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185 NE 100 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Da@ Job Address DS /% / O - ' Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant A t &X0,3 Master Permit # 1 14 y ( Owner's Address / " ,. v, e - . / Op CI v Phone 3 97/)., / /J Contracting Co. ,/" ,_. et, . f /G f "4---J Address / f I T 3 /✓ 1,4 d- Qualifier .0-°- !� . 1- r , ss# < ?hone 5 G S l 7g.S$ . State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor , Address Permit Type (circle one): BUILDING ELECTRICAL UMBING MECHANI AL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ' / I t..1- /G' fib.- TO: Square Ft. 3 Notary as to Owner and/or Cond President / , Date e ti) free&A / e . at�in v" ��// ✓7//1 /Wt'A My Commission Expires: f Estimated Cost (value) ffifk1S 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 construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signa } of Contractor or Owner-Builder Date C 5 75 y /03 O otary as to Contractor or Owner - Builder Date My Commission E NOTARY • OFFICIAL r ARY SEAL GLADYS J VILIAR NOTARYFUBLICSTATE OF FLORIDA VOMMISSION NO. CC714103 MYCOMMISSION FX?. Mr r,si BOND TOTAL DUE APPROVED: Zoning Building Electrical Mechanical Plumbing rn Engineering CO TRUCTION PERMIT F R: [W] New System [ Existing System [ \J] Repair [ Abandonment APPLICANT: AND( PROPERTY STREET ADDRESS: LOT: �JJ / r 2 $L / . 25-- OCK: � SUBDIVISION: PROPERTY ID #: [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] ®� -o(3 > 2070 [OR TAX ID NUMBER] - SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. w ei 4 ,b s/f Q.em c. � /.r s�/ ® gt,. � ., C TANK AE • BIC 1 I� / �fP � �MUL - TI -C �� ERED I�SER SYSTEM DESIGN AND SPECIFICATIONS ] [GALLO J / GPD SEPTI / ].[GALLON; / GPD] T [ A [ N A I N F I E L D D [304:.>] R [ ] SQUAR TYPE SYSTEM: CONFIGURATION: 0 T H E R STATE OF FLORIDA DEPARTMENT OF HEALTH'AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC /8s° .F. /Oo CAPACITY MULTI- CHAMBERED /IN SERIES:( ] [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] GALLONS PER DOSE DOSING TANK CAPACITY' DOSE RATE [ ] PER 24 HRS NO OF PUMPS: [ ] UARE FEET PRIMARY DRAINFIELD SYSIED SYSTEM [ /STANDARD [ ] FILLED [ ] MOUND [ [ ] TRENCH [ BED [ ELEVATION OF PROPOSED SYSTEM SITE [ f] /FT] [ABOVEOELOTTI BEN HMARK /REF BOTTOM OF DRAINFIELD TO BE [ 4 ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT LOCATION OF BENCHMARK: U, / 4)4111, FILL REQUIRED: [ ] INCHES SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: 9 HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not (Stock Number: 5744 - 001-4016 -0) PERMIT # DATE PAID FEE PAID $ RECEIPT # od e- ('P .6 45 7_ EXCAVATION REQUIRED: [ SC.) INCHES TITLE:. TITLE: be usgd> LL DE Zis M-CHAVEE Eu [ A/ ] olding Tank [ Temporary /Experimental [FT Other(Specify) • ( G f' / v AGENT : mtg. 594/ Dr4/.:7. • / /g; / S o .s Aric17 c� CPHU EXPIRATI DATE: Page 1 of 2 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number assigned by CPHU. APPLICATION FOR: Check type of permit, if "Other" specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT: Property owner's legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY ID#: 27 character id number for property. (CPHU may require property appraiser ID # or section/township /range /parcel number) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 10D -6, FAC. DRAINFIELD: Minimum specifications from Chapter IOD -6, FAC. OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED BY: County Public Health Unit (CPHU) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CPHU. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date issued. By '.',;:t.��,,,i� ' �ti'.' r�. ttiy=-....- c;.,._, rtR ,...n- ^ `✓!4^�v�'*""�.-- , .* - ` . v /V ...,n.r� "1.nt4 - ' - w '"'�,�,,- ' ^ar^"'lj""' - "`v - • - •.-cam •: �-. ---, . - • - w - �. - Notes:: Q Site Plan submi -STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number •/ .. . ..... - ■ i n 11 •G ■ _ i ns u . 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Plan Approved 4:.//#0 Date ; 4diffq County Health D ep� me r ALL CHANGES MUST BE APPROVE Y THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS-H Form 4015 which may be used) (Stock Number: 5744-DM-4015-6) PART II - SITE PLAN- Signature Not Approved Page 2 Permit No 1414:14 !4/ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT New Building ..___._— _.._..........._.. Remodeling__ _ Addition -. Size Septic Tank_... _Type of Tank —__ Feet of Drain Tile Dist Feet of Tank oc Drain Field from Well .. ._.__. —_ Nature of Water Supply: City-Well. Size of Soakage Pit Amount of Permit $ Z ( Signed) _ ' k 4/ 207 (Signed) My Commission Expires Notary Public, State of Florida z _ 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. E.-' Owner's Name and Address 4034 P.