PLUMBINGPermit 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 the rogress of work.
V ERR Y 9 Ot s °/ ✓ No. P� 91 Street/j t /
Owner's Name and Address
Registered Architect and/or Engineer �y Lj / f
Employing Plumb is N ROF SL0 APtili )24w/Am-66 No. / /- 3 a Street 06 4& / /
��//�� 441 i / �J'c B lock Subdivision �yj, g 'li / I/ �oeai:ion and Descript o of / 16 / "J
/16a /VOR e /0/ s7
Street and Number where work is to be performed — No.
Street
State work to be performed and purpose of building (By Floors)
New Building
Size Septic Tank 9 � Q /l D44 ' Type of Tank Fi /C - 2- g
Feet of Drain Tile
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Remodeling Addition
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - Well Size of Soakage Pit
(Signed)
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Repairs No. of Stories
Capacity Gals.
qatteit-
Date WO 16 — / 90
900
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 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 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
. p
v ' /1 0/ 6„, Master Plumber.
ss. c.F6a_ a�- X .
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 $25.00 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
FOUNTAINS
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.
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 the rogress of work.
V ERR Y 9 Ot s °/ ✓ No. P� 91 Street/j t /
Owner's Name and Address
Registered Architect and/or Engineer �y Lj / f
Employing Plumb is N ROF SL0 APtili )24w/Am-66 No. / /- 3 a Street 06 4& / /
��//�� 441 i / �J'c B lock Subdivision �yj, g 'li / I/ �oeai:ion and Descript o of / 16 / "J
/16a /VOR e /0/ s7
Street and Number where work is to be performed — No.
Street
State work to be performed and purpose of building (By Floors)
New Building
Size Septic Tank 9 � Q /l D44 ' Type of Tank Fi /C - 2- g
Feet of Drain Tile
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Remodeling Addition
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - Well Size of Soakage Pit
(Signed)
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Repairs No. of Stories
Capacity Gals.
qatteit-
Date WO 16 — / 90
900
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 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 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
. p
v ' /1 0/ 6„, Master Plumber.
ss. c.F6a_ a�- X .
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 $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials
and/or workmanship.
Applicant
(f) Other:
HU'.- -15 - 1990 12:37 FROM
Septic tank or Grease
aerobic unit 7 UV gallons interceptor gallons
Septic tank or
aerobic unit _ _ gallons Dosing tank gallons
Graywater
tank __ gallons
Laundry
waste tank ___® gallons
l
Other Requirements: rte✓ ft9 det r6
(a) Installation 'must be in accord with requirements of chapter 10D -6, FAC.
(b) A system construction permit is valid for a pe iced of one calendar year from date of issue
(c) Final installation inspection a `. p�roval is r; quire ore the system is covere ` o-
(d) Invert of stub -out for ±+ D�-� benchmark.
q y
' .� -` to be � f � ��'�
Invert of stub-out for to be _ benchmark.
Invert of stub -out for to be benchmark.
Invert of stub -out for to be benchmark.
