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16 NE 100 St (3).a May I have some more pcistilitM1 SHORES VILLAGE permit applications, PLUMBING INSPECTION DEPARTMENT Please,Thank you APPLICATION FOR PLUMBING PERMIT Permit Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether 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 16 N .E.• -,J,n rgxet Registered Architect and /or Engineer Location and Legal Description Lot. Employing Plumber's NameRQS-S-.- t- 6— T-a -s-lt Co . •. P . 0 s$0- cN644-44ie+e hr .— Street.. ,-- Street and Number where work is to be performed—No. _ 16 N.E. _ 1 00th Street Street State work to be performed and purpose of building (By Flom) _--.--__ New Building _ Remodeling —_ _ .___ Addition. Size Septic Tank___.__-_--- -- ---- -- - -- ----Type of. Tank_ Feet of Drain Tile._ _ __-- _,—Dist. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well..___._..- ___- .- ___.._._. _____.—._.Size of Soakage Pit Amount of Permit $ 4 t 00 (Signed)_ (Signed) Capacity Gals. Date.-- -.._ 4 -4.- 74 -- - -.... -- — — Repairs No. of Stories .......... 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 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. i bfc 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 be 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 au& re-inspection Is mede.neowary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUB" SHOWER• LAVA• TORIES SINKS SLOP SINKS LAUNDRY Tua" URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•N! TOTAL FIXTURES CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WILL SPRKLR. SYSTEM SWING POOL CONTR. LIST I 25 CHICK .a May I have some more pcistilitM1 SHORES VILLAGE permit applications, PLUMBING INSPECTION DEPARTMENT Please,Thank you APPLICATION FOR PLUMBING PERMIT Permit Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether 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 16 N .E.• -,J,n rgxet Registered Architect and /or Engineer Location and Legal Description Lot. Employing Plumber's NameRQS-S-.- t- 6— T-a -s-lt Co . •. P . 0 s$0- cN644-44ie+e hr .— Street.. ,-- Street and Number where work is to be performed—No. _ 16 N.E. _ 1 00th Street Street State work to be performed and purpose of building (By Flom) _--.--__ New Building _ Remodeling —_ _ .___ Addition. Size Septic Tank___.__-_--- -- ---- -- - -- ----Type of. Tank_ Feet of Drain Tile._ _ __-- _,—Dist. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well..___._..- ___- .- ___.._._. _____.—._.Size of Soakage Pit Amount of Permit $ 4 t 00 (Signed)_ (Signed) Capacity Gals. Date.-- -.._ 4 -4.- 74 -- - -.... -- — — Repairs No. of Stories .......... 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 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. i bfc 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 be 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 au& re-inspection Is mede.neowary by improper notice for inspection, or faulty materials and /or workmanship.