$4 to No / g Street_! - I D© Si. Registered Architect and /or Enginee _. _� ^� -- _...._ . . IA I AWt % t oyne� ell. « . SL`s A/E ve Employing Plumber's Name - -d Na .. _.....w......... I IsL .._ �,y, ... � .. � .. -. ]� t3on d al ptio - n � " Lot. _ . y Eke / Subdiv sion „/ g /'"" / Street N wher2 v1 k s to be performed -No Street .._..._E E . J 00 State work to be performed and purpose of building (By Floors)____. . ._. 1. ..S (..... ..._ A Repairs .IZ 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 !tax com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to he performed under this permit; and will post or cause to be posted' for inspection on the site of the work suc . . ublic notice or notices as are A O . required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be . under this permit. Ks are lionised by Miami Shores Village. 411111111 ' / Master Plumber. STATE OF FLORIDA, 1 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 bas 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 11.00 will be mad. whym snob r♦iupertfos, V m.d..a.omsary by hnproper sotioe for inspection, or faulty materials and /or workmanship. ship. CLOSET[ BATH TWIG SHOWERS LAVA• TORIES SINKS SLOP SK[ IN LAUNORT Tuns UR URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N[ TOTAL III/MIRES COMM LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR HEATER Dear WILL SPRKLR. S M SW IM'0 POOL CoNTE. LIST CHICK .-- Permit No 1414:14 !4/ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT New Building ..___._— _.._..........._.. Remodeling__ _ Addition -. Size Septic Tank_... _Type of Tank —__ Feet of Drain Tile Dist Feet of Tank oc Drain Field from Well .. ._.__. —_ Nature of Water Supply: City-Well. Size of Soakage Pit Amount of Permit $ Z ( Signed) _ ' k 4/ 207 (Signed) My Commission Expires Notary Public, State of Florida z _ 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. E.-' Owner's Name and Address 4034 P.$4 to No / g Street_! - I D© Si. Registered Architect and /or Enginee _. _� ^� -- _...._ . . IA I AWt % t oyne� ell. « . SL`s A/E ve Employing Plumber's Name - -d Na .. _.....w......... I IsL .._ �,y, ... � .. � .. -. ]� t3on d al ptio - n � " Lot. _ . y Eke / Subdiv sion „/ g /'"" / Street N wher2 v1 k s to be performed -No Street .._..._E E . J 00 State work to be performed and purpose of building (By Floors)____. . ._. 1. ..S (..... ..._ A Repairs .IZ 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 !tax com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to he performed under this permit; and will post or cause to be posted' for inspection on the site of the work suc . . ublic notice or notices as are A O . required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be . under this permit. Ks are lionised by Miami Shores Village. 411111111 ' / Master Plumber. STATE OF FLORIDA, 1 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 bas 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 11.00 will be mad. whym snob r♦iupertfos, V m.d..a.omsary by hnproper sotioe for inspection, or faulty materials and /or workmanship. ship. STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Applicant�� -'C� I p Permit Number 16- O7 c / P / ' 6i PART 11 - SYSTEM INSTALLATION INSPECTION AND FINAL IN APPROVAL - Installer t 7 ; Tank Yes Manuf cturer / ' 10 Proper tank legend: es 1141 No Tank material terial arc( Tank level: Yes / / 41 ^ No a X Tanks watertight: Yes ✓ No Tank size ��. gallons gallons gallons 18s ki .e. /00 S/. Proper tank outlet device: Yes I No Length feet feet feet Total = Width Drainfield Trench feet 1(1 J ft feet feet Systems located as permitted: Yes No Inspected by: 3a r c' C-o Date " F v ' Approved by PART HRS —H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744- 002. 4016-0) Length Width feet feet feet feet feet feet Total = ft Systems including plumbing stub -outs installed at proper elevation: / Average depth to drainpipe invert from finished grade• inches Y Average depth of drainfield gravel: 'di inches Minimum depth Proper gravel size: Yes '• No Backfill or fill mate ' I a required: (Quality) Yes L' No Other findings: (-01 -San g b Six( i Manhole or marker to grade: Yes No Absorption Bed Lengta2 D feet x 7 feet = 3 ft of gravel /Z.0 inches V Gravel is suitable quality: Yes LATION APPROVAL Length feet x feet= ft Proper No. drainlines: Yes No Proper pipe separation: Yes JZ. No Distribution box level: Yes No Yes No Maximum depthi7'.d Inches No (Quantity) Yes v AN APPROVED INSTALLATION DOES NOT GUARANTEE PERFORMANCE No Date \ - 7 ° d NTY PUBLIC HEALTH UNIT Note: Completed copies -of, this form will be provided to the applicant, installer and the building department. Page 2 of 2 .01-a Villje of Miami Shores JOB / -', , Z ADDRESS INSPECTION S A i�,. /3 Aid / TIME READY (l 9 REMARKS N9 3983 INSPECTOR DATE a- Permit No.