600 NE 98 St (11)PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY) g
Date Job Address 6'0 0 N G'� r f/ 5 Tax Folio'// 3.Z� / /Aa
Legal Description O // a- /�( p S as Permit # 3 3 6 /
Lessee / Tenant /PO / '`, S 5 r d1 ,� f c
4;e26 //� 5 Owner's Address
Contracting Co. :4 01 ew,4 ape?/T L Address
Qualifier, Q'e / • / 7 ep � 6 � i` (pc)
State#
Architect /Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRIC
WORK DESCRIPTION /P 4:4/ /3"..-c
Square Ft.
Signature of Owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires: ROTARY PUBLIC STATE OF FLORIDA
* * * * MY COMMI6SION EXP,r DEC.20,1994
BONDED THRU GENERAL INS. U
PERMIT FEE: APPROVED: Fire
4s- ea
Competency # 2 3 7
Address
Address
Address
19 ..y.P_
IN
I 4 it: 5 4d,%e! Sec, y L,1
Phone / � / ,c1 ,3
/ ' ' 4 c -
1 •
ns . Co. 6c. /, , •c.
MECHANICAk PAVIIfG FENCE SIGN
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).
Estimated Cost
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 t„I;e work stated.
ignature of Contractor or Owner-Builder
Date : 2// 'f
L(/1 UU ...--‘,.._
Notary as to Contractor or Owner- Builder
' My Commission Expires: NOTARY PUBLIC STATE OF FLORIDA
* * * * MY COMMy$SION EXP
BONDED TTiRU GENERAL INS. UM.
Other
Zoning Building Electrical
5
Mechanical - Ylumbing I y g
Permit No._,L__�
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 confonnity 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
Feet of Drain Tile_
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
5s.
Street and Number where work is to be performed —No.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. Street
Registered Architect and /or Engineer___
Employing Plumber's Name No - A n,
Street __ _L �
Location and Legal Description Lot __Y_ Block___ /__ Subdivision o r
Date
76) Street_ Street- >e �{} — 1�
Dist. Feet of Tank or Drain Field from Well
Notary Public, State of Florida
State work to be performed and purpose of building (By Floors) _ _____..
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Nature of Water Supply: City —Well Size of Soakage Pit
�( v:
(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.
ya
( Signed)
_ vJ
Master Plutriber.
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
FOU NT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
Permit No._,L__�
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 confonnity 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
Feet of Drain Tile_
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
5s.
Street and Number where work is to be performed —No.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. Street
Registered Architect and /or Engineer___
Employing Plumber's Name No - A n,
Street __ _L �
Location and Legal Description Lot __Y_ Block___ /__ Subdivision o r
Date
76) Street_ Street- >e �{} — 1�
Dist. Feet of Tank or Drain Field from Well
Notary Public, State of Florida
State work to be performed and purpose of building (By Floors) _ _____..
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Nature of Water Supply: City —Well Size of Soakage Pit
�( v:
(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.
ya
( Signed)
_ vJ
Master Plutriber.
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.
LIST LIST
CHECK
SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G
TANK CONN. FIELD PIT TRAP H EATER WELL SYSTEM POOL
CONTR.
9
LIST
CHECK
Pemrit No./ 0 el
Amount of Permit $ c). 7
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 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.
No Street
Owner's Narne and Address__
Registered Architect and /or Engineer
Employing Plumber's Name__ 11_: -- A__ = _ _ . No Street
Location and Legal Description Lot ji d ' d Block / Q_i Subdivision
Street and Number where work is to be performed— No.__1 _ L __�!_' Es_ ____ _ Street
State work to be performed and purpose of building (By Floors)
New Building ✓ Remodeling_____________ ___ Addition Repairs No. of Stories
(Signed)
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 City7We11 Size of Soakage Pit
Date
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he urt erstands and accepts his ob tions 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
perforned 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)
___ h_c_xft(cr),
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 fo regoing application, and that he did sign the same, and that all facts
therein by him stated are true.
5S.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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
materia:s and /or workmanship.
CLOSETS S
BATH S
SHOWERS L
LAVA- S
SINKS
SLOP L
LAUNDRY U
URINALS C
CATCH F
FLOOR D
DRINKING b
bid v• W
W J ki T
TOTAL
CiL 9
9 1
1 _
_ - r
Pemrit No./ 0 el
Amount of Permit $ c). 7
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 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.
