PLUMBING PERMITSAPPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Date January 134 , 19 61
Owner's Name and Address. Col. S. D. Gibson N 108
Registered Architect and /or Engineer
Southeastern Gas Co. 2540 N.W. 29 Ave.
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors) connected S. Heater
and for no other purpose.
New Building Remodeling. Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building. Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building pernit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the ork such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su con actors, on work o be/perfo d under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) � C‘' FeF2 C
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Permit No f r I� e /-17 Read, Sworn to and Subscribed before me.
Disapproved
°LIV( (Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
ate
100 N.E. 101 St.
to me well known,
Notary Public, State of Florida
Street 101
Building Inspector My Commission Expires
PLANNI / BOARD DATE
Chairman / Member
Member Member
Member ...__._ Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
*BUILDING
ELECTRICAL
PLUMBING
Owner of ,� ,.�
Building o
fl
Architect
Contractor
or Builder
Legal Lot A- Bl.
Description
MIAMI SHORE' S VILLAGE, FLORIDA
DATE , f 1954___
PERMIT N? 10604
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
Contractor's
License No _
Amt. of
Permit
•
$ y ;r.<.••''
Address of
Building i
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. s ,
d
, o Lrr �,
Signed: ��' ^•• '"P , � e'r� BY
INSPeCTOR
In consideration of the issuance to me of this permit I agree to,iierform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting„ t is. permit I assume responsibility for all work done' by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY AUTHORITY
Permit No.1__6__4i Q kw-1
New Building Remodeling Addition
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date J
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
Registered Architect and /or Engineer
Employing Plumber's Nam — No Street
Location and Legal Description Lot Block
No Street
-- 3 _ /9-s/
Subdivision
Street and Number where work is to be performed —No /09 4/4 Street 1
State work to be performed and purpose of building (By Floors)
Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Amount of Permit $___, ___ (Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed ) _ ;,1(
' 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 inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT' NS
TOTAL
FIXTURES
CONTR.
LIST
/
'7 "
/
- --f /
7 `'-'
_ --
CHECK
! v
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL.
SPRKLR.
SYSTEM
SW IM'G
POOL
/y
CONTR.
LIST
` 1//S
CHECK
Permit No.1__6__4i Q kw-1
New Building Remodeling Addition
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date J
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
Registered Architect and /or Engineer
Employing Plumber's Nam — No Street
Location and Legal Description Lot Block
No Street
-- 3 _ /9-s/
Subdivision
Street and Number where work is to be performed —No /09 4/4 Street 1
State work to be performed and purpose of building (By Floors)
Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Amount of Permit $___, ___ (Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed ) _ ;,1(
' 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 inspection, or faulty
materials and /or workmanship.
Permit No
/J
7
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi .!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 ,, ee
�10 -�° - -- -- � -- �-�— '`�� = No 1 0 t% Street_ IA._ lcy � �� r`�•
Registered Architect and /or Engineer
Employing Plumber's Name ®
Amount of Permit $__
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No . treet__
State work to be erformed and purpose of building (By Floors) k .,� K �p
P P I'P g ( Y ) � I�.d �.r �_� � �. �� [�:1
(Signed) _
No. Street
New Building Remodeling Addition Repairs No. of Stories___
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Suppl}( "CityWell — Size of S akage Pith
C
l <''
,
7
Date
1
My Commission Expires Notary Public, State of Florida
T
R IQ
Master Pluihber.
x
2
Plum fg Inspectorrr
The undersigned applicant for this building permit does hereby certify that he un erstands and accepts his obligations as an employer of 4or
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 qr notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, op wbrk to �. performed- under this permit, as are
licensed by Miami Shores Village. g � v � � z J , , , t /
(Signed) ,.-
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
SW IM'G
POOL
CONTR.
