453 NE 99 StJ
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Lot
1; CONTRACTOR OR BUILDER
MIAMI SHORES VILLAG, FLORIDA
DATE
PERMIT N? 7427
Work to P erfo ed under this Permit
Al
AIL
r
Value of
Project
Architect
Contractor
or Builder
Legal
Description
Address of
Building
This permit i granted to e contractor or buil r .med above t.'con ct the building or
cation herefor in strict compliance with all ordinances ert ining thereto nd w th the u derstand'
plans, drawings, statements or specifications that may have been submi ed to and appro •d by
at any time if the work is not done in compliance with such ordinances or if the plans chan ' d
permit is granted is the understanding that the contractor or builder named above ass . es th •,, es.
regulations pertaining to the work covered hereby whether shown on the plans or dra ings o '
sibility for work done by his agents, servants or employees. ..
•
e
s
0
s
Amt. of
• Permit
all
In consideration of the issuance to me of this permit I agree to perform the w k covered hereunder in compliance with
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper auth
In acc tin . s permit I assume responsibility :for all work done by either myself, my agent, servant or employee.
Bl.
Si
Subdi-
vision
BY
SP
'CM
C •R
194._
Contractor's
License No
t• stall the equipment or de ice describ .. e appli-
the work will be performed in compliance wi h• any
r•. municipal authorities. This Permit may be revoked
7
ioi, . uthorization. further condition upon which his
nsib ity or a tho knowledge of the ordin nd
e st i • cations and that he s . . /.on-
nancel a
s of Mia
AUTHORITY
regulations
ored Village.
r
: ontractor
r Builder L it
egal Bl.
)escription
ddress of
uilding
This permit i granted to a contractor or buil. =r . med above t. conSf&uct the building or
{tion herefor in strict compliance with all ordinance . er fining thereto : nd w th the understandi
lans, drawings, statements or specifications that may have been submi ed to and appro d by t
any time if the work is not done in compliance with such ordinances or if the plans e than d
ermit is granted is the understanding that the contractor or builder named above ass es th res
;gulations pertaining to the work covered hereby whether shown on the plans or dr ings o i
bility for work done by his agents, servants or employees.
,LI
Signed.
Value of
Project
t
•
• ALAN
pr
i n
e
to
e
Amt. of
Permit
UILDING
LECTRICAL
LUMBING
)wner of
uilding
rchitect
Lot
s" CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 7427
Work to perfo}ilned under this Permit _ f
fi
Subdi-
vision
BY
NS
R
1941_
stall the equipment or de • ice descri. e appli-
th the work will be performed in compliance with any
II II municipal authorities. This Permit may be revoked
�i out.,tuthorization.: further condition upon which this
si 1it\for a tho , knowledge of the ord es and
st le ts cations and that he ss espon-
..'1��
In consideration of the issuance to me of this permit I agree to perform the w.rk covered hereunder in compliance with all
ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper auth
accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
DATE
Contractor's
License No
manes and regulations
s of Miami Shores Village.
AUTHORITY
Permit No 7
Application] her
structure herein d scri
and all provisions of
of Miami Shores Vill
building during progr
Owner Name and Ad
Registered Architect and /or Engineer
Size Septic Tank
Feet of Drain Tile
Amount of Permit $
ss.
0
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
. e' o ' - proval of the detailed statement of the plans and specifications herewith submitted for the building or other
eplication is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
I - 1 . s of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
. sha I be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
f work. ,
ess No._
Employing Plumber's Name__ "' No. Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be perforied—No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Type of Tank Capacity Gals
/
Dist. Feet of Tank)or Drain Field from Well
Nature of Water Supply: City -Well / L ®
Size of Soakage Pit
( S
The undersigned applicant lor this building permit does hereby certify that he unserstands and accepts his obligations as
nployer of 1 or
under ,the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has c m-
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)
Date y'
STATE OF FLORIDA, 1
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.
Street_,
No. of Stories
'uI
Plumbinj Inspector
. Master Plumber.
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
--
CONTR.
LIST
)
A
�, �f
-
-_
CHECK
C
7S
VS
�ia
..�C,
C /
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
/
/ '
CHECK
1 /Ce,
Permit No 7
Application] her
structure herein d scri
and all provisions of
of Miami Shores Vill
building during progr
Owner Name and Ad
Registered Architect and /or Engineer
Size Septic Tank
Feet of Drain Tile
Amount of Permit $
ss.
0
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
. e' o ' - proval of the detailed statement of the plans and specifications herewith submitted for the building or other
eplication is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
I - 1 . s of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
. sha I be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
f work. ,
ess No._
Employing Plumber's Name__ "' No. Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be perforied—No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Type of Tank Capacity Gals
/
Dist. Feet of Tank)or Drain Field from Well
Nature of Water Supply: City -Well / L ®
Size of Soakage Pit
( S
The undersigned applicant lor this building permit does hereby certify that he unserstands and accepts his obligations as
nployer of 1 or
under ,the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has c m-
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)
Date y'
STATE OF FLORIDA, 1
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.
Street_,
No. of Stories
'uI
Plumbinj Inspector
. Master Plumber.
FIXTURES I meat I Fl I
Floor
Floor
Floor
Floor
Floor
Floor Floor
Floor
Floor
age
Attic
Yard
Stable
Total
Septic Tanks
Bunson
Burners
.
Water Closets
Other
Appliances
Bath Tubs
Wall
Heaters
Basins
,
Wash Trays
Sinks
Water Heaters
Slop Sinks
Garage Drains
Shower Baths
Grease Traps
d
Floor Drains
Stoves
Bunson
Burners
Water
Heaters
Other
Appliances
Wall
Heaters
APPLICATION FOR PLUMBING AND GAS PERMIT
Division of Building Inspection
Hollywood, Florida
To the Division of Building Inspection:
The undersigned hereby applies for a permit to do plumbing according to the following specifications
and plan:
Location: Street
No. Building, New or Old? Used for What? Number of Stories_
Owner's Name
Where is sewer or septic tank situated?
How far distant from any dwelling, well or cistern is the septic tank?
Do windows in closet apartments open directly to outer air?
What is size of main soil pipe?
Of what material is soil pipe?
First Inspection
Hollywood, Florida, , 19_.
GAS
Make all checks payable to City of Hollywood
Permit No
Application No
Fee
Final Inspection_ Applicant's Name
Approval Certificate Issued Address
-
/7
a
:1 r/
t -- .