PLUMBING PERMITPermit No 744°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 Shares Village and all rules and regulations of the Budding 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
Owners Name and Address No / g 0 / Street ._ E '
Registered Architect and /or Engineer (1 _
t WI /Mien sC AMrI � , .. ,, Fr ... �- -� JA I - ,� - Na. II Sa : 4& •
Street and Number where work l /2- be performed —No � G / treet ..__. ( /' / S '
State work to be performed and purpose of building (By Floors)__._ — �e- LA- _3.�L/- !T. •---- .4A.1!/t, e. � •
New Building..__.._ -- .-- ....... -..__. Remodeling Addition- .------ •-- _..... Repairs
Size Septic Tank_._ _Type of T"
Feet of Drain Tile __Dist Feet of Tank or Drain Field from Well .. -._...
Nature of Water Supply: City—Well. Size of Soakage Pit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(S)- - ---- IVfAVAZCCX/
- -- ----- --------- --`1
(Si
No. of Stories ........
Plumbing inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and it com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work 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 err
required by the Act. The undersigned agrees to employ only such sub - contractors, on k to be y am; • under this permit, as are
licensed by Miami Shores Village. �/
/ 7
Master Plumber.
STATE OF FLORIDA,
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 appbation, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Flarlda
NOTE: A re- Inspection fee of $1.00 will be made when mob rrr.hspaotias is medo by bnproper notice for inspection, or faulty
material and /at workmanship.
CLOSETS
BATH
TU•S
aHOW[Rn
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDR
Tune
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKI NO
FOUNT•N[
TOTAL
FIXTURES
CONTa.
LIST
CHECK
•—
SEPTIC
TANK
SEWER
CONN.
DRAIN
FI[LO
SOAKAO[
PIT
G
TRAP
SOLAR
HATER
DEEP
WELL
BPRKLR.
SYSTEM
SWIM
POOL
Cetera.
LIST
CHICK
- _
Permit No 744°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 Shares Village and all rules and regulations of the Budding 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
Owners Name and Address No / g 0 / Street ._ E '
Registered Architect and /or Engineer (1 _
t WI /Mien sC AMrI � , .. ,, Fr ... �- -� JA I - ,� - Na. II Sa : 4& •
Street and Number where work l /2- be performed —No � G / treet ..__. ( /' / S '
State work to be performed and purpose of building (By Floors)__._ — �e- LA- _3.�L/- !T. •---- .4A.1!/t, e. � •
New Building..__.._ -- .-- ....... -..__. Remodeling Addition- .------ •-- _..... Repairs
Size Septic Tank_._ _Type of T"
Feet of Drain Tile __Dist Feet of Tank or Drain Field from Well .. -._...
Nature of Water Supply: City—Well. Size of Soakage Pit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(S)- - ---- IVfAVAZCCX/
- -- ----- --------- --`1
(Si
No. of Stories ........
Plumbing inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and it com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work 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 err
required by the Act. The undersigned agrees to employ only such sub - contractors, on k to be y am; • under this permit, as are
licensed by Miami Shores Village. �/
/ 7
Master Plumber.
STATE OF FLORIDA,
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 appbation, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Flarlda
NOTE: A re- Inspection fee of $1.00 will be made when mob rrr.hspaotias is medo by bnproper notice for inspection, or faulty
material and /at workmanship.
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT
Applicant /`�"cW Per it Number
871852
/ 2 of , vl /L T f�fiT
PART II - SYSTEM INSTALLATION INSPECTION AND FIN L NST L'14 APPROVAL
Installer �`4 /-1/ Pren
Proper tank legend: Yes No
Tanks watertight: Yeses No Tank size
Proper tank outlet device: Yes _J__/ No
Drainfield Trench
Length
feet
feet
feet
Total =
Systems located as permitted:
Other findings
Inspected by
Date
,Wproved by:
Width
feet
feet
feet 4
ft
Manhole or marker to grade: Yes
Absorption Jd
Length Width Length feet x feet / ft
feet feet Length feet x feet= ft
feet feet Proper No. drainlines: Yes Elo
//
feet feet Proper pipe separation: Yes No
Total = ft Distribution box level: Yes No N
Yes No
HRS —H Form 4016, Jan 86 (Replaces Feb 85 edition which may be used)
(Stock Number: 5744-002- 4016 -4)
Tank material
'` /4
Average depth to drainpipe invert from finished grade: ' inches Maximum depth. /CI Inches
n
Average depth of drainfield gravel: / 4 inches Minimum depth of gravel /2 / /inches
Proper gravel size: Yes t No Gravel is suitable quality: Yes ✓' No
Backfill or fill material as required: (Quality) Yes 4,7_ No (Quantity) Yes ✓ No
Systems including plumbing stub -outs installed at proper elevation: Yes No
Date 7-2- 67
PART III - F_,1; L INSTALLATIO
APPROVAL
Tank Manufacturer
<Tank level: Yes No
gallons gallons gallons
'% •
No AA
�' COUNTY PUBLIC HEALTH UNIT
AN APPROVED INST' LATION DOE NOT GUARAIT�
Note: Completed copies of this form will be provided to the applicant, installer and the building department.