LIST
—
CHECK
Permit No
/J
7
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi .!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 ,, ee
�10 -�° - -- -- � -- �-�— '`�� = No 1 0 t% Street_ IA._ lcy � �� r`�•
Registered Architect and /or Engineer
Employing Plumber's Name ®
Amount of Permit $__
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No . treet__
State work to be erformed and purpose of building (By Floors) k .,� K �p
P P I'P g ( Y ) � I�.d �.r �_� � �. �� [�:1
(Signed) _
No. Street
New Building Remodeling Addition Repairs No. of Stories___
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Suppl}( "CityWell — Size of S akage Pith
C
l <''
,
7
Date
1
My Commission Expires Notary Public, State of Florida
T
R IQ
Master Pluihber.
x
2
Plum fg Inspectorrr
The undersigned applicant for this building permit does hereby certify that he un erstands and accepts his obligations as an employer of 4or
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 qr notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, op wbrk to �. performed- under this permit, as are
licensed by Miami Shores Village. g � v � � z J , , , t /
(Signed) ,.-
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
Contractor
or Builder
Legal
Description
Address of
�
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 9157
Work to be performed under this Permit
2
Architect
/
Subdi-
vision
Value of
Project $
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 statemenjs or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
f
Sued: BY
INSPECTOR "p+
In consideration of the issuance to me of this permit I agree tb perform the work covered hereunder in compliance with Al ordinances and regulations
pertaining tlieret and in strict cQnfophity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting t ermit assu .. responsibility for all work done by either, myself, my agent, servant or employee.
' V RA TOR OR UILDER
DATE `., - �� 1951
Contractor's
License No
Amt. of
Permit $
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
❑ PERMIT N° 10362
This permit is ranted 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: r " s _. { ... ,e .t 7 BY
I14SPFCTOR
In consideration of the issuance to me of this permit I agree rd perform the work covered hereunder in compliance with all ordinances and regulations
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 eithir, m} self, my agent, servaat or employee
CONTRACTOR OR BUILDER
Bl.
MIAMI SHORES VILLAGE, FLORIDA
DATE /
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
BY
195 J
Contractor's
License No
Amt. of
Permit
AUTHORITY
•UILDING
LECTRICAL
LUMBING
)wner of
. uilding
.rchitect
i'
lenrnak
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 5687
Work to be performed
: ontractor
r Builder
,ega1 Lot / ' q t. / / V Bl. Subdi- ) f
)escription vision , T
r �
.ddress of t , J f * 2^ r Value of Amt. of
; uilding /` Project Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
.lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
t 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
ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he ass yp es respon-
ibility for work done by his agents, servants or employees. °
Signed. 6 , i !:/`>''•*� !: B . /�'
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and•regulations
.ertaining thereto and in strict conformi with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n acc- •ling thi permmit I a e respo •ility for all work done by either myself, my agent, servant or employee.
under this Permit
,f2tdi
DATE " 2- 3 194
Contractor's
_License No. / Z
CONTRACTOR OR BUIL r R BY AUTHORITY
BUILDING
ELECTRICAL
.PLUMBING
'Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
/3 7 iy
Address of �" 9 , P,,,%' jj
9
Building / �i
•
I 46..411LI
CONTRACTOR OR BUII:
MIAMI SHORES VILLAGE, FLORIDA
PERMIT No
Bl. 4 -0" .
5687
DATE
9 23
1947
Contractor's
License No. / la y / L
R oed Work to be performed under this Permit 2211 7
Subdi-
vision
Value of o `' "
Project Permit
Amt. y
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
work covered he sib lit for work done by his , servants or employees er shown on the plans gl c�r � ings Br ii the statemnts or specification that he mimes respon-
Signed' � By
INS CTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with
pertaining thereto and in ,strict conformi with the plans, drawings, statements or specifications submitted to the proper auth
In accepting'thi -partnit I assume respo 'bilit for all work done by either myself, my agent, servant or employee.
{ I y.,
BY
rdinances anc4egglitions;
of Miami Sho`fes age.
