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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 CLOSE YS BATH TUBB SHOWERS LAVA• TORIES SIN" SINK[ LAUNDRY TU[[ U RINAL/ CATCH eA[IN FLOOR I DRAIN DRINKING FOUHT•NB D•iai (,LI.?y /�,Z i« I 1 /k ,k g . —7---- TOTf.L FIXTURE[ __ CONTR. LIT f l / / / / CHECK '3 .vv /.So /.:-t' o 3.00 J 6 -o /. 50 — - /.5J / 6 SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H DEEP WELL SPRKLR. SYSTEM SWIM'O POOL 1.4"4- I + -,j, . . { -L%• _— CONTR. LIST 1 _ CHECK 4 15 3 •? J .. _�• 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