Page 2 of 2
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 . ' C _Tti • � (.�
- --- - L - - -- - -• -- No. —_ .-- ----- - - ---_ Street_ f -_..
Amount of Permit $
STATE OF FLORIDA,
sa
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEi 'Y
APPLICATION FOR PLUMBING 4'`4•,AR T
( Signed) _
Date__
./?3*z
Registered Architect and /or Engineer __ __,_ _____ —
Employing Plumber's Name. lk)" 1 �/ _kc24_c /_Q_-- 'Pr C No - _------ ._.._ -./ - -6 Street_-__ 4 ' -
Location and Legal Description Lot_._ Block_ Subdivision
Street and Number where work is to be performed— No.___ _ .__ _ Street
State work to be performed and purpose of building (By Floors)__ _ _. S_ _ ! 21 e L / �
New Building __- Remodeling___ _______ Addition Repairs t No. of Stofies.__
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
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 Pennanent Supplement, and bus com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed . by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the si • the work such • . is/notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, onwor to be per : med "under this permit, as are
licensed by Miami Shores Village.
( Signed)._ !!
My Commission Expires Notary Public, State of Florida
Plumber.
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 $1.00 will be made when such re- inspection is made• necessary by improper notice for inspection, or faulty
materials and /or worlmmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
KS
SINKS
SLOP
SINKS
LAUNDRY
Tues
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FI %TORES
CONTR.
LIST
'CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FI ELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
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 . ' C _Tti • � (.�
- --- - L - - -- - -• -- No. —_ .-- ----- - - ---_ Street_ f -_..
Amount of Permit $
STATE OF FLORIDA,
sa
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEi 'Y
APPLICATION FOR PLUMBING 4'`4•,AR T
( Signed) _
Date__
./?3*z
Registered Architect and /or Engineer __ __,_ _____ —
Employing Plumber's Name. lk)" 1 �/ _kc24_c /_Q_-- 'Pr C No - _------ ._.._ -./ - -6 Street_-__ 4 ' -
Location and Legal Description Lot_._ Block_ Subdivision
Street and Number where work is to be performed— No.___ _ .__ _ Street
State work to be performed and purpose of building (By Floors)__ _ _. S_ _ ! 21 e L / �
New Building __- Remodeling___ _______ Addition Repairs t No. of Stofies.__
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
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 Pennanent Supplement, and bus com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed . by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the si • the work such • . is/notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, onwor to be per : med "under this permit, as are
licensed by Miami Shores Village.
( Signed)._ !!
My Commission Expires Notary Public, State of Florida
Plumber.
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 $1.00 will be made when such re- inspection is made• necessary by improper notice for inspection, or faulty
materials and /or worlmmanship.
Villagg of Miami Shores N9 4832
JOB
ADDRESS 7. l
INSPECTION
TIME READY
REMARKS CX4 / d�Y/ • jT - i' i
INSPECTOR
DATE
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DATE >`yer3A -1.. 1947
ELECTRICAL PERMIT N? 7668 Contractor's
PLUMBING License No
Owner of
Building T )24"
Legal Lot
Description
Work to be performed under this Permit
Architect
Contractor 66
or Builder '' 5' �' -—
Address of `� ,.� Value of Amt. of
Buildin g / V ..'f .1 /:-' 4.1 P roject Permit / ') e j
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 he assumes respon-
sibility for work done by his agents, servants or employees. / A n. ,q ti �
B -- V '
Signed.
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinaices and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to e proper authorities of.Miami Shores Village.
