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1190 NE 100 St (3)BUILDING ❑ PLUMBING ELECTRICAL A f PERMIT N °. 9390 ROOFING ❑ Owner of Building -'� -`-— Architect Contractor ✓ 3 tr el * " or Builder .:` -t °f •: eI..,., k . 'r, 1 4,. 4 ='7 4. �, . _ � ;; Legal Lot 11 "i" Description I i Bl Address of . " 4 ' Building � ;> 7' � ' ., ./Kb-e' .. _ CONTRACTOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA Date / i Contractor's License No. Subdi- vision Sq. Ft. Value of 11 Amount of Project $ I I Permit $ 6 Work to be performed under this Permit BY AUTHORITY 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 applica- tion 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. r A 1° y ,4" ' " Signed' t t /' � . .,- ' � -' i P . . 4 (INSPECTOR) BY - '� + , (, ; , °: In consideration of the issuance to me of this permit I dgree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, wings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume. responsibility for all wok done by either, myself, my agent, servant or employee. 19 7 Permit No.___1_-_ - !__)--- Registered Architect and /or Engineer_______ Employing Plumber's Name _AWL Location and Legal Description Lot_ ______ Nature of Water Supply: City —Well. 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 h in specified or not. A copy of approved plans and specifications must be kept at building during progress of work. l :—/ f� , Owner's Name and Address__ __________________ _ No. L L__ 9° — Street_ A l e 7 / ee ' C - • - -- - - Street--- Block Date Street and Number where work is to be performed— No._--_ ---1-1C_ - - - - - -. I S re State work to be performed and purpose of building (By Floors)_LA7 __ C J!5!_ e _C 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 __Size of Soakage Pit - - - - -- (Signed ) — The undersigned applicant for this building permit does hereby certify that he understands and accepts under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen plied with the provisions thereof, and will require similar compliance from all contractors or sub - contract performed under this permit; and will post or cause to be posted for inspection on of the wo required by the Act. The undersigned agrees to employ only such sub- contractor , . ' . rk to licensed by Miami Shores Village. My Commission Expires 44 a / Notary Public, State of Florida - 5 5'3 Subdivision ._ Plumbing Inspector. obligations as an employer of labor nt Supplement, and has com- d by him in the work to be c notice or notices as are this permit, as are M ter Plumber. STATE OF FLORIDA, as. COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS LS 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.___1_-_ - !__)--- Registered Architect and /or Engineer_______ Employing Plumber's Name _AWL Location and Legal Description Lot_ ______ Nature of Water Supply: City —Well. 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 h in specified or not. A copy of approved plans and specifications must be kept at building during progress of work. l :—/ f� , Owner's Name and Address__ __________________ _ No. L L__ 9° — Street_ A l e 7 / ee ' C - • - -- - - Street--- Block Date Street and Number where work is to be performed— No._--_ ---1-1C_ - - - - - -. I S re State work to be performed and purpose of building (By Floors)_LA7 __ C J!5!_ e _C 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 __Size of Soakage Pit - - - - -- (Signed ) — The undersigned applicant for this building permit does hereby certify that he understands and accepts under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen plied with the provisions thereof, and will require similar compliance from all contractors or sub - contract performed under this permit; and will post or cause to be posted for inspection on of the wo required by the Act. The undersigned agrees to employ only such sub- contractor , . ' . rk to licensed by Miami Shores Village. My Commission Expires 44 a / Notary Public, State of Florida - 5 5'3 Subdivision ._ Plumbing Inspector. obligations as an employer of labor nt Supplement, and has com- d by him in the work to be c notice or notices as are this permit, as are M ter Plumber. STATE OF FLORIDA, as. COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship MIAMI SHORES VILLAGE, FLORIDA \ . UILDING . a E LECTRICAL ❑ DATE 195 PERMIT N? 8 477 Contractors . LUMBING License No 4 , OOFING ❑ wner of Aiding rchitect Dntractor - Builder =gal ascription ddress of iilding Lot f.° t ❑ Work to be performed under this Permit ti . CONTRACTOR BUILDER Bl. Signed• Subdi- vision Sq. Ft Value of Project $ Amt. of 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 refor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, awings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any .Le 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 anted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations staining to the work covered hereby whether shown on the plans or drawings or in the statements o specifications and that he assumes responsibility for work ne by his agents, servants or employees. ,or "y : '( 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 regulations rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 7 MfAMI kORES VILLAGE, FLA. JOB k / -1-�- ADDRESS /1 7 AI C- c7 , / "C' — INSPECTION ' 0/e 12 TIME READY /''^`%- / 2 - Y- �- REMARKS 1 N9 5462 INSPECTOR DATE BUILDING ELECTRICAL PLUMBING ROOFING Owner of Li Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA ❑ DATE !r� 1957 PERMIT N? 4834 Contracto =s ❑ License No 1 ❑ Work to be performed under this Permit Architect >" ,A- Contractor, or Builder '; x. _ • - • Legal Lot Description Address of /`J Building J i f ,,af ,4' ! (• rN B1 BY Value of Project $ Subdi- vision Amount of II Permit $ v 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 state nts or specifications and that he assumes responsibility for work done by his agents, servants or employees. ., ' (` �, Signed �. r �:.� , � ..d am BY '44 INSPECTOR �,;.° In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all or nces 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or,amployee. AUTHORITY e, MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No 1 92-3 Date...-.._ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub itted for a 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 En Employing Plumber's Name I r ' - 4tad. •■ 7-e° No Street-__ Location and Legal Description Lot_.______ 1 Block Subdivision — p________.____ Street and Number where work is to be performed —No gs _._.. Street.- _i..0.4 State work to be performed and purpose of building (By Flocs)__ _. —....- New.Building - -_ - -_ _ -- ....... Remodeling_—.