910 NE 99 St (9)�/ Co APPLICATION FOR PLUMBING PERMIT /
Permit No ° 0 k D ate... O Z ,L._7/r , _ - -- - - ...__..._.�
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 Dopy of approved plans and specifications must be kept at
building during progress of work.
Owners Name and Address
Registered Architect an or Engin
g I 's N ∎ e l m 1\ r
M to inn and Legal Description Lot
Street and Number where work is to be performed —No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(SI
Rink (KO Sub& N
D Street L� 7r� SL . _ _
State work to be performed and purpose of building (By Floors )_____ _ _ _ �. .. V �l On 'A 1 �'- d •
_. .
New Building. Remodeling —_ ___. _ _ Repairs No. of Stories
No 9i,
Size Septic Tank__ _Type of Tank____
Feet of Drain Tile Dist- Feet of Tank oe Drain Field from Well .. ._.___..__
Nature of Water Supply: City —Well. Size of Soakage Pit
Street ...�"�
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 5968, 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 weer to he
performed under this permit; and will post or cause to be posted for inspection on the site of the wor ch public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, work to caned under this permit, as are
licensed by Miami Shores Village. ,` • El asi
STATE OF FLORIDA, 1 µ
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 depose/ and says that he is the ..._ ......._..._.. -.... _ _.... —. _ -.
of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expire Notary Public, State of Florida
aster Plumber. -
NOTE: A re- inspection fee of $1.00 will be made when snob reigned= is made'asoaoary by Improper notice for Inspection, or helty
materials and /or workmanship.
CLOScrs
BATH
Tu •[
aNOW[R/
LAVA•
TORI[/
SINK/
SLOP
SINK/
LAUNDR
Tuve
URINAL/
CATCH
BASIN
FLOOR
DRAIN
DRINKI NO
FOUNT WS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FI LLD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
D[5P
WELL
BPRKLR.
S M
SW IM'O
POOL
-
CONTR.
LIST
-_
.--
CHECK
�/ Co APPLICATION FOR PLUMBING PERMIT /
Permit No ° 0 k D ate... O Z ,L._7/r , _ - -- - - ...__..._.�
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 Dopy of approved plans and specifications must be kept at
building during progress of work.
Owners Name and Address
Registered Architect an or Engin
g I 's N ∎ e l m 1\ r
M to inn and Legal Description Lot
Street and Number where work is to be performed —No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(SI
Rink (KO Sub& N
D Street L� 7r� SL . _ _
State work to be performed and purpose of building (By Floors )_____ _ _ _ �. .. V �l On 'A 1 �'- d •
_. .
New Building. Remodeling —_ ___. _ _ Repairs No. of Stories
No 9i,
Size Septic Tank__ _Type of Tank____
Feet of Drain Tile Dist- Feet of Tank oe Drain Field from Well .. ._.___..__
Nature of Water Supply: City —Well. Size of Soakage Pit
Street ...�"�
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 5968, 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 weer to he
performed under this permit; and will post or cause to be posted for inspection on the site of the wor ch public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, work to caned under this permit, as are
licensed by Miami Shores Village. ,` • El asi
STATE OF FLORIDA, 1 µ
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 depose/ and says that he is the ..._ ......._..._.. -.... _ _.... —. _ -.
of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expire Notary Public, State of Florida
aster Plumber. -
NOTE: A re- inspection fee of $1.00 will be made when snob reigned= is made'asoaoary by Improper notice for Inspection, or helty
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
,
Permit No s�/ 7 7 Date ...-- •---- -- --- •— •- • MARCH 31ST -- _....._ 80
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 DEAN C L A E S E N N 910 N• E.
Registered Architect and /or Engineer
-
Employhi` Plumber's Name 0 '.LE AL._IE.P T T C T 9 N K rizitz i
Location and Legal Description Lot. Block SubdI on._ __ __.. 33166
Street and Number where work is to be performed —No 910 N • E • Street. 99TH 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 2 S Q • F2. Dfst Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of Soakage Pik .....
Amount of Permit $ 6-:11
Capacity Gals..._...-...__
(Signed)__L �11a_
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 5988, 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 u are
required by die Act. The undersigned agrees to employ only such sub- contractor, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( C K
Master Plumber.
STATE OF FLORIDA, I .s.
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 dep ores and says that he is the ._____._..._.._---- • - - -. - - ... - --
of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re inspection fee of $1.00 will be made whoa mob misapeotian M mede•neoewrr by improper notice for inspection, at faulty
materials and/or workmanship.
CLOSETS
BATH
TUBS
11
LAVA•
TORIES
SIN"
SLOP
SINKS
LAUNDRY
Tuns
URINALS
CATCH
Oasis
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
200
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
Davi
WELL
SPRKLR.
SYSTEM
SWIM'G
P001.
c
CHECK
- Q.FT
r _
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
,
Permit No s�/ 7 7 Date ...-- •---- -- --- •— •- • MARCH 31ST -- _....._ 80
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 DEAN C L A E S E N N 910 N• E.
Registered Architect and /or Engineer
-
Employhi` Plumber's Name 0 '.LE AL._IE.P T T C T 9 N K rizitz i
Location and Legal Description Lot. Block SubdI on._ __ __.. 33166
Street and Number where work is to be performed —No 910 N • E • Street. 99TH 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 2 S Q • F2. Dfst Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of Soakage Pik .....
