1140 NE 100 St (11)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.
Owner's Name and Address
Registered Architect and /or Engin r_ -
Employing Plumber's Name. r6!L
Amount of Permit $__
Size Septic Tank
Feet of Drain ----------------
Nature of Water Supply: City —Well.
• My Commission Expires
MIAMI SHORES ILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed )—
Date
No.-- -- - - -_ _.------ ----- _ -_ --. Street
Street_
Notary Public, State of Florida
Location and Legal Description Lot Bl _� Subdivision
Street and Number where work is to be performed —No �� I 0d Street
State work to be performed and purpose of building (By Floors) _
New Building — Remodeling_ __M ._ —__ Addition._.____ Repairs No. of Stories.
ank_— Capacity Gals
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 .fgations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors -mployed 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) P
r2,
Master Plufilbes. — et
STATE OF FLORIDA, t
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 hizr. 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
FIXTUR E6
CONTR.
LIST
- - .V+
--
--
CHECK
-.. ...
...............
SEPTIC
TANK
SEWER
CONN.
DRAIN.
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL.
SPRKLR.
SYSTEM
SW IM'G
POOL.
CONTR.
LIST
- - ---
CHECK
•
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.
Owner's Name and Address
Registered Architect and /or Engin r_ -
Employing Plumber's Name. r6!L
Amount of Permit $__
Size Septic Tank
Feet of Drain ----------------
Nature of Water Supply: City —Well.
• My Commission Expires
MIAMI SHORES ILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed )—
Date
No.-- -- - - -_ _.------ ----- _ -_ --. Street
Street_
Notary Public, State of Florida
Location and Legal Description Lot Bl _� Subdivision
Street and Number where work is to be performed —No �� I 0d Street
State work to be performed and purpose of building (By Floors) _
New Building — Remodeling_ __M ._ —__ Addition._.____ Repairs No. of Stories.
ank_— Capacity Gals
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 .fgations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors -mployed 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) P
r2,
Master Plufilbes. — et
STATE OF FLORIDA, t
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 hizr. 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
PERMIT N° 4209
Work to be performed under this Permit ) +E:.' ,-r r 4 ,.
Owner of
Building �' r' f . ..';
Architect
Contractor
or Builder / . c` e ' `t. .s �," c_. . ;° ;, t . ,„.
Legal Lot s BI. '�+ ('
llescription , f i.
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA `
DAT -., 4y/ 194
Subdi-
vision
r License No. 0 9 CI
•
l - ! Value of Amt. of
� ,�;.,, � / a : -
, !/ r . fr. - ` �, Project Permit . w..
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
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that assumes respon-
sibility for work done by his agents, servants or employees. ;..-
Signed. L •e + B
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
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.
CONTRACTOR OR BUILDER
INSPECTOR
BY AUTHORITY