622 NE 98 St (10)Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
of Miami Shores Village sb be complied with, in specified or not. A copy
Owner's Name and A
building during progress 4 ork.
Registered Architect and /or; gineer
• c
Employing Plumber's Na _ ' ✓'��� �^
Feet of Drain Ti1e_______________________
Nature of Water Supply: City —Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT k
ss.
Amount of Permit $__
My Commission Expires
igned)
of approved plans
✓No
Street
Location and Legal Description Lot__ _______________ ______ — ________— ___________Block
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 Repairs No. of Stories
Size Septic Tank_—____ _—________ _____ ___________ Type of Tank . Capacity Gals.____—______ —__ --
ist. Feet of Tank or Drain Field from Well
Size of oakage 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
perforated under this permit; and will post or cause to be posted for inspection the site of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub-cont 'ors, on work to be pe ormed under this permit, as are
licensed by Miami Shores Village.
Date
regulations of the Building
and specifications must be
Street/ o
Subdivision __— ___________— __— __________
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 be has carefully read the foregoing application, and that he did sign the same, and tbat all facts
therein by him stated are true.
Notary Public, State of Florida
-4
J
Master Plumber.
or other
Florida,
Division
kept a c f-
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
Fl EL
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
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
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
of Miami Shores Village sb be complied with, in specified or not. A copy
Owner's Name and A
building during progress 4 ork.
Registered Architect and /or; gineer
• c
Employing Plumber's Na _ ' ✓'��� �^
Feet of Drain Ti1e_______________________
Nature of Water Supply: City —Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT k
ss.
Amount of Permit $__
My Commission Expires
igned)
of approved plans
✓No
Street
Location and Legal Description Lot__ _______________ ______ — ________— ___________Block
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 Repairs No. of Stories
Size Septic Tank_—____ _—________ _____ ___________ Type of Tank . Capacity Gals.____—______ —__ --
ist. Feet of Tank or Drain Field from Well
Size of oakage 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
perforated under this permit; and will post or cause to be posted for inspection the site of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub-cont 'ors, on work to be pe ormed under this permit, as are
licensed by Miami Shores Village.
Date
regulations of the Building
and specifications must be
Street/ o
Subdivision __— ___________— __— __________
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 be has carefully read the foregoing application, and that he did sign the same, and tbat all facts
therein by him stated are true.
Notary Public, State of Florida
-4
J
Master Plumber.
or other
Florida,
Division
kept a c f-
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.
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 reguiations of the Building Division
of Miami Shores Village s 11 be complied with, whether 'herein specified or not. A copy of . approved plans and specifications must be kept a
building during progress i s ork. - -_
+y l'
_ 7
— -- — / �
l g F= e y r 41 N j J �r v Street _ - - ----- �-
Registered Architect and /or }gi eer ,16/ p ,p
Employing Plumber's Na -'' =. _:__ __ /° -9r • �! G Ll . r !/ �
Location and Legal Description Lot__
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT (fit
My Commission Expires
_Block
7/
(Signed) - -- -- ----- ---- ------
Date_
/f
Subdivision_
Street
_Capacity Gals._
Size Septic Tank____ ___________________________________ Type of Tank
Feet of Drain Tile________— _________ _L gist. Feet of Tank or Drain Field from Well
t a
Nature of Water Supply: City — W �_�! Size of ,Soakage Pit.
�K 1 f 4 � _ .: - .<�.,.a, _ ,°mod... I,.
- a sh
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
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 o the site of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub -cont tors, on work to be performed under this permit, as are
licensed by Miami Shores Village. y _
(std, = __h:
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
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
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
V
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 reguiations of the Building Division
of Miami Shores Village s 11 be complied with, whether 'herein specified or not. A copy of . approved plans and specifications must be kept a
building during progress i s ork. - -_
+y l'
_ 7
— -- — / �
l g F= e y r 41 N j J �r v Street _ - - ----- �-
Registered Architect and /or }gi eer ,16/ p ,p
Employing Plumber's Na -'' =. _:__ __ /° -9r • �! G Ll . r !/ �
Location and Legal Description Lot__
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT (fit
My Commission Expires
_Block
7/
(Signed) - -- -- ----- ---- ------
Date_
/f
Subdivision_
Street
_Capacity Gals._
Size Septic Tank____ ___________________________________ Type of Tank
Feet of Drain Tile________— _________ _L gist. Feet of Tank or Drain Field from Well
t a
Nature of Water Supply: City — W �_�! Size of ,Soakage Pit.