AUTHORITY
t
Permit No
building during progress of work.
Owner's Name and Address
Street and Number where work is to be performed —No i 1)
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
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
No Street
Registered Architect and /or Engineer
,rte
Employing Plumber's Name No / E' Street
Location and Legal Description Lot _ Block Suu bdivision
Street____ / sr
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
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well . Size of Soakage Pit
(Signed)
Plumbing Inspector.
• The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE. J
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
/2),..07s-,z
' Hz/L
/ `°s
TOTAL
FIXTURES
CONTR.
LIST -
`�
`J
/
/
2
/
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
/
CONTR.
LIST
CHECK
Permit No
building during progress of work.
Owner's Name and Address
Street and Number where work is to be performed —No i 1)
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
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
No Street
Registered Architect and /or Engineer
,rte
Employing Plumber's Name No / E' Street
Location and Legal Description Lot _ Block Suu bdivision
Street____ / sr
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
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well . Size of Soakage Pit
(Signed)
Plumbing Inspector.
• The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE. J
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.
/9
3
7r
3— vv• C
; S//d il/tP'S
/- 6,w /(
/- 7°K A Y
11
si
/11/r. /e/Viy (7%, Jw/s/ E
. � . /0 / 6-r cf.
4 1 • C ',Pro 0 CO,, , i TO
v,4
Permit No (1-*
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of. Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress'tif work. /
Owner's Name and Address t' ( S � �4� /0 0 4A_ No Street..— /O 1 ..
Registered Architect and /or En gyleer
£et laytn� F1u�gtsp�{n� / .
/ fj :� ..._
> o tioon and / Legal Descrl ption Lot ��1 B Subdivision
Street and Number where work is to be performed -No / 0'0 i ( Street /&. L cT~I A4 (4'
Amount of Permit 8 �� f Q0
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors)____
New Building..- Remodeling —__ _ __ - -- Addition.
Size Septic Tank— _Type of Tan1 —
Feet of Drain Tile. -. _ Dist Feet of Tank or Drain Field from Well ..._.__-
Nature of Water Supply: City -We1L Size of Soakage Pit
(Signed)
Repairs
'C - F. - - -
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 Pennanent Supplement, and hrs com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wore to he
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Ra-co
-1
STATE OF FLORIDA, I
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 si the
therein by him stated are true.
Notary Public, Stag, ai ;IOT ?da
�aiwZ: bc1 My1'w Colmnfrlraioo -
•
4,4
17 S7 _
No. of Stories ........
�9 `P I o f I
rooz. M aster Plumber.
NOTE: A re- inspection fee of 81.00 will be made whoa snob abaspaotlan is mede•aeoauary by r notice for Inspection. or faulty
materials and /ar workmanship.
CLOSETS
BATH
Tu••
aMOWIRa
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuve
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•N•
TOTAL
/ixTulle
CONTR.
LIST
CHICK
SEPTIC
TANK
SIWIR
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DRIP
WILL
SPRKLR.
SYSTEM
SW IM'0
POOL
I
CONTR.
LIST
►--
CHICK
Permit No (1-*
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of. Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress'tif work. /
Owner's Name and Address t' ( S � �4� /0 0 4A_ No Street..— /O 1 ..
Registered Architect and /or En gyleer
£et laytn� F1u�gtsp�{n� / .
/ fj :� ..._
> o tioon and / Legal Descrl ption Lot ��1 B Subdivision
Street and Number where work is to be performed -No / 0'0 i ( Street /&. L cT~I A4 (4'
Amount of Permit 8 �� f Q0
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors)____
New Building..- Remodeling —__ _ __ - -- Addition.
Size Septic Tank— _Type of Tan1 —
Feet of Drain Tile. -. _ Dist Feet of Tank or Drain Field from Well ..._.__-
Nature of Water Supply: City -We1L Size of Soakage Pit
(Signed)
Repairs
'C - F. - - -
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 Pennanent Supplement, and hrs com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wore to he
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Ra-co
-1
STATE OF FLORIDA, I
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 si the
therein by him stated are true.