__. -_ Owner's Name and Address ore/ L Registered Architect and /or — MIAMI SHORES VI LLAGli; PLUMBING INSPECTION DEPARTMENT Employing Plumber's Name 13 2 No / Location and Legal Description Lot APPLICATION FOR PLUMBING 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 $ (Signed ) Date - 14, - 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 wilding 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 :got. A copy of approved plans and specifications must be kept at building during progress of work. S -L : My Commission Expires Notary Public, State of Florida ._.._ - • -- - _ --- S. No._ ..___ -- ti , E Street_.._ c}1 Block Street and Number where work is to be performed -No / r s 4 /- 0- - • L° - Street State work to be performe8 and purpose of building (By Floors)_ .. ___ v� •r) 7' e_ U - New Building __ - Remodeling_ __.__.__ _ _ __ Addition._._ _ _..___... Repairs. No. of Stories -- Capacity Gals (Siga0d)- 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 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 subcontractors 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 tlie 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. Master Plumber. STATE OF FLORIDA, a. 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. NOTE: A re-inspection fee of $1.00 will be made when suck re- inspection is made .necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBE SHOWERS LAVA• TORIES SINKS S SLOP SINKS LAUNDRY Tuff U CATCH OASIN FLOOR DRAIN DRINKING FOUNT •NS TOTAL FIETURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER Ore WELL S►RKLR. SYSTEM IIWIM'a POQL CONTR. LIST CHECK Permit No.__. -_ Owner's Name and Address ore/ L Registered Architect and /or — MIAMI SHORES VI LLAGli; PLUMBING INSPECTION DEPARTMENT Employing Plumber's Name 13 2 No / Location and Legal Description Lot APPLICATION FOR PLUMBING 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 $ (Signed ) Date - 14, - 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 wilding 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 :got. A copy of approved plans and specifications must be kept at building during progress of work. S -L : My Commission Expires Notary Public, State of Florida ._.._ - • -- - _ --- S. No._ ..___ -- ti , E Street_.._ c}1 Block Street and Number where work is to be performed -No / r s 4 /- 0- - • L° - Street State work to be performe8 and purpose of building (By Floors)_ .. ___ v� •r) 7' e_ U - New Building __ - Remodeling_ __.__.__ _ _ __ Addition._._ _ _..___... Repairs. No. of Stories -- Capacity Gals (Siga0d)- 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 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 subcontractors 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 tlie 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. Master Plumber. STATE OF FLORIDA, a. 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. NOTE: A re-inspection fee of $1.00 will be made when suck re- inspection is made .necessary by improper notice for inspection, or faulty materials and /or workmanship. J. M. (BUCK) COUNCIL, PRES. 4150 N. W. SEVENTH AVENUE MIAMI 37, FLORIDA PHONE 7 -8718 Miami Shores Village Division of Plumbing Inspection 10050 N. E. 2nd Ave., Miami, Florida APPLICATION FOR PLUMBING PERMIT: For: Alfred E. Powers 185 N. E. 100 St., Re -lay 25' of Drain Tile. (NOTE) March 23, 1956 BUCK PLUMBING INC . Ready to be put on board for Inspection. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot 0 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT ? 3426 195 f DATR 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 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 in 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 regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY s Permit No Application is hereby made for the approval structure herein described. This application is and all provisions of the Laws of the State of of Miami Shores Village shall be co lied building during progress of work. Owner's Name and Address . Registered Architect and /or Engineer y _ Employing Plumber's Name Location and Legal Description Lot__ Street and Number where work is to be performed —No. Size Septic T � � Feet of Drain Tile___ Amount of Permit $_ 6 APPLICATION FOR PLUMBING PERMIT My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Date of the detailed statement of the plans and specifications herewith submitted for the building or other made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, Florida, all.o;dinances of Miami Shores Village and all rules and regulations of the Building Division with, wl ethe t herein specified or nos, A copy of approved plans and specifications must be kept at Type of Tank . 0. Street Street Block Subdivision___ ______ ________ _______ __________ • 1/ Street – -.. ,.. . State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. Size of &kage it (Signed) w� .- Capacity Gals r - j f 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 Suppleinent, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public. State of Florida Master Plumber. 