1247 NE 101 St (14)Permit No '" " 7 'ilk Date..._..___ .1-24-79
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
stricture 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 Al h 11 p O t t No
Registered Architect and /or Engineer 1 C T k q
Employing Plumber's Nua±e ? I ? EB'a x°' 1 344 H i a 1' a h 1 .. Na,,.,...�.�.._.... -. ttrwl.._ .�._.. :......_.....-,..
Location and Legal Description Lot. B SubdivWon.___
-
Street and Number where work is to be performed —No 1747 )\
State work to be performed and purpose of building (By Floors)-- _. _.._.
New Building.._ .----- .........._.. Remodeling — Addition.- ---- ...._... Repairs. No. of Stories. . .....
Size Septic Tank_..
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit $ $9 • 5 0
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub•eontracton, on work to be performed under this permit, as are
licensed by Miami Shores Village.
to11(1 1 Cy Amenf
oniony Comyo
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
l�l streg-
Type of Tank—.—_
Nit. Feet of Tank or Drain Field from Well
Size of Soakage
y
( Signed) —� '—.! _ — ._ - - - ! �.. — .._ � ..... �
Plumbing Ins
(Signed)
Ci L--� - - -- ....._
Master Plumber.
STATE OF FLORIDA, f u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the f--- .- .- ..------ - -_ - -• - -... —._.. _ _..
of the above described construction, that he bas carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated.are_ true.
P$l 7 : , Sta¢z. oP %irk rt Ear
NOTE: A re inspection fee of $1.00 win be made when web wllaspaotiatr Y asade.ueossary by improper sake for laspecdon, es bulb
materials and /or workmanship.
CLOSETS
BATH
TUS$
SHOWERS
LAVA.
TORItS
SINKS
SLOP
SINKS
LAUNDRY
Twos
tJR :NALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
Count.
LIST
CHICK
SEPTIC SEWER DRAIN SOAKAGE GRIMM
TANK CONK. FIILD PIT TRAP
SOLAR
HEATER
MEP
WILL
SPRKLR.
SYSTIM
SWIM• -
POOL
CLW,�
1 -757W /200 sa.ft. -$4.50
I�
PO &K i11 -$5.00
CHICK
Permit No '" " 7 'ilk Date..._..___ .1-24-79
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
stricture 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 Al h 11 p O t t No
Registered Architect and /or Engineer 1 C T k q
Employing Plumber's Nua±e ? I ? EB'a x°' 1 344 H i a 1' a h 1 .. Na,,.,...�.�.._.... -. ttrwl.._ .�._.. :......_.....-,..
Location and Legal Description Lot. B SubdivWon.___
-
Street and Number where work is to be performed —No 1747 )\
State work to be performed and purpose of building (By Floors)-- _. _.._.
New Building.._ .----- .........._.. Remodeling — Addition.- ---- ...._... Repairs. No. of Stories. . .....
Size Septic Tank_..
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit $ $9 • 5 0
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub•eontracton, on work to be performed under this permit, as are
licensed by Miami Shores Village.
to11(1 1 Cy Amenf
oniony Comyo
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
l�l streg-
Type of Tank—.—_
Nit. Feet of Tank or Drain Field from Well
Size of Soakage
y
( Signed) —� '—.! _ — ._ - - - ! �.. — .._ � ..... �
Plumbing Ins
(Signed)
Ci L--� - - -- ....._
Master Plumber.
STATE OF FLORIDA, f u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the f--- .- .- ..------ - -_ - -• - -... —._.. _ _..
of the above described construction, that he bas carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated.are_ true.
P$l 7 : , Sta¢z. oP %irk rt Ear
NOTE: A re inspection fee of $1.00 win be made when web wllaspaotiatr Y asade.ueossary by improper sake for laspecdon, es bulb
materials and /or workmanship.
' APPLICATION FOR PLUMBING PERMIT
Permit No .. 1 Ly ®f _ Date 104.3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of 'Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
ig/- -8//,'7
Owner's Name and Address
Registered Architect and /or Engin rr fi -�
Employing Plumber's Name tt-_ ptc�,0,t`
Location and Legal Description Lot c
Street and Number where work is to be performed -No 4 0
State work to be performed and purpose of building (By Floors) _._..