In accepting this permit I assume responsibility for all work- done by either myself, my agent, servant or e . : .f ee.
r r A
1 .O 0
Subd
vision
CONTRACTOR OR BUILDER BY
AUTHORITY
0
V
❑ DATE r a* -^ f 195
W P E R M 1 T br9 4208 Contractors ,, r -
License No
❑ ' rr. ,�,,rr . �
Work to be performed under this Permit '- ' . 4-4...,
;UILDING
:LECTRICAL
'LUMBING
1OOFING
)wner of
luilding
`.rchitect
= ontractor
}r Builder
-egal
)escription
�ddress of
; uilding
7
MIAMI SHORES VILLAGE. FLORIDA
�1 1 .fit A
Lot
.d
CONTRACTOR OR BUILDER
l
B1
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
erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
me 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
ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
.ertaining to the work covered hereby whether shown on the plans or drawings-,2r in the statements or specif ations and that he assumes responsibility for work
one by his agents, servants or employees. y
Signed: > 'r" ,�� � � P f � ` BY
INSPECTOR
In consideration of the iss3.tanarp to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
, ertafning thereto \and in strict .conforfnity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
epting this permit I assume 4osp6nsi�ilityfr all work done by either, myself, my agent, servant or employee.
BY
Subdi-
vision
Value of
Project $
Amount of
Permit $
AUTHORITY °IMP
JOB:
BUILDING
ELECTRICAL
PLUMB�NB
WORK
DONE BY':
REQUESTED
• Se--e4,
,/r? -- - O
The following is ready for inspection: -
Inspector's Report:-
/
• ,/1 &z, / /' -5'
- q2-- - /
WILL BE READY
J
`�1J L �`�C�i
JOB:
BUILDING
ELECTRICAL
PLUMB IG
A PD: J/
WORK
DONE BY:
REQUESTIiED WILL BE R llY
'
The Following is ready for inspection:-
Inspector's Report: -
it
Permit No .
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for th / building or ot)Ser
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 h, w eth r herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. / v
Owner's Name and Address 1 ' `,!
Registered Architect and /or Engineer_
Employing Plumber's Name Pit L /IV No. Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No / ._ Ni Street 1
State work to be performed and purpose of building (By Floors) 1—' �� off? 4 -
New Building Remodeling Addition Repairs
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 $
The undersigned applicant for this building permit does hereby certify that he un.erstands and accepts his obligations as an employer of la. or
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 sdch 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.
FLORIDA, 1
OF DADE. j
\-; MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
ss.
APPLICATION FOR PkUMBING PERMIT
No Street
igned)
( Signed) _e
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.
P.. New /9
Plumbing nspector.
aster Plumber.
CLOSETS
BATH
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No .
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for th / building or ot)Ser
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 h, w eth r herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. / v
Owner's Name and Address 1 ' `,!
Registered Architect and /or Engineer_
Employing Plumber's Name Pit L /IV No. Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No / ._ Ni Street 1
State work to be performed and purpose of building (By Floors) 1—' �� off? 4 -
New Building Remodeling Addition Repairs
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 $
The undersigned applicant for this building permit does hereby certify that he un.erstands and accepts his obligations as an employer of la. or
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 sdch 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.
FLORIDA, 1
OF DADE. j
\-; MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
ss.
APPLICATION FOR PkUMBING PERMIT
No Street
igned)
( Signed) _e
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.
P.. New /9
Plumbing nspector.
aster Plumber.
Permit No.
30 3 /
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date Jan. 20, 1942
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 Allison Improvement Go.
Registered Architect and /or Engineer
Employing Plumber's Name __ _ No. Street______
Block_ 185 Subdivision_ B!ee!l9 See.
Location and Legal Description Lot_____ __ ________��___________ ____ �_____ _ _
1iE 101st St.
No
1201
Street and Number where work is to be performed —No 1201 Street
State work to be performed and purpose of building (By Floors)
New Building des Remodeling Addition Repairs
NE 101st St.
Street-------- - - - --
No. of Stories______________
1 50 - 1 . 8DX,1-
Size Septic Tank_____ __ — Type of Tank Capacity Gals._____— ______—�
Feet of Drain Tile__________
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $__�__
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
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.
ss.
My Commission Expires
Dist. Feet of Tank or Drain Field from Well
_(Signed)
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors on work to be performed under this permit, as are
(Signed
Master Plumbe
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
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No.
30 3 /
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date Jan. 20, 1942
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 Allison Improvement Go.
Registered Architect and /or Engineer
Employing Plumber's Name __ _ No. Street______
Block_ 185 Subdivision_ B!ee!l9 See.
Location and Legal Description Lot_____ __ ________��___________ ____ �_____ _ _
1iE 101st St.
