910 NE 99 St (7)MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
L )Je . Zi'
Permit No Date.. s5 ! 7. /S!.G'.:
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su1Smitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Misrnti Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation 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.
Owners Name and Address C-) ! ' C /
S
.3egistered Architect and /or Engineer
Employing Plumbers Name Pi r1ft +a+'1 ki L -
Location and Legal Description Lot- Bloch
Street and Number where work is to be performed —No. q )t f _._.. Street 9 1 /
State work to be performed and purpose of building (By Floors)_-_ .___ _ _...___._____..______._.__
New Building Remodeling —_ _ ._ Addition._._. Repairs No. of Stories
Size Septic TartlL _.------ •--------- - - - - -- _...Type of Tank__
Feet of Drain Tile.____ ____ __ _Dist. Feet of Tank or Drain Field from Well..
Nature of Water Supply: of Soakage Pit
Amount of Permit $
My Conunission Expires
( signed ).77;
_1 ,13 IISCo �V
(Signed) "4
No. 9 1 S t r e e t . . . . . . .
e6. Street l�f�� ra t� ... f/ 4• .3.3ci3
Capacity Gals.
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
undcr the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent lupi.lement, and has con-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed ly him in iL work 'o b'
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publt notice of no'iccr ,is as
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be ormed :.. this k alrinit,
licensed by Miami Shores Village.
STATE OF FLORIDA,
u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personal:;• cppearer;
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 teat all :acts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made wham such re- inspectloo I. mede'neoessary by Improper notice for inspection, or faulty
materials and /or workmanship.
a
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SEPTIC
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DEEP
WELL
SPRKLR.
SYSTEM
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MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
L )Je . Zi'
Permit No Date.. s5 ! 7. /S!.G'.:
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su1Smitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Misrnti Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation 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.
Owners Name and Address C-) ! ' C /
S
.3egistered Architect and /or Engineer
Employing Plumbers Name Pi r1ft +a+'1 ki L -
Location and Legal Description Lot- Bloch
Street and Number where work is to be performed —No. q )t f _._.. Street 9 1 /
State work to be performed and purpose of building (By Floors)_-_ .___ _ _...___._____..______._.__
New Building Remodeling —_ _ ._ Addition._._. Repairs No. of Stories
Size Septic TartlL _.------ •--------- - - - - -- _...Type of Tank__
Feet of Drain Tile.____ ____ __ _Dist. Feet of Tank or Drain Field from Well..
Nature of Water Supply: of Soakage Pit
Amount of Permit $
My Conunission Expires
( signed ).77;
_1 ,13 IISCo �V
(Signed) "4
No. 9 1 S t r e e t . . . . . . .
e6. Street l�f�� ra t� ... f/ 4• .3.3ci3
Capacity Gals.
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
undcr the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent lupi.lement, and has con-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed ly him in iL work 'o b'
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publt notice of no'iccr ,is as
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be ormed :.. this k alrinit,
licensed by Miami Shores Village.
STATE OF FLORIDA,
u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personal:;• cppearer;
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 teat all :acts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made wham such re- inspectloo I. mede'neoessary by Improper notice for inspection, or faulty
materials and /or workmanship.
a
Permit No.
Feet of Drain Tile_
Amount of Permit $ __ t '`
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby nfi 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 ork.
Owner's Name and Address ___: _t__ - -'L.__! _ C__�.�_'!_ L�+�'+4'" 0 _:.r' No.
?:,istered Architect and /or Ehginee
Employing Plumber's Name _�k� ..e:-�
Location and Legal Description Lot_ __Block__
Street and Number where work is to be performed —No 7l0
State work to be performed and purpose of building (By Floors) ___
T) N o./ 2 O 2
Size Septic Tank — ____ Type of Tank
Dist. Feet of Tank or Drain Field from Well
(Signed)
Date__,_
Street__
Sulzdsion_�
New Building_____ W______ Remodeling __ Addition Repairs No. of Stories_______.......
