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.