(e) Fill quality and quantity:
System design and specifications by
Construction authorized
STATE OF FLORIDA
DEPARTMENT OF AEALTH AND REHABILITATIVE SERVICES
c(5`GiSr:ii= SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT
Miami
Woo 87 °6
PA T G SVUILM COPYSTKIG r00(i SiP CW - iCA'lONS AND CONSMUCTION APPROVAL --------
`rFeament Tank
^ r `
County Public bip^ +h Unit
Authority: Chapter 381. FS
Chapter 10D-6, FAC
Mintfriurn IN airtfieeach Opt 19lra:v uni AbsaepVca
Size
TO 95549191 P.01
Permit Number
Square Feet
Square Feet
Square Feet
_ Square Feet
Title
beef Sixe
L . Square Feet
Square Feet
—_� Square Feet
Square Feet
Date /6 -92
Date of Application
PART 1 - APPLICATION-- -
Name of Owner Telephone � r ��� �
/ Telephone Numbers ,97,2• /547
Mailing Address of Owner _. //65
Owner's Agent ��>�i 4
Builder E _p1Jk (1 . _ et ""
Agent's Mailing Address z - /o . � i'
Telephone No. __�- /.5(� 5_ 0_
Property Street Address _ 3 N ' /a/ P. '
Lot No. /2 Block No..174 Subdivision ,! . //f2,5 / 02 a
Subdivided
� Date
NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BOUNDS DESCRIPTION
This Application is for: New System
- _ Repair
Type of
Establishment
Type of
Residential
DEPART T ENT OF H
STATE OF FLORIDA
EALTH AND REHABILITATIVE
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
23
Permit Application Number
•
Sewage Flow
(Gallons per day)
TOTALLOw = _
No. Bedrooms
(each dwelling unit)
JAIJ
3 ROL NO. ;c 1 Applicant's Signature
Form 4015, Feb 85 (Obsoletes previous od.tions Which may not be ute4)
c.k Number. 5744.001- 4015.1)
Authority: Chapter 381, FS �/i / 0
Chapter 10D-6, FAC
Heated or Cooled Area
(each dwelling unit)
ft
ft
act Directions to Property
Existing System
Sewage Flow
Based On
•
No. Dwelling Sewage Flow
Units (Gallons per day)
•-•
.1
•
knv st-.7)4;c4,
NUJ-15-1990 12:36 FROM
NVA,f
?I1 4 Tals.K •
r - -
: 14 4 . < D,W
• 1
. ■ ! '
\ I i
!
ti
t. _
•
lJ W n L.L.=s;'? 17.4r
01 tz'X WTI
b.)
.."
TO
P
A
ST
DEPARTMENT OF
,AvECOUNTy
SAW
• -
l i-gf 4 r 4 1.,,Atailf.1 •
••• fmr..4
95549191 P.02
_ .
'SQ. ft. wiqy
FtAl NEI ELD TO BE NOT IISS.
A LEvEL DATUM (NGM
rNcHes QF SAND :
Om 0 "I? v:NI7P_LO
ae • .11•4
•
•
,•
pROVED•
TE OF FLORIDA
HEALTH & REHABILITATION SERVICr;S
EPARTMErIT OF PUBLIC }t ALT
RY E41 IS SECTION
.ONSITE SWAGE DISPOSAL SYSTEM OWIY
ial NO. 0
• • Date10—
rZF Pt-\i
•
_ rt F U-OvirPEA) Ron tlevA A 11% 11:
ri a, 11 too
•
r•
TOTAL P.02
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(C-2;14 CONNIE'S SEPTIC TANG CO., INC. _ a '
Permit No P. 0. BOX 651 o HIALEAH, FLORIDA 33011 Date__ _ 3 .____ - --
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 ` -- o No.
Amount of Permit
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
(Signed) _
(Signed)_
Street__ /1 _ v 3 11E/0/1
Registered Architect and /or Engineer ----- _ —_ -_- _- ---- ---- _ —_____
Employing Plumber's Name __ -- ��---- -_ - - -- No.___---- __ —_ -- Street_
----__- -
Location and Legal Description Lot________ ____________ —____ Block__ Subdivision
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)______
New. Building Remodeling_____ ____ Addition Repairs No. of Stories _______ ..... ____......
Street
Size Septi ___
__- ---- ---- -• _-- -_Type of Tank
Feet of Dr __- -- -- cq � -__ -
o! Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well.____ ....... -__ ___________________________Size of Soakage Pit
Capacity Gals.
ctor.
The undersigned applicant for this.building permit does hereby certify that he understands and accepts his obliga o . as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permane pplement, 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, ork to be permed unj1e{ • permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same; and that all facts
therein by him stated are true.
Notary Public, State of Florida
ter P
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
R INALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
,
CONTR.