�K 1 f 4 � _ .: - .<�.,.a, _ ,°mod... I,.
- a sh
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
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 o the site of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub -cont tors, on work to be performed under this permit, as are
licensed by Miami Shores Village. y _
(std, = __h:
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
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.
Job
D
Address
REQUEST FOR INSPECTION
Company.
Inspection
C
Time Ready
Date Ready /. �'
A.M.
BUILDING
ic
ELECTRI
PLUMBING
Owner of I
Building • � 1/
v .r
PERMIT N? 8173
Work to be performed under this Permit
Architect
Contractor
or Builder - �9
Legal /' Lot Bl.
Description
t
(ti.'
69 " ( „ .r %
C ONTRACTOR OR BUILDER i •
MIAMI SHORES VILLAGE, FLORIDA
Signed.
r
Subdi-
vision
Value of
Project
BY
DATE( 1947_
Contractor's
License No
Address of , � .
Building U. 2. ° ,,, � y `; • ? :r ,
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 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. K ///
INSPECTOR
Amt. of
Permit >7 • r
By
In consideration of the issuance to me of this permit I agree to perform /th€ work covered hereunder in compliance with all . ordin c and g n4-
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper author!l of Mimi Sho�'Vf1 a2'ge °''
In accepting this permit I assume responsibility for all work done by either myplf, my agent, servan or employee.
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 194_
Contractor's
License No.
PERMIT N? 3407
Work to be performed under this Permit
Owner of
Building
Bl.
Subdi-
vision
Value of
Project
illARNING: This C01141TSlgfl =V t;:. i6latio ,- . o
VPhr Preductivra Ece :d F :r duns sticrz fl b•: ,
V j am cattlianid 1® Gz :2 getrg 7L7 Prtdur.udi:
Board ate -72 Glerth j Rite Cv S i E%AS'JiIIe t 1
Ciget2.
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• B
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 regula-
tions pertaining thereto and in strict conformity with the plans, awtngs, statements or specifications submitted to the proper authorities of Miami Shores
Villa. In accepting this permit 'I assume responsibility for all ork dpnfi either myself, my agent, servant or employee.
/#
BY AUTHORITY
Permit No 27
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submit ed 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 wor
Owner's Name and Address
Registered Architect and /or En ineer
Employing Plumber's Naive
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES 'VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date6 _ - - 7
No Z Street
(Signed)
No ) ZZ Street__
Location and Legal DescriptiKn Lot_______________________ __ _____ _________— _________Block____ Subdivision
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 Repairs No. of Stories
Size Septic Tank Type of T 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
(Signed)_ O 7- °>
Plumbing nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an emplo�er of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, an 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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
My Commission Expires Notary Public, State of Florida
Master Plumber.
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
LAUNDR
TUBS
URINALS
CATCH
BASIN
FLOOR
FLOOR
DRAIN
DRINKING
FOUNT
pr
AS I IFIXTURES
'I
TOTAL
CONTR.
LIST
J
p
/ ®
Y
/
) 5-
j
0
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
��a lr
Si 4 ' DEEP
HEATER WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
1
/
CONTR.
LIST
/
CHECK CHECK
Permit No 27
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submit ed 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 wor
Owner's Name and Address
Registered Architect and /or En ineer
Employing Plumber's Naive
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES 'VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date6 _ - - 7
No Z Street
(Signed)
No ) ZZ Street__
Location and Legal DescriptiKn Lot_______________________ __ _____ _________— _________Block____ Subdivision
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 Repairs No. of Stories
Size Septic Tank Type of T 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
(Signed)_ O 7- °>
Plumbing nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an emplo�er of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, an 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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
My Commission Expires Notary Public, State of Florida
Master Plumber.
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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING !"
