940 NE 99 St (2)Permit
Owner's Name and Address
Registered Architect and /or
Employing Plumber's Nam
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING 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 wi whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Street
Location and Legal Description Lot____- ___________— ( � Block Su
Street and Number where work is to be performed —No / O Street
� - - -- — _._. - - eec.. f ry- 1 Q
State work to be performed and purpose of building (By Floors) _ _ _ .------- __.------- __ - -
New Building _— .___ -_ -- Remodeling _--------- .--- .--- __ -___ Addition_ -__ Repairs No. of Stories . . .. ... . .. .. .. . .
Size Septic Tank er
Feet of Drain Tile — __
Nature of Water Supply: City
Amount of Permit $ I 0 a
STATE OF FLORIDA,
COUNTY OF DADE.
Type of Tank —__
(Signed)-
(Signed
Capacity Gals..
__ —Dist. 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 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 si : f the work such publ' . ce or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, •• k to be p under this permit, as are
licensed by Miami Shores Village.
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.
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 insp. 'n, or faulty
materials and /or worlananship.
CLOSETS
BATH
TUBE
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
SW IM'G
POOL
CONTR.
LIST
- - --
CHICK
Permit
Owner's Name and Address
Registered Architect and /or
Employing Plumber's Nam
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING 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 wi whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Street
Location and Legal Description Lot____- ___________— ( � Block Su
Street and Number where work is to be performed —No / O Street
� - - -- — _._. - - eec.. f ry- 1 Q
State work to be performed and purpose of building (By Floors) _ _ _ .------- __.------- __ - -
New Building _— .___ -_ -- Remodeling _--------- .--- .--- __ -___ Addition_ -__ Repairs No. of Stories . . .. ... . .. .. .. . .
Size Septic Tank er
Feet of Drain Tile — __
Nature of Water Supply: City
Amount of Permit $ I 0 a
STATE OF FLORIDA,
COUNTY OF DADE.
Type of Tank —__
(Signed)-
(Signed
Capacity Gals..
__ —Dist. 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 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 si : f the work such publ' . ce or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, •• k to be p under this permit, as are
licensed by Miami Shores Village.
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.
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 insp. 'n, or faulty
materials and /or worlananship.
i
r.
Permit No _
Registered Architect and /or Engineer
Employing Plumber's Name ____A. ii__Zee.pttic__ —Ta c___ t
Location and Legal Description Lot. ` +7
Street and Number where work is to be performed —No
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
LICATION FOR PLUMBING PERMIT
940
State work to be performed and purpose of building (By Floors) install
New Building XX Remodeling Addition
Date_Dataenther
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 Paul Thomas No. Street -
No. blab Street N.W. 27_ kb_ __ .
Block i 0 Subdivision Miami____shQr. -
street____AY_R,lie!___ 1_2th___SL_a
septic tank and drain Lilo
Repairs No. of Stories
Size Septic Tank Type of Tank precast
Feet of Drain Tile 100 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Capacity Gals. 604
Amount of Permit $ - - - - - -- — 1.00 ________ ------__________ — — — — -- (Signed) 4 --'- -{ — •- I -- ...
r
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Master Plumber.
0 . 4 - ' ,� .. lC,,.A.,.«, ...
Plumbing 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.
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 andjor workmanship.
CLOSETS
BATH
TUDS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUDS
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
X
CHECK
i
r.
Permit No _
Registered Architect and /or Engineer
Employing Plumber's Name ____A. ii__Zee.pttic__ —Ta c___ t
Location and Legal Description Lot. ` +7
Street and Number where work is to be performed —No
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
LICATION FOR PLUMBING PERMIT
940
State work to be performed and purpose of building (By Floors) install
New Building XX Remodeling Addition
Date_Dataenther
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 Paul Thomas No. Street -
No. blab Street N.W. 27_ kb_ __ .
Block i 0 Subdivision Miami____shQr. -
street____AY_R,lie!___ 1_2th___SL_a
septic tank and drain Lilo
Repairs No. of Stories
Size Septic Tank Type of Tank precast
Feet of Drain Tile 100 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Capacity Gals. 604
Amount of Permit $ - - - - - -- — 1.00 ________ ------__________ — — — — -- (Signed) 4 --'- -{ — •- I -- ...
r
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Master Plumber.
0 . 4 - ' ,� .. lC,,.A.,.«, ...
Plumbing 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.
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 andjor workmanship.
Permit No. 3J _ 6 -__�
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 ___ i _ `' No
Registered Architect and /or Engineer _____________ _____ __ _ _____
Employing Plumber's Name No Street__1__
Location and Legal Description Lot_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building_________.____ W______ Remodeling Addition Repairs No. of Stories
Size Septic Tank__ Type of Tank
Capacity
Feet of Drain Tile_._ �^ c �__ ___ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—wrelt.