No Street
Owner's Narne and Address__
Registered Architect and /or Engineer
Employing Plumber's Name__ 11_: -- A__ = _ _ . No Street
Location and Legal Description Lot ji d ' d Block / Q_i Subdivision
Street and Number where work is to be performed— No.__1 _ L __�!_' Es_ ____ _ Street
State work to be performed and purpose of building (By Floors)
New Building ✓ Remodeling_____________ ___ Addition Repairs No. of Stories
(Signed)
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 City7We11 Size of Soakage Pit
Date
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he urt erstands and accepts his ob tions 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
perforned 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)
___ h_c_xft(cr),
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 fo regoing application, and that he did sign the same, and that all facts
therein by him stated are true.
5S.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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
materia:s and /or workmanship.
PLUMBING IN MIAMI 30 YEARS
STA1 \IDiEY KI N
l-O tick o Ieoek nor
1\1. b e7 ' ST AVE
basil s1N/
wA3Nriti V U To s 6PM:
TANK
9 Q4/L.P/L
444 d
.44714-
B In
/L
al
1
c o i-
NORTON PLUMBING CO.
CONTRACTING - REPAIRING
MAINTENANCE
8011 N. W. 1ST PLACE PHONE 7-3897
MIAMI 88, FLORIDA
ESTIMATES CHEERFULLY GIVEN
Permit No / 3-- - 3
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
85.
- -- M Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING `''`iJAIli
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for (he 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.
/ r '
Owner's Name and Address l No._ a—c) Street ° ` y
Registered Architect and /or Engineer 6- Q. __ np II
Employing Plumber's Name. A-"��- 2-C. .' 4-414."-, _ ic No
Location and Legal Description Lot Block.
Street and Number where work is to be performed—No 6__C
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition____ Repairs No. of Stories ..............
Size Septic Tank Type of Tank_
Feet of Drain Tile _____.__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply. ity —Well _ Size of Soakage Pit
Capacity Gals
r
(SiBIIed) - - - - -- -
The undersigned applicant for this building permit does hereby certify that he understands and accepts Is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid: ' ennanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub -contr tors 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
_ Street
Subd
Notary Public, State of Florida
6 9
Street > 1- _
Plumbing Inspector.
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 workmanship.
CLOSETS
BATH
TUBS
SHOWER!
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
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
SW IM'O
POOL
CONTR.
LIST
CHECK
Permit No / 3-- - 3
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
85.
- -- M Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING `''`iJAIli
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for (he 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.
/ r '
Owner's Name and Address l No._ a—c) Street ° ` y
Registered Architect and /or Engineer 6- Q. __ np II
Employing Plumber's Name. A-"��- 2-C. .' 4-414."-, _ ic No
Location and Legal Description Lot Block.
Street and Number where work is to be performed—No 6__C
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition____ Repairs No. of Stories ..............
Size Septic Tank Type of Tank_
Feet of Drain Tile _____.__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply. ity —Well _ Size of Soakage Pit
Capacity Gals
r
(SiBIIed) - - - - -- -
The undersigned applicant for this building permit does hereby certify that he understands and accepts Is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid: ' ennanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub -contr tors 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
_ Street
Subd
Notary Public, State of Florida
6 9
Street > 1- _
Plumbing Inspector.
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 workmanship.
Amount of Permit $
STATE OF FLORIDA, i
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Date
Application is herebyfmade for the approval of the detailed statement of the plans and specifications herewith submitted for the building other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, lorida,
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 ..ST...I_.. -. _ ..... 1 N G__ No.___ 6 OO
Registered Architect and /or Engineer .....
-- ._ __ --_ - _ /
Employing Plumber's Name a ✓ � N e 7 0 //C / /NK 4 /! _ S� !f' Street/S?,2IU
Location and Legal Description Lot_ _______ _____ __________ _______—`_ _ —_ / Block__ y ( Subdivision
Street and Number where work is to be performed— No._ ° ' y F Lt c Street
State work to be performed and purpose of building (By Floors )_.______ ______ __ ____
___._
New Building Remodeling______ Addition Repairs No. of Stories.