A
_Capacity Gale-L4lftr _1i_ V
Nature of Water Supply: City —Well Size of Soakage Pit ..... __ ....
__________-- ____�_�___�.;
(Signed) 'f - - --
/ Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that IA understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiledkeneral 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public. State of Florida
Street27, _!_ 4? ' ttlfJ r t.. •
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
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No.
Feet of Drain Tile_
Amount of Permit $ __ t '`
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby nfi 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 ork.
Owner's Name and Address ___: _t__ - -'L.__! _ C__�.�_'!_ L�+�'+4'" 0 _:.r' No.
?:,istered Architect and /or Ehginee
Employing Plumber's Name _�k� ..e:-�
Location and Legal Description Lot_ __Block__
Street and Number where work is to be performed —No 7l0
State work to be performed and purpose of building (By Floors) ___
T) N o./ 2 O 2
Size Septic Tank — ____ Type of Tank
Dist. Feet of Tank or Drain Field from Well
(Signed)
Date__,_
Street__
Sulzdsion_�
New Building_____ W______ Remodeling __ Addition Repairs No. of Stories_______.......
A
_Capacity Gale-L4lftr _1i_ V
Nature of Water Supply: City —Well Size of Soakage Pit ..... __ ....
__________-- ____�_�___�.;
(Signed) 'f - - --
/ Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that IA understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiledkeneral 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public. State of Florida
Street27, _!_ 4? ' ttlfJ r t.. •
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.
Permit No.
building during progress of work.
Amount of Permit $_ ______________
MIAMI SHORES VILLAGE
APPLICATION FOR PLUMBING PERMIT
0 Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
Owner's Name and Address ___.,,r% $,,r______ _IL_ _ No. __ /IC __,14/ - ____. Street_ _— _ '1_,.
t'tegistered Architect and /or Engineer
Employing Plumber's Name 1t _fI _ No.__7Lt_j_.i____1 __f_!`_ Street___AL__S..Y_il2_,f� 54;
Location and Legal Description Lot_____ f -- i# –, Block (fl) _ Subdivision..
Street and Number where work is to be performed —No Al____ , _Sr"__c___ Street________,_ _'"
State work to be performed and purpose of building (By Floors)
New Building__.__ —__ ________— Remodeling Addition
Type
___ Dist. Feet of
Size Septic Tank
Feet of Drain
Nature of Water Supply: City — Well" Size of Soakage Pit
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
My Commission Expires
PLUMBING INSPECTION DEPARTMENT
Repairs No. of Stories________.___.
of Tank . Capacity Gals._____________ —__ --
Tank or Drain Field from Well__
)--
'Plumbing Inspector.
rtify tl`he understands and accepts his obligations as an employer of labor
}
_(Signed)
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
STATE OF FLORIDA,
COUNTY OF DADE. ss,
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
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No.
building during progress of work.
Amount of Permit $_ ______________
MIAMI SHORES VILLAGE
APPLICATION FOR PLUMBING PERMIT
0 Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
Owner's Name and Address ___.,,r% $,,r______ _IL_ _ No. __ /IC __,14/ - ____. Street_ _— _ '1_,.
t'tegistered Architect and /or Engineer
Employing Plumber's Name 1t _fI _ No.__7Lt_j_.i____1 __f_!`_ Street___AL__S..Y_il2_,f� 54;
Location and Legal Description Lot_____ f -- i# –, Block (fl) _ Subdivision..
Street and Number where work is to be performed —No Al____ , _Sr"__c___ Street________,_ _'"
State work to be performed and purpose of building (By Floors)
New Building__.__ —__ ________— Remodeling Addition
Type
___ Dist. Feet of
Size Septic Tank
Feet of Drain
Nature of Water Supply: City — Well" Size of Soakage Pit
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
My Commission Expires
PLUMBING INSPECTION DEPARTMENT
Repairs No. of Stories________.___.
of Tank . Capacity Gals._____________ —__ --
Tank or Drain Field from Well__
)--
'Plumbing Inspector.
rtify tl`he understands and accepts his obligations as an employer of labor
}
_(Signed)
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
STATE OF FLORIDA,
COUNTY OF DADE. ss,
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.