__.___ Addition 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 Soakage Pit Amount of Permit $ ( Signed) - -- — Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, 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 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). No..._.._.—.._._..._....-.-- Street My Commission Expires Notary Public, State of Florida Repairs.____._....- .-- .-- -..... No of Stories Capacity Gals Master Plumber. STATE OF FLORIDA, } a. 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 foregodng 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 TUSS SHOWERS S LAVA. TORTE SINKS SLOP SINKS LAUNDRY Tins URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL PIATURKS CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL $PRKLR. SYSTEM SWIM'0 POOL CONTR. UST CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No 1 92-3 Date...-.._ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub itted for a 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 En Employing Plumber's Name I r ' - 4tad. •■ 7-e° No Street-__ Location and Legal Description Lot_.______ 1 Block Subdivision — p________.____ Street and Number where work is to be performed —No gs _._.. Street.- _i..0.4 State work to be performed and purpose of building (By Flocs)__ _. —....- New.Building - -_ - -_ _ -- ....... Remodeling_—.__.___ Addition 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 Soakage Pit Amount of Permit $ ( Signed) - -- — Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, 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 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). No..._.._.—.._._..._....-.-- Street My Commission Expires Notary Public, State of Florida Repairs.____._....- .-- .-- -..... No of Stories Capacity Gals Master Plumber. STATE OF FLORIDA, } a. 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 foregodng 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. ...t Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or otliet 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Permit No. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name___._ f: .' Location and Legal Description Lot_..__._..._.._._._.__ _. __ ._ _ _ _ Block______. _._______ Subdivision Street and Number where work is to be performed —No. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._.__.___...... Street State work to be performed and purpose of building (By Floors ) _ New Building Remodeling Addition Repairs__ 1 _ Street-. - -. Size Septic Tank Type of Tank_._ Capacity Gals. Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $. d 41) My Commission Expires (Signed). (Signed Date Street. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent Supplement, and 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 art licensed by Miami Shores Village. No. of Stories 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 tat. therein by him stated are true. STATE OF FLORIDA, �. COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally i.ppeare 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 fdul materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUOB URINALS CATCH BASIN FLOOR DRAIN DR! tilt NO FOU NT' N5 TOTAL FIXTUREI cowl'. cowl'. LIST - -- _ - - —_ CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM G POOL CONTR. LIST CHECK ...t Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or otliet 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Permit No. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name___._ f: .' Location and Legal Description Lot_..__._..._.._._._.__ _. __ ._ _ _ _ Block______. _._______ Subdivision Street and Number where work is to be performed —No. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._.__.___...... Street State work to be performed and purpose of building (By Floors ) _ New Building Remodeling Addition Repairs__ 1 _ Street-. - -. Size Septic Tank Type of Tank_._ Capacity Gals. Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $. d 41) My Commission Expires (Signed). (Signed Date Street. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent Supplement, and 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 art licensed by Miami Shores Village. No. of Stories 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 tat. therein by him stated are true. STATE OF FLORIDA, �. COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally i.ppeare 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 fdul materials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING Permit No T ` 2 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of wor Owner's Name and Address. Registered Architect and /or Ennmee Employing Plumber's Name!� Size Septic Tank L2 = Feet of Drain Tile__ Nature of Water Supply: City —Well ___ - ----- --••-- STATE OF FLORIDA, } COUNTY OF DADE. Street_ -- - _-- ----- .--- -- _ --.._ Location and Legal Description Lot____._. ____ _ Block_ rivet t_______ Subdivision Street and Number where work is to be performed —No / 9 t9 »� . 00 Street State work to be performed and purpose of building (By Floors)_ _ New Building Remodeling _______.________________ Addition. Amount of Permit $ ( Signed) _ Street Repairs No. of Stories Type of Tank_____ Capacity Gals. Dist. Feet of Tank or Drain Field from Well ._Size of Soakage Pit umbing 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) Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by hitr, 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 worllrmanship. CLOSETS BATH TUBE SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuns U RINALS 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. LtBT CHECK ` -- MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING Permit No T ` 2 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of wor Owner's Name and Address. Registered Architect and /or Ennmee Employing Plumber's Name!� Size Septic Tank L2 = Feet of Drain Tile__ Nature of Water Supply: City —Well ___ - ----- --••-- STATE OF FLORIDA, } COUNTY OF DADE. Street_ -- - _-- ----- .--- -- _ --.._ Location and Legal Description Lot____._. ____ _ Block_ rivet t_______ Subdivision Street and Number where work is to be performed —No / 9 t9 »� . 00 Street State work to be performed and purpose of building (By Floors)_ _ New Building Remodeling _______.________________ Addition. Amount of Permit $ ( Signed) _ Street Repairs No. of Stories Type of Tank_____ Capacity Gals. Dist. Feet of Tank or Drain Field from Well ._Size of Soakage Pit umbing 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) Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by hitr, 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 worllrmanship.