(Signed)_
(Sign
i StreeL Y0 e4 ' J i
Capacity Gals
My Commission Expires Notary Public, State of Florida
Size Septic Tank / Type of Tank___
_,
Feet of Drain Tile... / - V ../0 _ Dist. Feet of Tank or Drain Field from Well
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 contracto or ub- contractors - mployed by in the work to be
performed under this permit; and will post or cause to be posted for inspection on site f the wor su tc • otice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contracto on ork to b is permit, as are
licensed by Miami Shores Village.
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 be 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.
�oAcc9
CLOBLTB
BATH
Tues
SHOWERS
S
LAVA-
TORIES
S
SINKS
SLOP
SIN KS
LAUNDRY
TUBE
U
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
Comm
LtOT
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LHIT
-
_ - - --
CHICK
Amount of Permit $
STATE OF FLORIDA, i
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Date
Application is herebyfmade for the approval of the detailed statement of the plans and specifications herewith submitted for the building other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, lorida,
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 ..ST...I_.. -. _ ..... 1 N G__ No.___ 6 OO
Registered Architect and /or Engineer .....
-- ._ __ --_ - _ /
Employing Plumber's Name a ✓ � N e 7 0 //C / /NK 4 /! _ S� !f' Street/S?,2IU
Location and Legal Description Lot_ _______ _____ __________ _______—`_ _ —_ / Block__ y ( Subdivision
Street and Number where work is to be performed— No._ ° ' y F Lt c Street
State work to be performed and purpose of building (By Floors )_.______ ______ __ ____
___._
New Building Remodeling______ Addition Repairs No. of Stories.
(Signed)_
(Sign
i StreeL Y0 e4 ' J i
Capacity Gals
My Commission Expires Notary Public, State of Florida
Size Septic Tank / Type of Tank___
_,
Feet of Drain Tile... / - V ../0 _ Dist. Feet of Tank or Drain Field from Well
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 contracto or ub- contractors - mployed by in the work to be
performed under this permit; and will post or cause to be posted for inspection on site f the wor su tc • otice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contracto on ork to b is permit, as are
licensed by Miami Shores Village.
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 be 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 $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
�oAcc9
CONTR.
LI T
CLO•R•
BATH
TUB[
SHOW [R•
LAVA •
TORIES
61NK•
SLOP
SINK[
LAUNDRY
Tun[
URINALS
CATCH
BASIN
FLOOR DRINKING
DRAIN FOUNT'NB
I
TOT..L
FIxTL RE•
/
1
-
•
CHICK
- --
SEPTIC
TANK
SIWIR
co. NN
DRAIN
PI[Lo
SOAKAGI
PIT
GRIMM
TRAP
SOLAR
HEATER
DI[P
WELL
SPRKLR.
SYSTIM
BWIM'O
POOL
L
C RI
LIST
CHICK
_ --
rcr,ni, No. .1 - 2, .U..Q_.L
MIAMI SNORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
i' hereby made for the approval of the detailed statement of the plans and specifications herewith sub' u• .A for the building or other
;tructurc herein described. This application is made in compliance and conformity with the Building Ordinance of Mi.; ! Shores Village, Florida,
d,:d all pro%isions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic" of the Building Division
01 Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec fications most be kept at
',uilding during progress of work. 1
'.kvrler's Name and Address l.?_ //�� . ,5-L (7 arv$ _..._. No._. Q� _r Street ? ? -1-Az ' r
.egist led Architect and /or Engineer � � Ce PC o'I .
` Gam_/ 11'62 124,8 No .. __7 tic/ / 9 1
:mploying Plumber's Name '- -- -- -- ....._ ._-- ,........D .,..:,.... . street ..
Location and Legal Description Lot_ L Bloclt
Street and Number where work is to be performed —No __4(2_ /,. D
State work to be performed and purpose of building (By Floors) _... .._ ..... _...__...- ......
_
Nev Building Remodeling_— _ Addition .___..i,l Repairs
Subdivision _.
Street //E 7.5" i"*
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
- -- -- -- ---- ---- -------- // - - - - --
Amount of Permit $. (sr • t2Z)
STATE OF FLORIDA, ,
COUNTY OF DADE.
My Conumission Expires
Capacity : ,als
(Signed)_
(Signed) __
Date........? 1 /..- - --
No of Stones
Notary Public, State of Florida
Plumbin3 Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an e n;>loyct !oho)
umdl:r the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent :upi lement, and lids
l,l -d with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed 1 y him in ' o ..I rk b-
i .rformed under this permit; and will post or cause to be posted for inspection on the site of the work such pohl' notice T. no user a a:
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed '.l this J n u,, ,u .