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 SINES LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK EWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No Application is hereby made for the approval structure herein described. This application is and all provisions of the Laws of the State of of Miami Shores Village shall be co lied building during progress of work. Owner's Name and Address . Registered Architect and /or Engineer y _ Employing Plumber's Name Location and Legal Description Lot__ Street and Number where work is to be performed —No. Size Septic T � � Feet of Drain Tile___ Amount of Permit $_ 6 APPLICATION FOR PLUMBING PERMIT My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Date of the detailed statement of the plans and specifications herewith submitted for the building or other made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, Florida, all.o;dinances of Miami Shores Village and all rules and regulations of the Building Division with, wl ethe t herein specified or nos, A copy of approved plans and specifications must be kept at Type of Tank . 0. Street Street Block Subdivision___ ______ ________ _______ __________ • 1/ Street – -.. ,.. . State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. Size of &kage it (Signed) w� .- Capacity Gals r - j f 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 Suppleinent, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public. State of Florida Master Plumber. 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. A. • Permit No Size Septic Tank__ Feet of Drain Tile____ / Location and Legal Description Lot__ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 co plied 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 - Registered Architect and /or Engineer,� ,f Employing Plumber's Name No - �' ./ Block Street New Building Remodeling Addition Repairs No. of Stories . Type of Tank . Capacity Gals Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage "it. (Signed) Date Street Street Subdivision__ My Commission Expires Notary Public. State of Florida i Amount of Permit $_ _(Signed) Plum ng Inspector. The undersigned applicant for this building permit does hereby certify that 1 l a ufiderstands and accepts his obligations as a employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppl ment, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fl 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 CONTR. LIST CHECK SEPTIC TANK EWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST i CHECK A. • Permit No Size Septic Tank__ Feet of Drain Tile____ / Location and Legal Description Lot__ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 co plied 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 - Registered Architect and /or Engineer,� ,f Employing Plumber's Name No - �' ./ Block Street New Building Remodeling Addition Repairs No. of Stories . Type of Tank . Capacity Gals Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage "it. (Signed) Date Street Street Subdivision__ My Commission Expires Notary Public. State of Florida i Amount of Permit $_ _(Signed) Plum ng Inspector. The undersigned applicant for this building permit does hereby certify that 1 l a ufiderstands and accepts his obligations as a employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppl ment, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or fl materials and /or workmanship. y P 6 ermit No. ti Application is hereby made for the approval of the detailed statement of the plans and specifications he vith 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 Engine Employing Plumber's Name__ __ ___ __ _ _ __ No._ -6 2 1 ___ .Gv3treet /� SSubdivisi ,p on Street and Number where work is to be performed —No / f1__I 1 // . " < Street 1 d Location and Legal Description Lot Block Feet of Drain Tile { J Nature of Water Supply: City—Well STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT N O S ( Signed) Dat L Street • My Commission Expires Notary Public, State of Florida - 15 xr State work to be performed and purpose of building (By Floors) New Building Remodeling Addition v Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals .____6■ Dist Feet of Tank or Drain Field from Well Size of Soakage Pit Amount of Permit $ ___ ../ ( Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be perform d under this permit, as are licensed by Miami Shores Village. 