Date ` t)
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 V. V^ L u t`, N_1 ______ No.__ _� _ Street/ I F. o
Registered Architect and /or Eryineer
Employing Plumber's Name‘ : t t e 14_/`' °,.i i' ^ I r' ^ ., _ 1 � f" - 2 n / Street
Location and Legal Description Lot________
Permit No
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____ Repairs No. of Stories.
Size Septic Tank Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
._Size of Soakage Pit
Nature of Water Supply: City —Well
4 tom
Amount of Permit $
STATE OF FLORIDA, t ss.
COUNTY OF DADE.
My Cnnunission Expires
Block____ _ ______.. Subdivision
Capacity Gals
(Signed)
?MI ,
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 bus 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 ices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on n work to be performed under, is as are
licensed by Miami Shores Village. ti
(S gndd)
Master Plumber.
G'
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 hire: 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
OW
SH"E"
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
et-
/ o
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
C,IFERS
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
0--,%""
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING !"
Date ` t)
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 V. V^ L u t`, N_1 ______ No.__ _� _ Street/ I F. o
Registered Architect and /or Eryineer
Employing Plumber's Name‘ : t t e 14_/`' °,.i i' ^ I r' ^ ., _ 1 � f" - 2 n / Street
Location and Legal Description Lot________
Permit No
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____ Repairs No. of Stories.
Size Septic Tank Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
._Size of Soakage Pit
Nature of Water Supply: City —Well
4 tom
Amount of Permit $
STATE OF FLORIDA, t ss.
COUNTY OF DADE.
My Cnnunission Expires
Block____ _ ______.. Subdivision
Capacity Gals
(Signed)
?MI ,
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 bus 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 ices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on n work to be performed under, is as are
licensed by Miami Shores Village. ti
(S gndd)
Master Plumber.
G'
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 hire: 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.
Size Septic Tank
Feet of Drain Tile
Amount of Permit $ l s f
oZ•
STATE OF FLORIDA, 1
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
_ Block__
Nature of Water Supply: City - Well.---_— ....... ----- _______- ........... - ___ -.- ..Size of Soakage Pit
Permit No ---1) 3 Date. fe ( "
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 .rdinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, wh erein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work e__,..___....
Owner's Name and Address � - No._--- 5t - -- ---- -- -- --- Street
Registered Architect and /or Engineer___ -- lG?J?�' t _lL :e ____ _ -- -e J - y G_fcr ` ,1.,/-,3"/ �, L
Employing Plumber's Name -___ No. 3 " ? ( C 1 Street
Location and Legal Description Lot
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_ -_- /` Repairs No. of Stories. . . ........ ........ ..-
(Signed) - -- `_ '`�`' -
umbing Inspector.
Notary Public, State of Florida
er Plumber.
Subdivision
_ .Type of Tank___ Capacity Gals
__Dist. Feet of Tank or Drain Field from Well
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of la,or
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and lla ,c4>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
on on the Site- ef work ch publi . notice or .no c es as are
performed under this permit; and will post or cause to be posted' for tnia on work to }}d�,, a ormed d - + is permit, as are
required by tlie Act. The undersigned agrees to employ only such 7' P p
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
T UBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
INALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N6
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
/ J( \
Size Septic Tank
Feet of Drain Tile
Amount of Permit $ l s f
oZ•
STATE OF FLORIDA, 1
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
_ Block__
Nature of Water Supply: City - Well.---_— ....... ----- _______- ........... - ___ -.- ..Size of Soakage Pit
Permit No ---1) 3 Date. fe ( "
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 .rdinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, wh erein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work e__,..___....
Owner's Name and Address � - No._--- 5t - -- ---- -- -- --- Street
Registered Architect and /or Engineer___ -- lG?J?�' t _lL :e ____ _ -- -e J - y G_fcr ` ,1.,/-,3"/ �, L
Employing Plumber's Name -___ No. 3 " ? ( C 1 Street
Location and Legal Description Lot
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_ -_- /` Repairs No. of Stories. . . ........ ........ ..-
(Signed) - -- `_ '`�`' -
umbing Inspector.
Notary Public, State of Florida
er Plumber.