No
1201
Street and Number where work is to be performed —No 1201 Street
State work to be performed and purpose of building (By Floors)
New Building des Remodeling Addition Repairs
NE 101st St.
Street-------- - - - --
No. of Stories______________
1 50 - 1 . 8DX,1-
Size Septic Tank_____ __ — Type of Tank Capacity Gals._____— ______—�
Feet of Drain Tile__________
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $__�__
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
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.
ss.
My Commission Expires
Dist. Feet of Tank or Drain Field from Well
_(Signed)
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors on work to be performed under this permit, as are
(Signed
Master Plumbe
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.
'50B: Ovit:
BUILDING
ELECTRICAL
PLUMBING
•
The Following is ready for
Inspectorts Report: -
A DD / 1
WORK
DOFF] BY:
R LELTED
A A
inspection:-
/0 2t1-1
c;k
: WILL BE READY
JOB:
BUILDING
PLUMBING •
Inspector s Report :-
2
,t
ADD:
1 f
The following is ready for inspection:-
ELECTRICAL .
. : WORK /-
V : DONE BY •
. . •
. .
RELUESTED : WILL BE READY
-P ,- , : 7)-/ / "%
07'.79 le-,, V : ,' /
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 .1111.113 Improvement Co. 1201 101t St
----- - - - - -- No.---- - - - - -- Street--- --- --- --- s
------ --- - - . .
Registered Architect and /or Engineer
Employing Plumber's Name No __.___ Street__
Location and Legal Description _Block 18 5 Subdivision iiii__B e.Z.& $8C •
Street and Number where work is to be performed —No 1 Street N' 101st Sty
State work to be performed and purpose of building (By Floors)
New Building yet_____________ Remodeling Addition Repairs No. of Stories
Size Septic Tank_ Type of Tank . Capacity Ga1s.1 -8Dx_ 1-1oDX
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 $_
3o3J
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date__ Jana_ __20. 1942
- (Signed) - -- - - --
My Commission Expires Notary Public. State of Florida
Master Plumber.
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 under signed agrees to employ only such sub - contractors on work to be performed under this permit, as are
(Signed) 1 –� - -- - (
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
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 .1111.113 Improvement Co. 1201 101t St
----- - - - - -- No.---- - - - - -- Street--- --- --- --- s
------ --- - - . .
Registered Architect and /or Engineer
Employing Plumber's Name No __.___ Street__
Location and Legal Description _Block 18 5 Subdivision iiii__B e.Z.& $8C •
Street and Number where work is to be performed —No 1 Street N' 101st Sty
State work to be performed and purpose of building (By Floors)
New Building yet_____________ Remodeling Addition Repairs No. of Stories
Size Septic Tank_ Type of Tank . Capacity Ga1s.1 -8Dx_ 1-1oDX
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 $_
3o3J
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date__ Jana_ __20. 1942
- (Signed) - -- - - --
My Commission Expires Notary Public. State of Florida
Master Plumber.
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 under signed agrees to employ only such sub - contractors on work to be performed under this permit, as are
(Signed) 1 –� - -- - (
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.
a •- t
Amount of Permit $___
Permit No.____'"__.l�
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned
appeared
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tyre building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address 1 J a _�' _. No. _________ Street__
Registered Architect ald /or En 2_ _ --ie-a _ ? _______sL
Employing Plumber's Name rr � _� � , No. Street_______
_Block__1____LI��„______ Subdivis),o
Street____
Location and Legal Des2ription Lot__
a •
My Commission Expires
MIAMI SHORES VILLAGE
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
Nature of Water Supply: City '" Size of Soakage ._
(Signed) —
(Signed;
1_s
Notary Public. State of Florida
( ✓,r
New Building Remodeling Addition Repairs No. of Stories_____
Size Septic Tank_____ — ______ Type of Tan l( „ _ i. _C_L!____Capacity Gals._
Feet of Drain Tile_�Je_�_ Feet of Tank or Drain F' Id from Well_____ _— ^_�________
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify tI$t he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Comp ed 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 *le Act. The under signed agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
TF Master Plumber.
12, u✓
authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
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 be 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
/
/
r
CHECK
SEPTIC
TANK
SEWER DRAIN
/CONN. •• ••■FIELD
SO
GE
IT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
t
//
CHECK
� j
4 ?
