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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.