Licensed by Miami Shares Village.
�J
Mast Plumber
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, perwr e', ; , ppearec.
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 be has carefully read the foregoing application, and that he did sign the same, and that all acts
therein by him, stated are true.
NOTE: A re- inspection fee of $1.00 will be made whoa such re-inspection le mede eesary by improper notice for inspecton, st tautly
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTOON DEPARTMENT
• APPLICATION FOR PLUMBING PERMIT
t ' V
Permit Nov
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building cor 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 07 not. A copy of approved plans and specifications must be kept at
building during progress of work. 6 0 0 IV qp gregt-.V•
,c m )14
Owner's Name and Address No Street._
Registered Architect and/or Engineer
Emplobin PluiAbel9r. Em t L P Vet/ 4 .;! No.
S 14 .
/ / tiolancidgai Stesaiption Lot. Subdivision IXP
Street and Number where work is to be performed—No
State work to be performed and purpose of building (By Floors)___
Amount of Permit
, 0
My Commission Expires
We 1, I v ..... .....
New Building___ Reinodeling Addition. Repairs No. of Stories ...
Size Septic Tank_ Type of Tank__
Feet of Drain Tile— __Dist Feet of Tan or Drain Field from Well .
Nature of Water Supply: City—WelL
Size of Soakage Pit
•
(si . LEVEROCK BY
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 Worlzrnen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and lids oryrn-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the wor '.. to be
performed under this permit; and will post or cause to be posted for inspection an the site of the work such public notice or notices as ary
required by tlie Act. The undersigned agrees to employ only such sub-contractors, onn vork to be performed und this perinit, as
are
lice:wed by Miami Shores Village.
(Signed)
Di/ b of/a0K V Master Plumber.
STATE OF FLORIDA, t se.
COUNTY OF DADE. 1
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 oregains application, and that he did sign the same, and that all facts
therein by hira stated are true.
Notary Public, State of Florida
Plumbing Inspector.
NOTE: A re-lizspection fee of 81.00 will be made when snob nmiaapsetton in made •neesseary by iinpniper nodes for Inspection, et fealty
materials and/or workmanship.
CLoscrs
B AH
Smowano
LAVA.
y
SINKS
SLOP
L A
URINALS
i,"..1 NH
FLOOR
DRAIN
DRINKI NO
FOUNT' N•
T OTA L
FIXTURES
CopEnt.
LIST
CHECK
.....
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKA OK
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW I li '0
POOL
.......
CONTR.
X
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTOON DEPARTMENT
• APPLICATION FOR PLUMBING PERMIT
t ' V
Permit Nov
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building cor 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 07 not. A copy of approved plans and specifications must be kept at
building during progress of work. 6 0 0 IV qp gregt-.V•
,c m )14
Owner's Name and Address No Street._
Registered Architect and/or Engineer
Emplobin PluiAbel9r. Em t L P Vet/ 4 .;! No.
S 14 .
/ / tiolancidgai Stesaiption Lot. Subdivision IXP
Street and Number where work is to be performed—No
State work to be performed and purpose of building (By Floors)___
Amount of Permit
, 0
My Commission Expires
We 1, I v ..... .....
New Building___ Reinodeling Addition. Repairs No. of Stories ...
Size Septic Tank_ Type of Tank__
Feet of Drain Tile— __Dist Feet of Tan or Drain Field from Well .
Nature of Water Supply: City—WelL
Size of Soakage Pit
•
(si . LEVEROCK BY
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 Worlzrnen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and lids oryrn-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the wor '.. to be
performed under this permit; and will post or cause to be posted for inspection an the site of the work such public notice or notices as ary
required by tlie Act. The undersigned agrees to employ only such sub-contractors, onn vork to be performed und this perinit, as
are
lice:wed by Miami Shores Village.
(Signed)
Di/ b of/a0K V Master Plumber.
STATE OF FLORIDA, t se.
COUNTY OF DADE. 1
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 oregains application, and that he did sign the same, and that all facts
therein by hira stated are true.
Notary Public, State of Florida
Plumbing Inspector.
NOTE: A re-lizspection fee of 81.00 will be made when snob nmiaapsetton in made •neesseary by iinpniper nodes for Inspection, et fealty
materials and/or workmanship.
