PLUMBING PERMITMIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
N 70 -73 v787 -4 —
Permit No (� 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 work.
Owner's Name and Address M _Kl 1250 NE 101 Street
__------ _- -___ -� --- _._.__ No.— __— ___..___ — — Street -_ _
Registered Architect and /or Engineer------- - -_ - -.
Employing Plumber's Name Peoples Gas S No.. 564 Strom — NE 125th Street
Block Subdivision
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._ -__ -_- Repairs No. of Stories.._ ..... ........
Location and Legal Description Lot
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 of Soakage Pit
Amount of Permit ; -�
(S ) C-
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati '' as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent pplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employe • 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 tlie Act. The undersigned agrees to employ only such sub- contractors, • work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA, t ss.
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.
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 inspect-m, or faulty
materials and /or workmanship.
CLOSETS
TUBS
TUBS
SHOWERS
LAVA-
Toms
SINKS
SLOP
LAUNDRY
TUBS
URINALS
CATCH
BABI
FLOOR
DRAIN
DRINKING
FOUNT 'NB
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
BPRKLR.
SYSTEM
SWIM'G
POOL
Ran
A/C
W.H.
Dryer
corm.
LIST
CHECK
1
1
1
1.
4
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
N 70 -73 v787 -4 —
Permit No (� 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 work.
Owner's Name and Address M _Kl 1250 NE 101 Street
__------ _- -___ -� --- _._.__ No.— __— ___..___ — — Street -_ _
Registered Architect and /or Engineer------- - -_ - -.
Employing Plumber's Name Peoples Gas S No.. 564 Strom — NE 125th Street
Block Subdivision
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._ -__ -_- Repairs No. of Stories.._ ..... ........
Location and Legal Description Lot
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 of Soakage Pit
Amount of Permit ; -�
(S ) C-
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati '' as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent pplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employe • 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 tlie Act. The undersigned agrees to employ only such sub- contractors, • work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA, t ss.
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.
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 inspect-m, or faulty
materials and /or workmanship.
•i
t
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Date
Owner's Name and Address______ /_. .. _fri t Z 1250 /LS / 0 / cr No
Registered Architect and /or Engineer
Name and address of licensed contractor /6m
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done l °?6-0 /Vir yo/
State work to be done and purpose of building (by floors) L741.14 -
STATE OF FLORIDA,
COUNTY OF DADE.
Chainnan
Member
Member .
Council Approved
AMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
J
Remodeling r Addition Repairs
is 111 " Ad . -V1)7. ,
Street.
0 r s f ? , r lil�A q2-
19 '7'
and for no other purpose.
No. of Stories
New Building
To be constructed of Kind of foundation Roof Covering
C'' 1 c d
Estimated Total cost of improvements $
Zone cubage required
Distance to next nearest building .
Maximum live load to be borne by each floor___.
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to .- — —
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, Pennanent Supplement,
and has complied 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 subcon actors, on wo31r to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks
�TL
ss.
Disapproved
(Signed)
Building Inspe ,l'r
o ° Amount of Permit $
.Plan Cubage
Size of Building Lot
P ANNING BOARD
(Signed
1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Permit No Date ) Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
DATE
Member
Member
Member
Date Disapproved
to me well known,
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Owner's Name and Address Y M-QLl!/ p1
Registered Architect and /or Engineer
Name and address of licensed contractor__0 4-.-) ! — D_f_ -_1_' ' La,,„ tb ___
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1 _ 9_5 - D' d 9 • ,LO/ S 497 /24,„2/.s Y o
State work to be done and purpose of building (by floors )___222a3Z__e. 4 e 7A J- Dtl_lv cI rir!_ r _,. 7A/" 9ti 49 AC Lp_A- I I
._0z _fi-le ►-
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
0 0�
Estimated Total cost of improvements $ 2. Amount of Permit $ -
Zone cubage required ___.Plan Cubage
Distance to next nearest building _______— __Size of Building Lot
Maximum live load to be borne by :;ach floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
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 complied 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 subcontractors, on work to be performed under this
permit as are licensed by Miami Shores Village
Remarks (Signed) ;221 -e-14-4-4-2:
!'
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 ated are true.
Permit No 4,/ Date ( � _ Read, Sworn to and Subscribed before me.
Disapproved ____
( Signed) _
APPLICATION FOR BUILDING PERMIT
MIAMI SHORES VILLAGE
Date
BUILDING INSPECTION DEPARTMENT
and for no other purpose.
Date
, 196V
No , lrz3,5 c Street 71. , 1.'/ S T
n I Notary Public, State of Florida
Building Inspector 1 � _ My Commission Expires
PLA 1 BOARD DATE
Chairman Member
Member Member
Member __ Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
J3)
e
(
Permit No.__t ®;
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.