New Building--- _--- --- Y _--_- .. _. - - -._ Remodeling_._._ — _ - -_ Addition
-Size Septic Tank____1 - - - -- -Type of Tank_-_-__Q - - -- Capacity Gals. ______._ /05�
Feet of Drain Tile____
Nature of Water Supply: City-Well.
Amount of Permit $_
STATE OF FLORIDA, I
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Blor1r
_Dist. Feet of Tank or Drain Field from Well
_---------- _ -__ -_ __ -- _-Size of Soakage Pit
(Signed)_ L%
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig / ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennan' • 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 • • ce or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on w to be per d nde this permit, as are
licensed by Miami Shores Village.
(
No. 1 st7 — . Street____ ,/E / . /._ . .
No. _ 2? -- Street_ Lc/ /o
Su�bdi ivide ,. �� --- ---- ------ ---- - - - - --
Street .//l____/�7or
My Commission Expires Notary Public, State of Florida
Repairs No. of Stories
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 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
SIN"
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FI %TURES
CONT11.
LIST •
-
CHECK
-
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
COMM.
LIST
- --
CHECK
' APPLICATION FOR PLUMBING PERMIT
Permit No .. 1 Ly ®f _ Date 104.3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of 'Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
ig/- -8//,'7
Owner's Name and Address
Registered Architect and /or Engin rr fi -�
Employing Plumber's Name tt-_ ptc�,0,t`
Location and Legal Description Lot c
Street and Number where work is to be performed -No 4 0
State work to be performed and purpose of building (By Floors) _._..
New Building--- _--- --- Y _--_- .. _. - - -._ Remodeling_._._ — _ - -_ Addition
-Size Septic Tank____1 - - - -- -Type of Tank_-_-__Q - - -- Capacity Gals. ______._ /05�
Feet of Drain Tile____
Nature of Water Supply: City-Well.
Amount of Permit $_
STATE OF FLORIDA, I
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Blor1r
_Dist. Feet of Tank or Drain Field from Well
_---------- _ -__ -_ __ -- _-Size of Soakage Pit
(Signed)_ L%
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig / ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennan' • 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 • • ce or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on w to be per d nde this permit, as are
licensed by Miami Shores Village.
(
No. 1 st7 — . Street____ ,/E / . /._ . .
No. _ 2? -- Street_ Lc/ /o
Su�bdi ivide ,. �� --- ---- ------ ---- - - - - --
Street .//l____/�7or
My Commission Expires Notary Public, State of Florida
Repairs No. of Stories
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 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.
Permit No
Application is hereby mad 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 a n D 1
Street.
Location and Legal Description ..... __ _ Block- Subdivision
� a
Street and Number where work is to be performed—No - Street
State work to be performed and purpose of building (By Floors) ____ -_
New Building __ Remodeling —__ _______ Addition._
Size Septic Tank ..... ------- ___ -..
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 $ ------------ - -� - -- (Signed)-
Pterrublispector.
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 e work suc. . lie notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on ork to be pe orn under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__ Capacity Gals
&v
No.__ - _--------- _--- .____ -- Street.._
No..
(Signed)
Repairs No. of Stories.
Date._._ ® 1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
My Commission Expires Notary Public, State of Florida
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
Comm.
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 mad 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 a n D 1
Street.
Location and Legal Description ..... __ _ Block- Subdivision
� a
Street and Number where work is to be performed—No - Street
State work to be performed and purpose of building (By Floors) ____ -_
New Building __ Remodeling —__ _______ Addition._
Size Septic Tank ..... ------- ___ -..
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 $ ------------ - -� - -- (Signed)-
Pterrublispector.
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 e work suc. . lie notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on ork to be pe orn under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__ Capacity Gals
&v
No.__ - _--------- _--- .____ -- Street.._
No..
(Signed)
Repairs No. of Stories.