BULLDOG ❑
ELECTRICAL ❑ PERMIT N?
PLUMBING El
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
❑ Work to be performed under this Permit
15082
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
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 10083
Work to be performed under this Permit
Bl.
CONTRACTOR OR BUILDER
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
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder_
Legal
Description.
Address of
Building
Lot
Pl
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.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 10081
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No
Amt. of
Permit $
BY AUTHORITY
Permit No. 'J O ?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 o t. A copy of approved plans and specifications must be kept at building during the ogress of work.
`A 9 Owner's Name and Address � � M � • No. � Street SIN/ �
Registered Architect and /or Engineer
�o�V ei. j bog
Emplo rng P b e
// J Z / fio Na P ���
Location and Legal Description •
Street and Number where work is to be performed — No.
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
e
Size Septic Tank Type of Tank
Feet of Drain Tile
Nature of Water Supply: City - Well
Date
No. Street N � �' <V2
2
Block � Subdivisi n 7',9 ,lik
�O N , c� — S
V?�.�.Ay (SO �
Capacity Gals.
Repairs f No. of Stories
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Amount of Permit $
(Signed)4-%
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 complied with the provisions
thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be r formed 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 t : • e i ed agrees to employ
only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Sh. Vi11ag= 4
(Signed) �_ `i i# t �` i 7L& J
/ w Master Plumber.
ss.
COUNTY OF DAD'
�
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
STATE OF FLORI
A
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 $25.00 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
FOUNTAINS
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
Permit No. 'J O ?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 o t. A copy of approved plans and specifications must be kept at building during the ogress of work.
`A 9 Owner's Name and Address � � M � • No. � Street SIN/ �
Registered Architect and /or Engineer
�o�V ei. j bog
Emplo rng P b e
// J Z / fio Na P ���
Location and Legal Description •
Street and Number where work is to be performed — No.
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
e
Size Septic Tank Type of Tank
Feet of Drain Tile
Nature of Water Supply: City - Well
Date
No. Street N � �' <V2
2
Block � Subdivisi n 7',9 ,lik
�O N , c� — S
V?�.�.Ay (SO �
Capacity Gals.
Repairs f No. of Stories
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Amount of Permit $
(Signed)4-%
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 complied with the provisions
thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be r formed 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 t : • e i ed agrees to employ
only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Sh. Vi11ag= 4
(Signed) �_ `i i# t �` i 7L& J
/ w Master Plumber.
ss.
COUNTY OF DAD'
�
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
STATE OF FLORI
A
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 $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials
and/or workmanship.
Permit No 3 o S 4 3
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 the progress of work.
Owner's Name and Address 1 '� .S'4r-7r 10
Registered Architect and /or Engineer
Street
-
Block / Subdivision
E n loy g I l ' b / �7 to j
LLocafion and Legal Descript on Lot
/ /q
Street and Number where work is to be performed — No. l: O 0 /V .ver
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
d CC No. , 3:7 k(-
Type of Tank
Size Septic Tank
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)
My Commission Expires
(Signed)
ss.
Date
No. o
Repairs No. of Stories /
Capacity Gals.
e M 0 1 - l � h UA k
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understand 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 complied 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 hores Village.
/.1/(% 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.
Notary Public, State of Florida
7—
NOTE: A re- inspection fee of $25.00 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
FOUNTAINS
to 5,-,,f
0 � �` /I
j TOTAL
FIXTURES
CONTR.
.3
iZ
/
/
1 1
CHECK
j�`7
)/1.a
{
v
•y
2
` j
��
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G.
POOL
CONTR.
LIST
CHECK
Permit No 3 o S 4 3
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 the progress of work.
Owner's Name and Address 1 '� .S'4r-7r 10
Registered Architect and /or Engineer
Street
-
Block / Subdivision
E n loy g I l ' b / �7 to j
LLocafion and Legal Descript on Lot
/ /q
Street and Number where work is to be performed — No. l: O 0 /V .ver
Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
d CC No. , 3:7 k(-
Type of Tank
Size Septic Tank
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)
My Commission Expires
(Signed)
ss.
Date
No. o
Repairs No. of Stories /
Capacity Gals.
e M 0 1 - l � h UA k
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understand 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 complied 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 hores Village.
/.1/(% 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.
Notary Public, State of Florida
7—
NOTE: A re- inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials
and /or workmanship.