LIST
- --
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(C-2;14 CONNIE'S SEPTIC TANG CO., INC. _ a '
Permit No P. 0. BOX 651 o HIALEAH, FLORIDA 33011 Date__ _ 3 .____ - --
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 ` -- o No.
Amount of Permit
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
(Signed) _
(Signed)_
Street__ /1 _ v 3 11E/0/1
Registered Architect and /or Engineer ----- _ —_ -_- _- ---- ---- _ —_____
Employing Plumber's Name __ -- ��---- -_ - - -- No.___---- __ —_ -- Street_
----__- -
Location and Legal Description Lot________ ____________ —____ Block__ Subdivision
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)______
New. Building Remodeling_____ ____ Addition Repairs No. of Stories _______ ..... ____......
Street
Size Septi ___
__- ---- ---- -• _-- -_Type of Tank
Feet of Dr __- -- -- cq � -__ -
o! Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well.____ ....... -__ ___________________________Size of Soakage Pit
Capacity Gals.
ctor.
The undersigned applicant for this.building permit does hereby certify that he understands and accepts his obliga o . as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permane pplement, 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, ork to be permed unj1e{ • permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same; and that all facts
therein by him stated are true.
Notary Public, State of Florida
ter P
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.
30 6,5"0
Permit No._
Amount of Permit $
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 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 the progress of work.
Owner's Name and Address /1 3% Dcctde ,nyl No. Street I/6 3 /1)6 /C) / .S/
Registered Architect and /or Engineer
Empgg 4 b ®On e MA -6 ? /`/ YI C� No.3 ZZ / Z}! C�Z
/
Location and Legal Description Lbt �� J Block //!�
Street and Number where work is to be performed — No. / /6 A-) 6'
• /0/ S 7 •
Street
State work to be performed and purpose of building (By Floors) S1 )03)c r4m.i5 z)9/) <
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)
The undersigned applicant for this building permit does hereby certify that he understands and accep
Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permane
thereof, and will require similar compliance from all contractors or sub - contractors employed by him i
post or cause to be posted for inspection on the site of the work such public notice or notices as are
only such sub - contractors, on work to be performed under this permit, as are lice - • . by Miami
(Signed)
Date NW
Street '?7 ()!) / SC,J /p y
Subdivision /// ,s -e /O / N p /
Plumbing Inspector
s obligations as an employer of labor under the
plement, and has complied with the provisions
ork to be performed uu his permit; and will
th e un rsigned agrees to employ
Master Plumber.
ST E OF FLORIDA,
UNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated
are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $25.00 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
FOUNTAINS
TOTAL
FIXTURES
CONTR.
LIST
'
r
a
, r
{(
CHECK
*
\/1
SEPTIC SEWER
TANK CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G.
POOL
CONTR.
LIST
�Y1 V� •
CHECK
(]
7
30 6,5"0
Permit No._
Amount of Permit $
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 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 the progress of work.
Owner's Name and Address /1 3% Dcctde ,nyl No. Street I/6 3 /1)6 /C) / .S/
Registered Architect and /or Engineer
Empgg 4 b ®On e MA -6 ? /`/ YI C� No.3 ZZ / Z}! C�Z
/
Location and Legal Description Lbt �� J Block //!�
Street and Number where work is to be performed — No. / /6 A-) 6'
• /0/ S 7 •
Street
State work to be performed and purpose of building (By Floors) S1 )03)c r4m.i5 z)9/) <
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)
The undersigned applicant for this building permit does hereby certify that he understands and accep
Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permane
thereof, and will require similar compliance from all contractors or sub - contractors employed by him i
post or cause to be posted for inspection on the site of the work such public notice or notices as are
only such sub - contractors, on work to be performed under this permit, as are lice - • . by Miami
(Signed)
Date NW
Street '?7 ()!) / SC,J /p y
Subdivision /// ,s -e /O / N p /
Plumbing Inspector
s obligations as an employer of labor under the
plement, and has complied with the provisions
ork to be performed uu his permit; and will
th e un rsigned agrees to employ
Master Plumber.