Amount of Permit $ 6-:11
Capacity Gals..._...-...__
(Signed)__L �11a_
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 5988, 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 u are
required by die Act. The undersigned agrees to employ only such sub- contractor, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( C K
Master Plumber.
STATE OF FLORIDA, I .s.
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 dep ores and says that he is the ._____._..._.._---- • - - -. - - ... - --
of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re inspection fee of $1.00 will be made whoa mob misapeotian M mede•neoewrr by improper notice for inspection, at faulty
materials and/or workmanship.
- -^
CLOSETS
BATH
Tue•
SNOWaR�
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tugs
uRMALa
I
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT' PIS
TOTAL
FIIITURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
F IELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW 1111'G
POOL
CONTR.
LIST
X
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No a -LS 9 Date Q 3 L/
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. r 9 Owners Name and Address 0 -4 9 - 1 \ e L =�' °t t 9
n No. I o Street_. ` - 9q ' ...
Registered Architect and /or Engineer -
Employing Plumber's Na0 . .
Location and Legal Description Lot. Mork Subdivision__ _ ._—
Street and Number where work is to be performed -No Street_. .._..._._
State work to be performed and purpose of building (By FIoors) _____
New Building. ___ _ _ _ _ - . Remodeling___- ..- _- ._ -___ Addition._ - __ —..__ Repairs. No. of Stories. .................
Size Septic Tank._
Feet of Drain Tile
Nature of Water Supply: City -Well.
Amount of Permit $ 1 . S . • 0 _ 0 _
.Capacity Gals..
Type of
r)lat. Feet of Tank or Drain Field from Well
Size of Soakage Pit ....... __ ___._.__._..___.__.._. __.__.._._
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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 perfonnecl under this permit, as are
licensed by Miami Shores Village.
(Signed) .I , l r� 1/
Muter Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, • 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 dap deposes and says that be is the
of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be grade wham war t+riaspeotlosi is mada•aaoessary by improper notice for inspection, or faulty
materials and /or workn anship.
1�
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/
/ 26
Permit No Date
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 herem descnbed. 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 Div'sion
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. BIJOK No. 910 N.E. Street . _ 99th .St.
Registered Architect and/or Engineer ...
Employing Plumber's Name ABC SEPTIC TANK SERVICE _ No.. - 123 Street.. - th
Location and Legal Description Lot____.___ Block.
Street and Number where work is to be performed—No 910 N. _E
State work to be performed and purpose of building (By Floors)._
New Building Remodeling
Subdivision_
Street 29th . St .
Addition__ Repairs. No. of Stories . .
Size Septic Tank.. _ _ . Type of Tank ____ _ _ .Capacity Gals.
Feet of Drain Tile. . _ 2 _5! _ _ _. _Dist. Feet of Tank or Drain Field from Weal.
Nature of Water Supply: City—Well. _ _ Si , of Soakage Pit
Amount of Permit $
_ ( Signed). ._
Pln bin In ;pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli Jions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perma nt Supplement, oral 1 .
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by bin: 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 the 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.
STATE OF FLORIDA,
COUNTY OF DADE.
(Signed )_.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 by improper notice for inspection, or faulty
materials and/or worlananship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
61 N"
SLOP
SINKS
LAUNDRY
Tuss
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N6
TOTAL
F %TURES
CONTR.
LIST
CHECK
—
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL.
CONTR.
LIST
CHECK
.
--
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/
/ 26
Permit No Date
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 herem descnbed. 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 Div'sion
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. BIJOK No. 910 N.E. Street . _ 99th .St.
Registered Architect and/or Engineer ...
Employing Plumber's Name ABC SEPTIC TANK SERVICE _ No.. - 123 Street.. - th
Location and Legal Description Lot____.___ Block.
Street and Number where work is to be performed—No 910 N. _E
State work to be performed and purpose of building (By Floors)._
New Building Remodeling
Subdivision_
Street 29th . St .
Addition__ Repairs. No. of Stories . .
Size Septic Tank.. _ _ . Type of Tank ____ _ _ .Capacity Gals.
Feet of Drain Tile. . _ 2 _5! _ _ _. _Dist. Feet of Tank or Drain Field from Weal.
Nature of Water Supply: City—Well. _ _ Si , of Soakage Pit
Amount of Permit $
_ ( Signed). ._
Pln bin In ;pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli Jions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perma nt Supplement, oral 1 .
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by bin: 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 the 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.
STATE OF FLORIDA,
COUNTY OF DADE.
(Signed )_.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 by improper notice for inspection, or faulty
materials and/or worlananship.
BUILDING
ELECTRICAL
PLUMBING
Architect /
Contractor (, /p ,,.;
or Builder - 1 : f ' i2 - / : =
Lot -- . .,y y
/
Legal
Description
Address of 7/' '
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT •9 3220
Work to he erformed under this Permit
Owner of
Building
Bl.
Subdi-
vision
Value of
P roject
This per(nnit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in
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 malt
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 drativings or in the statements I- Anecificaji ns and
that he assumes responsibility for work done by his agents, servants or employees. i �` �,•
Signed•
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the }1fosk covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either mjse my agent, servant or employee.
'13Y
fr
DATE
Contractor's
License No.
j 1 •r {. �j �.�'�' y _ �f
•
Amt. of
Permit
13y i • 4'
AUTHORITY
194
the