APPLICATION FOR PLUMBING PERMIT
Permit No. Date__ f
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 ___!`
Location and Legal Description Lot
Amount of Permit $_
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
--- - - - - -- (Signed) -
No Street
Registered Architect and /or Engineer; ______ —_ .-____
Employing Plumber's Name No.ad Street'_.
_Block Su division_
Street and Number where work is to be performed—No _�_ Street_' — I__,__
State work to be performed and purpose of building (By Floors) ___1, _ d
New Building_ — __________— _ Remodeling Addition Repairs —___ No. of Stories
Capacity Gale
(Signed) - --- - --
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 .....
_____—____—___— __— _— ______________— _— __ —____.
Notary Public. State of Florida
--------------- - - --
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that Xte 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
•
Master Plumber. I
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared _--- --_ --- _ to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
APPLICATION FOR PLUMBING PERMIT
Permit No. Date__ f
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 ___!`
Location and Legal Description Lot
Amount of Permit $_
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
--- - - - - -- (Signed) -
No Street
Registered Architect and /or Engineer; ______ —_ .-____
Employing Plumber's Name No.ad Street'_.
_Block Su division_
Street and Number where work is to be performed—No _�_ Street_' — I__,__
State work to be performed and purpose of building (By Floors) ___1, _ d
New Building_ — __________— _ Remodeling Addition Repairs —___ No. of Stories
Capacity Gale
(Signed) - --- - --
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 .....
_____—____—___— __— _— ______________— _— __ —____.
Notary Public. State of Florida
--------------- - - --
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that Xte 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
•
Master Plumber. I
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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No � Date___
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address ____ _ / ___— _ _ __ No.__ Pt Street_ ____ e ff .Y--le! _ - - -_�
Location
Registered Architect and /or Engineer _________ X:101Vt;71
Employing Plumber's Name _.r�'_j_
and Legal Description Lot__
IC_ Block
Street and Number where work is to be performed —No 1%1 �2t 4 -
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.__—_________--
I
Feet of Drain Tile_ p_ __ _ ._ _ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Wel
--------------- ------ ----- - - -- -- -
0
Amount of Permit $_________________
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
-----------------
No.
Size of Soakage Pit
Street
Subdivision—
Notary Public. State of Florida
cs—
_(Signed)
ij
rtify tlyt'!te understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
lumbing Inspector.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No � Date___
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address ____ _ / ___— _ _ __ No.__ Pt Street_ ____ e ff .Y--le! _ - - -_�
Location
Registered Architect and /or Engineer _________ X:101Vt;71
Employing Plumber's Name _.r�'_j_
and Legal Description Lot__
IC_ Block
Street and Number where work is to be performed —No 1%1 �2t 4 -
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.__—_________--
I
Feet of Drain Tile_ p_ __ _ ._ _ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Wel
--------------- ------ ----- - - -- -- -
0
Amount of Permit $_________________
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
-----------------
No.
Size of Soakage Pit
Street
Subdivision—
Notary Public. State of Florida
cs—
_(Signed)
ij
rtify tlyt'!te understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
lumbing Inspector.
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.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
_ mg Contractor
or Builder
d
1
Legal Lot Bl.
Description
Address of
Building / " a, r`!`
MIAMI SHORES VILLAGE, FLORIDA
DATE
PERMIT N9 2999
Work to be performed under this Permit
Subdi-
vision
Value of
Project
Amt. of
Permit
19 4
Contractor's
License No.
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.
f:: r :..
Signed: By •s' '" '
• '' " , - - .
3 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-
'ons pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
illage. In accepting this permit I assume ronsibility for all work done by either myself, my agent, servant or employee.
f de c -,:, _..;''.4n.,-44 v' - -{ t ": y +i
CONTR?KLTC'SR OR BUILDER AUTHORITY
BY