ...A/ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Fbat)___Kef ' :.— V..7.2Q12.Q1 !_.- ''!RA.1! 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—Well. Size of Soakage Pit (Signed)_ 366 Street_ Air No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations ss an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Perinanent Supplement, and il„r com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contract nployed 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 w• public notice or notices as err required by the Act. The undersigned agrees to employ only such cab- contractors, work to . .._.,; , . er this permit, as are licensed by Miami Shores Village. 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 swan, upon oath deposes and says that he is the ...__.._ .._ ...... _ of the above described construction, that be 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 81.00 will be made whoa mob miaspaodon Y made'sslomary by improper Notice for inspection, or faulty matrial and /or workmanship. CLOSETS BATH Tun[ SHOWERS LAVA TORIES 11"4" SLO► SINKS LAUNDR Tugs URINALS CA TC H •ASIN FLOOR DRAIN DRINKING FOUNT' N• TOTAL PIIITUR[S CONTR. LIST CHECK - SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G FOOL CONTR. LIST CHECK Permit No NX L Amount of Permit 8 / 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 ordinance of Miami Shares Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether Benin 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 . _ �yi� M/Pim P , e e Avis, ,- t l I D /v = % 1 b Gov 1 s� -�� Na.- ,�.. ........ Iwmt.,4 , !�.. ✓- Location and'Legal Descrlptoa Lot Bloom Subdlxddon 6 6 Street ...A/ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Fbat)___Kef ' :.— V..7.2Q12.Q1 !_.- ''!RA.1! 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—Well. Size of Soakage Pit (Signed)_ 366 Street_ Air No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations ss an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Perinanent Supplement, and il„r com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contract nployed 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 w• public notice or notices as err required by the Act. The undersigned agrees to employ only such cab- contractors, work to . .._.,; , . er this permit, as are licensed by Miami Shores Village. 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 swan, upon oath deposes and says that he is the ...__.._ .._ ...... _ of the above described construction, that be 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 81.00 will be made whoa mob miaspaodon Y made'sslomary by improper Notice for inspection, or faulty matrial and /or workmanship.