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
Cti
•
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.
Size of Soakage Pit._
Plumbing Inspector.
rtify that he 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
(Signed) % r/% - (� ( r" C.
- r i e I;vfasvr Plumber.
Before me, the undersigned authority, a notary public, duly
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
therein by him stated are true.
My Commission Expires
1i? , ' , l
D a t e _ �. (.- C � w —
- )
Street --
authorized to administer oaths and take acknowledgments, personally
Notary Public. State of Florida
the same, and that all facts
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. 3J _ 6 -__�
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 ___ i _ `' No
Registered Architect and /or Engineer _____________ _____ __ _ _____
Employing Plumber's Name No Street__1__
Location and Legal Description Lot_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building_________.____ W______ Remodeling Addition Repairs No. of Stories
Size Septic Tank__ Type of Tank
Capacity
Feet of Drain Tile_._ �^ c �__ ___ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—wrelt.
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
Cti
•
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.
Size of Soakage Pit._
Plumbing Inspector.
rtify that he 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
(Signed) % r/% - (� ( r" C.
- r i e I;vfasvr Plumber.
Before me, the undersigned authority, a notary public, duly
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
therein by him stated are true.
My Commission Expires
1i? , ' , l
D a t e _ �. (.- C � w —
- )
Street --
authorized to administer oaths and take acknowledgments, personally
Notary Public. State of Florida
the same, and that all facts
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
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 3653
Work to be performed under this Permit /
Owner of
Building
Architect
•
Value of
Project
DATE
Contractor's
License No.
Amt. of
Permit
CONTRACTOR OR BUILDER BY AUTHORITY
194—
n n
r'4 NIZ4. 1
L,, �11�
tau ire c4�at�u• i ; sulk
natd ace be�Or sa��,l;5�
Subdi- this ; emit. It
vision -
Contractor
or Builder
Legal Lot Bl.
Description
Address of r' { t / ''�
Building c1 M
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. 1'
Signed - .w By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and 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 myself, my agent, servant or employee.
/6
r
i
JOB: AD:
BUILDING
ELECTRICAL
PLUI•fMBING
Inspector's Report: -
WORK
DONE BY
REQUESTED '
The following is ready for Inspection:
•
•
WILL BE READY
� .r ;y _
Permit No. _5.%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 Paul Thomas
Registered Architect and /or Engineer
Employing Plumber's Name Acme 5 p i_ _Tank co.
Location and Legal Description Lot___ o fi 7
Street and Number where work is to be performed —No. 940
State work to be performed and purpose of building (By Floors)
New Building XX Remodeling Addition
Size Septic Tank Type of Tank precast
Feet of Drain Tile 100 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $_— 1.00 (Signed)
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 Workrnen'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.
STATE OF FLORIDA, k
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
s s.
My Commission Expires
• MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
LICATION FOR PLUMBING PERMIT
Block
No Street
No. 5.7.45 street N. 2 7th Ave
install septic
(Signed) _ 1°l
Date--- De..c_£mb eS' 11,___1 4 0
Subdivision Uiami Shores
Street • E . gth _at,_i
tank and drain tile
Repairs No. of Stories
Capacity Gals
Notary Public, State of Florida
600
Plumbing Inspector.
Master Plumber.
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
X
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
X
CHECK
� .r ;y _
Permit No. _5.%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 Paul Thomas
Registered Architect and /or Engineer
Employing Plumber's Name Acme 5 p i_ _Tank co.
Location and Legal Description Lot___ o fi 7
Street and Number where work is to be performed —No. 940
State work to be performed and purpose of building (By Floors)
New Building XX Remodeling Addition
Size Septic Tank Type of Tank precast
Feet of Drain Tile 100 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $_— 1.00 (Signed)
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 Workrnen'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.
STATE OF FLORIDA, k
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
s s.
My Commission Expires
• MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
LICATION FOR PLUMBING PERMIT
Block
No Street
No. 5.7.45 street N. 2 7th Ave
install septic
(Signed) _ 1°l
Date--- De..c_£mb eS' 11,___1 4 0
Subdivision Uiami Shores
Street • E . gth _at,_i
tank and drain tile
Repairs No. of Stories
Capacity Gals
Notary Public, State of Florida
600
Plumbing Inspector.
Master Plumber.
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.
JILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT . N? 1667
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal Lot Bl.
Description
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance
with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may
be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed- By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and 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 1 assume responsibility for all work done by either myself, my agent, servant or employee.
Subdi-
vision
Value of
Project
CONTRACTOR X BUILDER BY
DATE 194—
Contractor's
License No
Amt. of
Permit
AUTHORITY ,