Owner's Name and Address ► ° -` :_ - - No.__--_•_ ..... ____ ...... _____ Street_
Registered Architect and /or Engineer______— _________ ___ . — _._ _ _ _ ___. ______------ _ - __ -
• No.______ __-- ___ -__ Street-_ __ - -_ -
Location and Legal Description Lot____-- _- ______._________.__.. __.___ Block__- Subdivision _____
Street and Number where work is to be performed —No.__ / &! Yi.�i...__ /.... /._... Street
State work to be performed and purpose of building (By Floors)_-_ ______ .... __ .... _____
____._
New Building_____ ______________. Remodeling___. _ _____ Addition________ Repairs No. of Stories
Employing Plumber's Name
Size Septic Tank
Feet of Drain Tile-_-_
Nature of Water Su
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank_
..... _____Dist Feet of Tank or Drain Field from Well
(Signed)_
Date / ' Vi i} ~
Capacity Gals.
ell. ____ _V 0 s _______ Size of Soakage Pit
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 thie 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.
9 (Signed)
Master Plumber.
STATE OF FLORIDA, ae. / / ' S
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.
My Commission Expires Notary Public, State of Florida
NO ' • A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
ma -. ' : and /or workmanship.
CLOUTS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
>
-,- -
TOTAL
FIXTURES
LIST
CLIST
3
/
1
1 y
7�
CHICK
...co
7 r
f �, p� ,
7s—
/ie�l
At
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE-
PIT
.
GREASE
TRAP
GOMM.
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
Cowrie. L W
LW
I
1
/ cY6
,
/
/S
3
�A
% 1
CHECK
6-"D
Permit No.__t ®;
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.
Owner's Name and Address ► ° -` :_ - - No.__--_•_ ..... ____ ...... _____ Street_
Registered Architect and /or Engineer______— _________ ___ . — _._ _ _ _ ___. ______------ _ - __ -
• No.______ __-- ___ -__ Street-_ __ - -_ -
Location and Legal Description Lot____-- _- ______._________.__.. __.___ Block__- Subdivision _____
Street and Number where work is to be performed —No.__ / &! Yi.�i...__ /.... /._... Street
State work to be performed and purpose of building (By Floors)_-_ ______ .... __ .... _____
____._
New Building_____ ______________. Remodeling___. _ _____ Addition________ Repairs No. of Stories
Employing Plumber's Name
Size Septic Tank
Feet of Drain Tile-_-_
Nature of Water Su
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank_
..... _____Dist Feet of Tank or Drain Field from Well
(Signed)_
Date / ' Vi i} ~
Capacity Gals.
ell. ____ _V 0 s _______ Size of Soakage Pit
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 thie 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.
9 (Signed)
Master Plumber.
STATE OF FLORIDA, ae. / / ' S
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.
My Commission Expires Notary Public, State of Florida
NO ' • A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
ma -. ' : and /or workmanship.
-S 3"
czie:
rikki
.7) ME,/ Ctiq K o - r
AciciEt.sz
NE/01 sT"'
j
•
t
*
t ,
1 Sew / Criv 4/
1 cc wt- „lel( Aer
1,4
7r41 4 4 Li 7.2'e
XCII11,67-0" ?/.8"5",
34 1 4A '2 48 2
/3:4" 7,5e: #08. 3
14/4kx c' 8 4 = 3 9. 2 - /2.“.7
77251
t. a C
1 1, 7te7i 233
Ig
47 0 4_, 0 G
1 x 2 s7
z:26
Ve 3.1
tjeYS r 6) 1 5 °
71 LE c,17
2 Roc - 1.72
toc ATI... z
4 6*A.hZ.! 240
/2 tS
P/ 1.12
cc c
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 4 -12 -93 Job Address 1250 NE 101 STREET Tax Folio // 3-ear i2!' 0020)
Legal Description G &l ,// G�
Owner / Lessee / Tenant LES PEACH Master Permit # 3397
Owner's Address 1250 NE 101 STREET, MIAMI SHORES 33138
Contracting Co. NORTH DADE SEPTIC TANK
Qualifier DENNIS NEVILLE
Square Ft. 300 SQ FT
Signature of owner and /or Condo President
Date:
as to Own
My "mmission Ex
* * *
APPROVED:
*
Condo President
S:
NOTARY KWIC; STATE OF FLORIDA AT LARGE
MY COMMISSION EXIII:1ES !JNE 19, 1995
BONDED TH1 U RRY & ASSOCIATE k
Zoning Building
Phone 895 -6161
Address 800 NW 111 STREET
SS# Phone 754 -3375
State 46 0258368 Municipal 46 Competency 46 12842 Ins.Co. ATLANTIC
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION INSTALL DRAINFIELD
Estimated Cost(value) $ 1000.00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating con uction and zo 'ng. Furthermore, I
aut16`orize t ove- named contractor to do the work state
FEES: PERMIT ,b 4 0 RADON C.C.F. f ,?) NOTARY
Sig -ture of Co
Date:
a
Fire
or Owner- Builder
or or Owner- Builder
t y as to
My Commissio ppj� Qgfig
NOTARY PUBCIC; TA OF FLORIDA AT LARGE
MY COMMISSION EXPIRES JUNE 19, 1995
TIDED TPRU NUCKL BERRY & ASSOCIATES .