Notary Public, Stag, ai ;IOT ?da
�aiwZ: bc1 My1'w Colmnfrlraioo -
•
4,4
17 S7 _
No. of Stories ........
�9 `P I o f I
rooz. M aster Plumber.
NOTE: A re- inspection fee of 81.00 will be made whoa snob abaspaotlan is mede•aeoauary by r notice for Inspection. or faulty
materials and /ar workmanship.
Owners Name and Address
Registered Architect and /or Engine_tiL5
Employing Plumber's Name__M.t- n!t _t__ C
Location and Legal Description Lot__.__ _____— _ .___ ___ _ Block
Street and Number where work is to be performed —No treet.
State work to be perforrne8 and purpose of building (By Floors) _____ -__r LR_ _._.___ - gam /_
New . Building __ -- _ -- Remodeling
Amount of Permit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(signed)._ ` - _ -4--.
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General
" plied with the provisions thereof, and will require similar compliance from all contracto
performed under this permit; and will post or cause to be posted' for inspection on the
required by the Act. The undersigned agrees to employ only such sub- contractors,
licensed by Miami Shores Village.
APPLICATION FOR PLUMBING PERMIT
Permit No "1173 3 Date ' C f 1 q 9—
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.
al(i. _ L_7 ` 6 Street__
Subdivisi
eAO1 - filevi PM
()s N S0 Street_ E / e / S T
x -C ( 7
2 S 1 ,544ec
Addition________ Repairs No. of Stories
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
Capacity Gals.
umbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
Florida Penman
ntractors e
e work
to be
u
oyed b
ch publi
erfo
My Commission Expires Notary Public, State of Florida
lement, and has crnn-
him in the work to be
notice or notices as are
s permit, as are
Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer • : the 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 81.00 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'N6
TOTAL
FIXTURES
CONTR.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FI ELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'S
POOL
CONTR.
LIST
CHECK
Owners Name and Address
Registered Architect and /or Engine_tiL5
Employing Plumber's Name__M.t- n!t _t__ C
Location and Legal Description Lot__.__ _____— _ .___ ___ _ Block
Street and Number where work is to be performed —No treet.
State work to be perforrne8 and purpose of building (By Floors) _____ -__r LR_ _._.___ - gam /_
New . Building __ -- _ -- Remodeling
Amount of Permit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(signed)._ ` - _ -4--.
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General
" plied with the provisions thereof, and will require similar compliance from all contracto
performed under this permit; and will post or cause to be posted' for inspection on the
required by the Act. The undersigned agrees to employ only such sub- contractors,
licensed by Miami Shores Village.
APPLICATION FOR PLUMBING PERMIT
Permit No "1173 3 Date ' C f 1 q 9—
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.
al(i. _ L_7 ` 6 Street__
Subdivisi
eAO1 - filevi PM
()s N S0 Street_ E / e / S T
x -C ( 7
2 S 1 ,544ec
Addition________ Repairs No. of Stories
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
Capacity Gals.
umbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
Florida Penman
ntractors e
e work
to be
u
oyed b
ch publi
erfo
My Commission Expires Notary Public, State of Florida
lement, and has crnn-
him in the work to be
notice or notices as are
s permit, as are
Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer • : the 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 81.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
�..--
CLOSrTS
BATH
Toes U86
S
LAVES
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE GREASE
PIT TRAP
SOLAR
NEATER
DEEP
ELL
SPRKLR.
SYSTEM
SW IM'O
POOL
CONTR.
LIST
CHECK
(/ P'') .
— � —
��
Net c
permit No /
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and 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. s .
Owner's Name and Address
Registered Architect and /or Engineer_
Employing Plumber's Name gri e .")
Location and Legal Description
Street and Number where work is to be performed —No —
State work to be performed and purpose of building (By Floors)_
New Building
Size Septic Tank.