6 %
a •- t
Amount of Permit $___
Permit No.____'"__.l�
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned
appeared
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tyre building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address 1 J a _�' _. No. _________ Street__
Registered Architect ald /or En 2_ _ --ie-a _ ? _______sL
Employing Plumber's Name rr � _� � , No. Street_______
_Block__1____LI��„______ Subdivis),o
Street____
Location and Legal Des2ription Lot__
a •
My Commission Expires
MIAMI SHORES VILLAGE
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
Nature of Water Supply: City '" Size of Soakage ._
(Signed) —
(Signed;
1_s
Notary Public. State of Florida
( ✓,r
New Building Remodeling Addition Repairs No. of Stories_____
Size Septic Tank_____ — ______ Type of Tan l( „ _ i. _C_L!____Capacity Gals._
Feet of Drain Tile_�Je_�_ Feet of Tank or Drain F' Id from Well_____ _— ^_�________
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify tI$t he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Comp ed 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 *le Act. The under signed agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
TF Master Plumber.
12, u✓
authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
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 be 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
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 194_
Contractor's
License No.
PERMIT N9 3031
Work to be performed under this Permit
Owner of
Building y "
Architect
Contractor
or Builder
Legal Lot Bl.
Description
Address of
Building -
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance
with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may
be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed• By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
/�.
Subdi-
vision
Value of
Project
Amt. of
Permit
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 2425
Work to be performed under this Permit
Bl.
Subdi-
vision
Address of Value of''`' /
Building ✓ Project { 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.
Signed•
In consideration of the issuance to me of this permit I agree to perform the work
tions pertaining thereto and in strict conformity with the plans, drawings, statements o
Village. In accepting this permit I assume responsibility for all work done try either
DATE
INSPECTOR
of
Amt. of
Permit
By
Contractor's
License No
covered hereunder in compliance with all ordinances and regula-
;..specifications submitted to the proper authorities of Miami Shores
self, my agent, servant or employee.
► ' ,,or, 1.3m
a t...
CONTRACTOR `OR BUILDER BY , ' AUTHORITY
19 4
BUILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
DATE
Contractor's
License No.
PERMIT N9 2994
Work to be performed under this Permit
194 l
Owner of
Building
Architect
Contractor "'r' ✓
or Builder - 01 ...
; %
Legal Lot Bl. Subdi-
vision
Description
Address of Value of - Amt. of
Building 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
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 ors drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed. ti By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my gent, servant or employee.
® l
CONTRACTOR OR BUILDER' '� ` {i°
BY AUTHORITY
PENNSYLVANIA -DIXIE cf0EkIT CORPORATION
149 RHODES - HAVERTY BLDG., Atlanta, GL— Walnut 2400
NEW YORK - PHILADELPHIA
CHATTANOOGA - BOSTON
ATLANTA - NAZARETH, PA.
DES MOINES - ROCHESTER, N.Y.
�
m
•
New Building
APPLICATION FOR PLUMBING PERMIT
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 Engineer
Employing Plumber's Name
Location and Legal Description Lot_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
Amount of Permit $
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Remodeling Addition.
No Street..
(Signed) __
Notary Public. State of Florida
7 .
Date___ - „__ -___
Street_-________- _- -____
_Block_ �_ �_ Subdivision
Repairs -___ No. of Stories_____
Size Septic Tank_
Type of Tard(.
P T- r- - - - - YP �y 4,44 ____Capacity Gals "
Feet of Drain Ttle_____ -_ "_______rat. Feet of Tank or Drain Fd from Well_______—___ _________- ____� ..... ___�_�___.�
Nature of Water Supply: City - We11 -.* ` L _ - _______________.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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. •
Master Plumber.
STATE OF FLORIDA,
ss.. `_ 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 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
F OUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
LIST
/
i
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN SOAKAGE
_, FIELD r t''PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
-ate
k
fr
CHECK
New Building
APPLICATION FOR PLUMBING PERMIT
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 Engineer
Employing Plumber's Name
Location and Legal Description Lot_
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
Amount of Permit $
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Remodeling Addition.
No Street..
(Signed) __
Notary Public. State of Florida
7 .
Date___ - „__ -___
Street_-________- _- -____
_Block_ �_ �_ Subdivision
Repairs -___ No. of Stories_____
Size Septic Tank_
Type of Tard(.
P T- r- - - - - YP �y 4,44 ____Capacity Gals "
Feet of Drain Ttle_____ -_ "_______rat. Feet of Tank or Drain Fd from Well_______—___ _________- ____� ..... ___�_�___.�
Nature of Water Supply: City - We11 -.* ` L _ - _______________.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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. •
Master Plumber.
STATE OF FLORIDA,
ss.. `_ 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 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.