ST E OF FLORIDA,
UNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated
are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials
and/or workmanship.
;UILDING
LECTRICAL
IUMBING
PERMIT N9 8545
Work to be performed under this Permit
)wner of
:wilding ..
.rchitect
: ontractor
r Builder
.egal Lot
)escription
Bl.
.ddress of
MIAMI SHORES VILLAGE, FLORIDA
DATE !
Subdi-
vision
Value of ,,/
Project
Contractor's
License No
Amt. of
Permit
194_
. uilding ,J: s - d 1
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
- gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
.bility for work done by his agents, servants or employees. /
Signed. f.t• * #t .' 14.. L .. B 1
INSPECTOR 7
In consideration of the issuance to me of this permit I agree to perform the w ork 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 Shores Village.
i accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRIW QB OR BUILDER BY AUTHORITY
Permit No.
y VVS
New Building
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 herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address No Street
Registered Architect and /or Engi /�'
Employing Plumber' s Names .a ta.�. 101∎•.r No Street
Location and Legal Description Lot ____________ Block._ � __ Subdivision
Street and Number where work is to be performed—No. _IL 4 °J 3 __ >7____ �______ 0. Street
State work to be performed and purpose of building (By Floors)
Remodeling Addition Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile
Amount of Permit $
7s- a
ss.
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed) . � t 7 �s
Plum 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)
Date //' /
aster Plumber.
STATE OF FLORIDA, 1
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.
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
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.
y VVS
New Building
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 herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address No Street
Registered Architect and /or Engi /�'
Employing Plumber' s Names .a ta.�. 101∎•.r No Street
Location and Legal Description Lot ____________ Block._ � __ Subdivision
Street and Number where work is to be performed—No. _IL 4 °J 3 __ >7____ �______ 0. Street
State work to be performed and purpose of building (By Floors)
Remodeling Addition Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile
Amount of Permit $
7s- a
ss.
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed) . � t 7 �s
Plum 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)
Date //' /
aster Plumber.
STATE OF FLORIDA, 1
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.
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
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 ce. De, �° ��� / No /1 Street . J /
Registered Architect and /or Engineer________________
Employing Plumber's Name_ r' fly " i_ ' ' ' No I.1__ _ Street__fe' */
Location and Legal Description Lot___ Block / '— � C Subdivision Jo" ' 'T
Street and Number where work is to be performed— No.______ _/ _ _ Street ' k-
State work to be performed and purpose of building (By Floors) /`' c -
New Building
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date/ ✓`26, 2 ' eti
Remodeling Addition Repairs No. of Stories 1
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile a Dist. Feet of Tank or Drain Field from Well
Nature of Water Suppl CityWell Size of Soakage Pit
Amount of Permit $
( Signed) ,
lumbing Inspector.
4
The undersigned applicant for this building permit does hereby certify that heyii rstands and accepts his obligati as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene al 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
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
c�
' . (`
TOTAL
FIXTURES
CONTR.
J
I
/
/
1
//
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
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 ce. De, �° ��� / No /1 Street . J /
Registered Architect and /or Engineer________________
Employing Plumber's Name_ r' fly " i_ ' ' ' No I.1__ _ Street__fe' */
Location and Legal Description Lot___ Block / '— � C Subdivision Jo" ' 'T
Street and Number where work is to be performed— No.______ _/ _ _ Street ' k-
State work to be performed and purpose of building (By Floors) /`' c -
New Building
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date/ ✓`26, 2 ' eti
Remodeling Addition Repairs No. of Stories 1
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile a Dist. Feet of Tank or Drain Field from Well
Nature of Water Suppl CityWell Size of Soakage Pit
Amount of Permit $
( Signed) ,
lumbing Inspector.
4
The undersigned applicant for this building permit does hereby certify that heyii rstands and accepts his obligati as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene al 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
STATE OF FLORIDA,
ss.
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.