Remodeling
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
od ele1ek Ce1ra
No._1 Q
.Type of Tank - Capacity Gals.
Feet of Drain Tile. __Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.
2
Amount of Permit $_
( Signed)._
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Perman
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors e
performed under this permit; and will post or cause to be posted for inspection on the site of the work s
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be � + f •. " ed
licensed by Miami Shores Village.
.41h All
( Signed)
Date
%.'.'Y S .__ No..— ____' ; ___ Street ._ '. f
My Conunission Expires Notary Public, State of Florida
Street /Of
__Block Subdivision__
a 0 `� Street
Addition____ Repairs No. of Stories.
Size of Soakage Pit
Plumbing Inspector.
as an employer of labor
pplement, and has corn -
by him in the work to be
c notice or notices as are
under this permit, as are
Master Plumber.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and. says that he is the_
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
.UILDING
,LECTRICAL
LUMBING
)wner of
- uilding
:ontractor
r Builder
MIAMI SHORES VILLAGE, FLORIDA
DATE 9 ' 1942
PERMIT N° 5698
Work to be performed under this Permit
Subdi-
vision
.rchitect r z
.egal Lot / 4 r is Bl. / .,:•`#
)escription
address of r r ,i � { - Value of Amt. of f f (
wilding �-, Projec Permit •
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be perfornied in compliance with any
dans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
t 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
,ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
egulations pertaining to the work covered hereby whether shown on the plans opdrawings or in e statements or specifications a that he assumes respon-
ibility for work done by his agents, servants or employees. i
Signed. INSPECTOR By i
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and..regulations
•ertaining thereto and in strict conformity with the plans, .drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
i accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
Contractor's / .' 7 / .
License No. b
CONTRACTOR OR BUILDER BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Building. /M
Owner of
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot / ?
Work to be performed
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
L., -/ mil/
B1.
/0 / 42
. DATE
N° 5698 Contractor's 73 7 4
) 1€
License No.
L: under this Permit '
Subdi-
vision
Value of
Project
BY
19 4/_
Amt. off/
Permit 4
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 irvoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed. without'authoriaation. A further condition upon which this
hermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowled e of the or nces and
regulations pertaining to the -work covered.liefeby.whether shown on the plans awin s or ' e statements ors ecification a e a es respon-
sibility for work done by his agents, servants or employees.
s
Signed. B
INSPECTO
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with ondinances arinedulailms
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.
' AUTHORITY
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name_; ' _.
7
New Building
Amount of Permit $
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
Date /
i F
.� p
No ,�id r'_1 St ✓L
Street
I Block Subdivision
Capacity Gals
My Commission Expires Notary Public, State of Florida
Master Plumber.
b
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.
No Street
Location and Legal Description Lot
Street and Number where work is to be performed —No / v/ � � � / Street
State work to be performed and purpose of building (By Floors)
Remodeling Addition Repairs No. of Stories
Size Septic Tank' Type of Tank____,; •
Feet of Drain Tile___I Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well ....... __ _________ ______ __________________ _________Size of Soakage Pit ______T-
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE .OF FLORIDA, 1
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
ALS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM •G
POOL
CONTR.
LIST
CHECK
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name_; ' _.
7
New Building
Amount of Permit $
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
Date /
i F
.� p
No ,�id r'_1 St ✓L
Street
I Block Subdivision
Capacity Gals
My Commission Expires Notary Public, State of Florida
Master Plumber.
b
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.
No Street
Location and Legal Description Lot
Street and Number where work is to be performed —No / v/ � � � / Street
State work to be performed and purpose of building (By Floors)
Remodeling Addition Repairs No. of Stories
Size Septic Tank' Type of Tank____,; •
Feet of Drain Tile___I Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well ....... __ _________ ______ __________________ _________Size of Soakage Pit ______T-
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE .OF FLORIDA, 1
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.