* * * * * * *
**
Mechanical Plumbing /A
/ )/ 11 ,0
ineering
TOTAL DUE 10
Other
Electrical
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Owner's Name and Address
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Registered Architect and /or Engineer______ _________
Name and address of licensed contractor
Date 2 ° /1 .> , 19
No Street
Location and legal description of lot to be built on:
Lot Block Subdivision
g
Street and Number where work is to be done 1 c (a ) ' ' 1/ -�2 t
State work to be done and purpose of building (by floors)
' �G � -- and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ .' .: Amount of Permit $ �� -- 6
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
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 complied 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 subcontractors n w rk to be performed under this
permit, as are licensed by Miami Shores Village. '
y
Remarks ( Signed) ! P. __ ' " / J ' ?
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Permit No i�L_? ' Date —__ Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Notary Public, State of Florida
•
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved
NOTE: A - arge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning B.
A re -ins. 'ction fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials an or workmanship.
Date Disapproved Date
Permit No // 6
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
New Building _------ ---- •- .- __ -_-- Remodeling__ -- -- --__ -_ Addition__
Amount of Permit $ ---
STATE OF FLORIDA,
COUNTY OF DADE.
My Comnussion Expires
(Signed )
Date._ • '' 7 " °7 ti
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.
f
Owner N wi t o R ss -I c o o RIM19C(� - - - -' e.-L -4 .---- - - - - -. No 9 Y'f3 (�U_R9 /cl -1I iit4 V 1") u E
Registered Architect and /or En y in r_.__—..-- _________ __ — __ _
En
0 .frd "l 7Cc 7.4-40t //fie. /7' WJNF I.A.3R
Employing Plumber's Name_- . - -- --- •- -. - -- - —
/V ' / ^56/i c
treet__ —
Location and Legal Description Lot__ Block- /
Street and Number where work is to be performed —No �"� Nfr ! '' 4a J Street __ i,?t f / J-7-1° 41 C
State work to be performed and purpose of building (By Floors)__ --
Subdivision.
Repairs No. of Stories.
Size Septic Tank_.__ _ — __ ,_ r X - Type of Tank S 7
Feet of Drain Tile-________ ,[ / 0 0 __.__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well .________________.____.____ _ __. Size of Soakage Pit
Capacity Gals 6 0 O
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 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 of the w. such publi .lice or notices as are
required by the Act. The undersigned agrees to employ only such sub contractor on work to per ed u r this t , as are
licensed by Miami Shores Village.
• _ I n ! s perm
(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 him stated are true.
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
TUBS
SHOWERS
LAVA-
TORIES
S INKS
SLOP
SINKS
LAUNDRY
T UBS
R INALS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N8
TOTAL
FIXTURES
CONTK.
LIST
CHECK
SEPTIC
TANK
SEWER
CONK.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
!-
CHECK
Permit No // 6
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
New Building _------ ---- •- .- __ -_-- Remodeling__ -- -- --__ -_ Addition__
Amount of Permit $ ---
STATE OF FLORIDA,
COUNTY OF DADE.
My Comnussion Expires
(Signed )
Date._ • '' 7 " °7 ti
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.
f
Owner N wi t o R ss -I c o o RIM19C(� - - - -' e.-L -4 .---- - - - - -. No 9 Y'f3 (�U_R9 /cl -1I iit4 V 1") u E
Registered Architect and /or En y in r_.__—..-- _________ __ — __ _
En
0 .frd "l 7Cc 7.4-40t //fie. /7' WJNF I.A.3R
Employing Plumber's Name_- . - -- --- •- -. - -- - —
/V ' / ^56/i c
treet__ —
Location and Legal Description Lot__ Block- /
Street and Number where work is to be performed —No �"� Nfr ! '' 4a J Street __ i,?t f / J-7-1° 41 C
State work to be performed and purpose of building (By Floors)__ --
Subdivision.
Repairs No. of Stories.
Size Septic Tank_.__ _ — __ ,_ r X - Type of Tank S 7
Feet of Drain Tile-________ ,[ / 0 0 __.__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well .________________.____.____ _ __. Size of Soakage Pit
Capacity Gals 6 0 O
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 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 of the w. such publi .lice or notices as are
required by the Act. The undersigned agrees to employ only such sub contractor on work to per ed u r this t , as are
licensed by Miami Shores Village.
• _ I n ! s perm
(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 him stated are true.
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.