Subdivision
_ .Type of Tank___ Capacity Gals
__Dist. Feet of Tank or Drain Field from Well
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of la,or
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and lla ,c4>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
on on the Site- ef work ch publi . notice or .no c es as are
performed under this permit; and will post or cause to be posted' for tnia on work to }}d�,, a ormed d - + is permit, as are
required by tlie Act. The undersigned agrees to employ only such 7' P p
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.
ut-.9
$2.00
Permit No
Application i- hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th Building Di lion
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 Martha Lummus 622 N . E . 98 St.
- _ No_ ...... --- ... - - - - - - -- - Street - -
Registered Architect and /or Engineer
Employing Plumber's Name Dade Gas Company_ - No. 1180 - - Street _ N °W. ° 7 3 St .
Subdivision.._
Street and Number where work is to be performed —No 622_ _ _ . _ Street N . E . 98 St .
State work to be performed and purpose of building (By Floors).
New Building-- - --- -- --- -- -__- _ _ - -- - -- _ -- Remodeling--- ____ -- _ -- -- -- _ Addition._._
Location and Legal Description Lot___
Size Septic Tank__ _ -- -- -- --
Feet of Drain Tile_ - . _ ___ _- _
Nature of Water Supply. City —Well.
Amount of Permit $ -
STATE OF FLORIDA, ss,
COUNTY OF DADE.
MIL O SNORES ES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPDUCQV1M FOR PLUMBING PERMIT
__ Type of Tank -- ---_ -- _ -.
.- __Dist. Feet of Tank or Drain Field from Well ..
Si r. of Soakage Pit
Block_
_ (Signed)_
(Signed
____ . _ - Repairs_
Date
Capacity Gals.
11 -11 -69
No. of Stories -
PLmbirg In:pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his q' '.ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, 'nd I as om-
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 no ices as are
required by tlie Act. The undersigned agrees to employ only such sub - contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personal) 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 .acts
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.
CLOGIZTS
BATH
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUHT'NS
4...
Logs
TOTAL
F %TURES
CONTR.
LIST
_
—
2.00
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WE_L
SPRKLR.
SYSTEM
SW IM - G
POOL
CONTR.
LIST
--
CHacK
ut-.9
$2.00
Permit No
Application i- hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th Building Di lion
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 Martha Lummus 622 N . E . 98 St.
- _ No_ ...... --- ... - - - - - - -- - Street - -
Registered Architect and /or Engineer
Employing Plumber's Name Dade Gas Company_ - No. 1180 - - Street _ N °W. ° 7 3 St .
Subdivision.._
Street and Number where work is to be performed —No 622_ _ _ . _ Street N . E . 98 St .
State work to be performed and purpose of building (By Floors).
New Building-- - --- -- --- -- -__- _ _ - -- - -- _ -- Remodeling--- ____ -- _ -- -- -- _ Addition._._
Location and Legal Description Lot___
Size Septic Tank__ _ -- -- -- --
Feet of Drain Tile_ - . _ ___ _- _
Nature of Water Supply. City —Well.
Amount of Permit $ -
STATE OF FLORIDA, ss,
COUNTY OF DADE.
MIL O SNORES ES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPDUCQV1M FOR PLUMBING PERMIT
__ Type of Tank -- ---_ -- _ -.
.- __Dist. Feet of Tank or Drain Field from Well ..
Si r. of Soakage Pit
Block_
_ (Signed)_
(Signed
____ . _ - Repairs_
Date
Capacity Gals.
11 -11 -69
No. of Stories -
PLmbirg In:pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his q' '.ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, 'nd I as om-
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 no ices as are
required by tlie Act. The undersigned agrees to employ only such sub - contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personal) 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 .acts
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.
Permit No 3 1
MIAMI SHORES VIL .,AG
PLUMBING INSPECTION DEPARTM •:
APPLICATION FOR PLUMBING ;... itn'
Date 6
Application is hereby made for the approval of the detailed statement of ibe plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and confor-b4 with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami .:ilures Village: and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specific 3 r'. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address____ ` � n!» `'`_'�_c_ No C Street
Registered Architect and /or ngiine
Employing Plumber's Name ✓`T' �°""`
Location and Legal Description Lot-_-- _--_ _________ __ _____ -- _-- - - - -__ _ __ _ ......... Subdivision
�j 2/ di
Street and Number where work is to be performed– No.___.______._.__ ��___w— _._..___.___. Street-
State work to be performed and purpose of building (By Floors) _
New Building _ Remodeling Addition___ Repairs No. of Stories
Amount of Permit $
/ 5'�D
5 .