Date._._ ® 1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
My Commission Expires Notary Public, State of Florida
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. • -
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
❑
o--` PERMIT N° 2649
0
0
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
DATR 1 ' 195
Contractor's
License No.
Work to be performed under this Permit
B1
Subdi-
vision
Value of
Project $
Amount of
Permit $
This permit is granted to the contractor or builder named above to construc 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 pip f s deration of once to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertain th Hato d .in s ct nformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
ceptin this I ss e popsibility for all T rk done by either, myself, my agent, servant or employee.
e p A �_ f .
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 1507
Work to be performed under this Permit
Owner of
Building
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 is 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.
pertaining thereto and in strict coAformity with the lans, drawings, statements . specifications submitted to the proper authorities of Miami Shores
age. In accepting this permit I aerrtune responsibility pr all work done by ea . Itself, my agent, servant or employee.
i e
ONTRACTOR OR BUILDER _ BY AUTHORITY
Subdi-
vision
Value of
Project
DATE - 194_
Contractor's
License No.
Amt. of
Permit
JOB:
BUILDING
ELECTRICAL
PLUMBING
t
_
•
I A)
,'
/ /
'
4
LI/
; . 1
Insp e c.t ar
4 ,t
1
• , ('
„••••nrY15
•
_ •
•
St
WORK
4 DONE BY
REQUESTED
The following is ready for Inspection: -
. • /
/1
AD: /
1
( If
WILL BE READY
•
•
•
, le-V.-CAI Lill ./7
BUILDING
ELECTRICAL
l(
•
•
•
•
Inspector's Report: -
•
•
•
•
•
•
•
•
•
•
The following is ready for Inspection:
r
AD: /2c/) N1
WORK
DONE BY
• ▪ REQUESTED
•
11 Q tom,• ,
WILL BE READY
s
Permit No
Owner's Name and Addr
Registered Architect and/
Employing Plumber's
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
PPLICATION FOR PLUMBING PERMIT
Application is hereby ma 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
No Street
Street_ - - - -__, f r "
Location and Legal Descriptio? Lot Block_ __ * Subdivv _u
Street and Number where work is to be performed —No. d__ Street____ /./_ is� sion . � 1__
____ c
State work to be perfo ed and purpose of building (By Floor
New Building _________i Remodeling Addition Repairs No. of Stories /
g g P
Date______ _J 12
'74Y _ 4 U Type of Tank ,!__' 3" S- e!04-
Capacity Gals.
t1_
Size Septic Ta w� ,�
Feet of Drain Tile _ 1* Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: y —Well. Size of Soakage Pit.
-- -- - - - --- -- - - - - - -- -7 - / � --- -- -
Amount of Permit $_______Z__6
_(Si ted)
Plu
ing 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 inspect n 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 ntractors, on work to be perryt i under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. t ss.
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 him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
Tuef
$ROWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
rues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIg
TA f{fC
Y /
SEWER
CONN.
_ . 60,
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP SPRKLR.
WELL SYSTEM
SWIM'G
POOL
CONTR.
//
(.....D
7---
CHECK
CHECK
Permit No
Owner's Name and Addr
Registered Architect and/
Employing Plumber's
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
PPLICATION FOR PLUMBING PERMIT
Application is hereby ma 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
No Street
Street_ - - - -__, f r "
Location and Legal Descriptio? Lot Block_ __ * Subdivv _u
Street and Number where work is to be performed —No. d__ Street____ /./_ is� sion . � 1__
____ c
State work to be perfo ed and purpose of building (By Floor
New Building _________i Remodeling Addition Repairs No. of Stories /
g g P
Date______ _J 12
'74Y _ 4 U Type of Tank ,!__' 3" S- e!04-
Capacity Gals.
t1_
Size Septic Ta w� ,�
Feet of Drain Tile _ 1* Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: y —Well. Size of Soakage Pit.
-- -- - - - --- -- - - - - - -- -7 - / � --- -- -
Amount of Permit $_______Z__6
_(Si ted)
Plu
ing 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 inspect n 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 ntractors, on work to be perryt i under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. t ss.
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 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.