120 NE 100 St (8)-� --
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
-
SEPTIC
TANK
SEWER
CONN.
DRAIN,
FIELD(
'.SOAKAGE
PIT.
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
_
CHECK
.
MIAMI SHORES VILLAGE
1. "esua7. No
A �+ C�
Application is hereb • n ie for the approval of the detailed statement of
p_ y ppr state ent. 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
bulding progress of work. •
Owners Name and Address o ._ No. Street._
Registered Architect and /or Engineer ____ _________— __________--- ____
Employing Plumber's Nam _ - _il _fa __'ll_t 2 __ EJ a ___1i. _____________ _ Street__ -- -__ ---
Location and Legal Description Lot _____ -__________________,____ —__.__ Bloelr . Subdivision _ ___
.Street and Number where work is to be performed —No t. . _IVIE • Street .149_0
State work to .be performea and purpose. of building (By Floors )_________________________
New Building , Remodeling__.__ ____ ___ Addition__
. Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile" 1 _ __ e_C! s t. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well..____ ..__._. ..... of Soakage Pit
Amount of Permit $
. My Commission Expires
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)._
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an mployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supple, ent, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by m 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 lice or notices as . are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed u der this permit, as are
licensed by Miami Shores Village.
(Signed)0 0 C . ' K C MAX &O •
• Master Plumber.
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.. -
NOTE: A re- inspection fee of $L00 will be made when such re- inspection is made necessary . by improper notice for inspection, or faulty
materials and /or workmanship.
Date
Repairs
74 0
No. of Stories._
Notary Public, State of Florida
Plumb r! Inspector.
Permit No..
Owner's Name and Address __
Registered Architect and /or E
Employing Plumber's Name
New Building_
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 co lied with, whether herein specified or not. A copy of approved plans and specifications must be ke t at
building during progress of wor) r !r �j
Amount of Permit $_
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT C
My Commission Expires
MIAMI SHORES VI LLAG E
No
(Signed
/ 2.0
Location and Legal Description Lot__
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
Remodeling Addition Repairs
Date __._ ._ 1, '/
Streel!_ i = /C
Street/
Block
Size Septic Tank_________ —_ _________— ________ Type of Tank . Capacity Gals
Feet of Drain Tile________Lj________ —__ ___ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
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 i'
materials and /or workmanship.
No. of Stories__
_(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 -. work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. ss'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared _ ...... _____________
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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
FIE
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No..
Owner's Name and Address __
Registered Architect and /or E
Employing Plumber's Name
New Building_
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 co lied with, whether herein specified or not. A copy of approved plans and specifications must be ke t at
building during progress of wor) r !r �j
Amount of Permit $_
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT C
My Commission Expires
MIAMI SHORES VI LLAG E
No
(Signed
/ 2.0
Location and Legal Description Lot__
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
Remodeling Addition Repairs
Date __._ ._ 1, '/
Streel!_ i = /C
Street/
Block
Size Septic Tank_________ —_ _________— ________ Type of Tank . Capacity Gals
Feet of Drain Tile________Lj________ —__ ___ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
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 i'
materials and /or workmanship.
No. of Stories__
_(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 -. work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. ss'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared _ ...... _____________
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.