(Signed)_
No.__- .7 /. /____f" 7 Street__ ,9g
My Cocrmission Expires Notary Public, State of Florida
Size Septic Tank Type of Tank_ Capacity Gals.
Feet of Drain Tile 3o r _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City ei1• _________Size of Soakage Pit
Plumbing Inspector.
i
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 bus 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) _ --
–.. ,2474–e-- 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.
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'NB
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
_
30 1
CHECK
Permit No 3 1
MIAMI SHORES VIL .,AG
PLUMBING INSPECTION DEPARTM •:
APPLICATION FOR PLUMBING ;... itn'
Date 6
Application is hereby made for the approval of the detailed statement of ibe plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and confor-b4 with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami .:ilures Village: and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specific 3 r'. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address____ ` � n!» `'`_'�_c_ No C Street
Registered Architect and /or ngiine
Employing Plumber's Name ✓`T' �°""`
Location and Legal Description Lot-_-- _--_ _________ __ _____ -- _-- - - - -__ _ __ _ ......... Subdivision
�j 2/ di
Street and Number where work is to be performed– No.___.______._.__ ��___w— _._..___.___. Street-
State work to be performed and purpose of building (By Floors) _
New Building _ Remodeling Addition___ Repairs No. of Stories
Amount of Permit $
/ 5'�D
5 .
(Signed)_
No.__- .7 /. /____f" 7 Street__ ,9g
My Cocrmission Expires Notary Public, State of Florida
Size Septic Tank Type of Tank_ Capacity Gals.
Feet of Drain Tile 3o r _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City ei1• _________Size of Soakage Pit
Plumbing Inspector.
i
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 bus 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) _ --
–.. ,2474–e-- 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.
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.
Permit No. _1
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 got. A copy of approved plans and specifications must be kept at building during the ` � progress of work.
Owner's Name and Address / C V No. 6 2 Z Street I 9 3 -7 ' J
Size Septic Tank
Amount of Permit $
APPLICATION FOR PLUMBING PERMIT
Registered Architect and /or Engineer
ss��Employi g /�/ 1 � mbe Q r' � / LL ` I JI P
ocation and Legal esci'1'ptioniL t / eo
Street and Number where work is to be performed — No.
Street
State work to be performed and purpose of building (By Floors) V 1
New Building Remodeling Addition
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
C ( No. C- Street �.
Block /®/ Subdivisi
R 0 0 1 � I A, 1
Repairs Y No. of Stories
Type of Tank Capacity Gals.
1
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - Well Size of Soakage Pit
(Signed)
(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 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 th ' ct. The undersigned agrees to employ
only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Wires Villa
STATE OF FL I'• IDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
S S.
Date
Maste Plumber.
( 2J y/ 1 vez
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. _1
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 got. A copy of approved plans and specifications must be kept at building during the ` � progress of work.
Owner's Name and Address / C V No. 6 2 Z Street I 9 3 -7 ' J
Size Septic Tank
Amount of Permit $
APPLICATION FOR PLUMBING PERMIT
Registered Architect and /or Engineer
ss��Employi g /�/ 1 � mbe Q r' � / LL ` I JI P
ocation and Legal esci'1'ptioniL t / eo
Street and Number where work is to be performed — No.
Street
State work to be performed and purpose of building (By Floors) V 1
New Building Remodeling Addition
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
C ( No. C- Street �.
Block /®/ Subdivisi
R 0 0 1 � I A, 1
Repairs Y No. of Stories
Type of Tank Capacity Gals.
1
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - Well Size of Soakage Pit
(Signed)
(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 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 th ' ct. The undersigned agrees to employ
only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Wires Villa
STATE OF FL I'• IDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
S S.
Date
Maste Plumber.
( 2J y/ 1 vez
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.