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 SINKS SLOP SINKS LAUNDRY TUBS URINALS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST / CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST / CHECK y P 6 ermit No. ti Application is hereby made for the approval of the detailed statement of the plans and specifications he vith 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 Engine Employing Plumber's Name__ __ ___ __ _ _ __ No._ -6 2 1 ___ .Gv3treet /� SSubdivisi ,p on Street and Number where work is to be performed —No / f1__I 1 // . " < Street 1 d Location and Legal Description Lot Block Feet of Drain Tile { J Nature of Water Supply: City—Well STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT N O S ( Signed) Dat L Street • My Commission Expires Notary Public, State of Florida - 15 xr State work to be performed and purpose of building (By Floors) New Building Remodeling Addition v Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals .____6■ Dist Feet of Tank or Drain Field from Well Size of Soakage Pit Amount of Permit $ ___ ../ ( Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be perform d under this permit, as are licensed by Miami Shores Village. 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. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot that he assumes responsibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE 194 PERMIT N° 3116 \ // Contractor's License No. Work t•_ • e performed under this Perms' J f 4 I Subdi- Value of Project 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-an with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been'submitte o 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 o if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor orkbuilder amed above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown o ,tlie plans or drawings or it the statements or specifications and Signed: o. '� =i��� B i/`, - / ,,- INSPECTOR In consideration of the issuance to me of this permit I agree to perform the7ork covered hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. BY Amt. of Permit � AUTHORITY BUILDING ELECTRICAL PLUMBING MIAMI SHORES VILLAGE, FLORIDA DATE J 194 Contractor's ' Lice No ii > PERMIT N9 3116, Wor • e per under this Permit' Owner of Building Architect Contractor i �L) L e 1 �r ,c i or Builder Legal Lot 1 Bl. Description Address of Building CONTRACTOR OR BUILDER „:” r. Subdi- Value of Project PermiAmt. t C Permit � 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 with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted 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 on if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or• named atteire assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether ihown o'pftoe'. ans or d fwings or in the statements or s -cifi Dons and that he assumes responsibility for work done by his agents, servants or employees. A., Signed • ,,� By INSPECTOR In consideration of the issuance to me of this permit I agree to perform tli yiork covered hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, state�dt� nts or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by'€ither myself, my agent, servant or employee. BY AUTHORITY C BUILDING ELECTRICAL PLUMBING Owner of Building / Architect Contractor or Bui•Fcier— Legal Lot jfi Bl. Description Address of Building • MIAMI SHORES VILLAGE, FLORIDA DATE ` 194 J Contractor's License No. PERMIT N9 1228 Work to be performed under this Permit / Subdi- vision Value of Project • Amt. of Permit 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 in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. - v Signed:. ., °`�;,! °� ., t t' By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in; c ompliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miangl.Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. r !i!! ON TRACTOR 0 UILDER BY AUTHORITY LLL...... OWNER LOT BLOCK SUBDIVISION x e i1 vc'. f..,'`r Date Issued to cShoresThllage F L O R I D A PLUMBING PERMIT N9 757 to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a 4 story building at Fixtures Fixtures $ Sewer $ Septic Tank i' $ / Total $ / Village Plumbing Inspector Received Payment by OWNER LOT BLOCK SUBDIVISION - e ,, oe Ji G Issued to ;1,1 e4074..44.0.A E449,--eZe,e4e) ec:6 For a _story Fixtures to install the fceo described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. aiami cShores llage F L O R D A PLUMBING PERMIT N9 757 building at Fixtures $ Sewer $ tic Tank / $ Total $ / U v Village Plumbing Inspector a / Received Payment by _ 7 ;( 1 Permit No STATE OF FLORIDA, } COUNTY OF DADE. ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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. d__ . Street Street and Number where work is to be performed —No Registered Architect and /or Engineer , -� r Employing Plumber's Name ---' .___ No 'y / Street ) C" Block Subdivision ••' ' Location and Legal Description Ljot:162- ■• i '� State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals. 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) r �' (Signed) "�_� • Street 2 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance.' from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. s Notary Public, State of Florida ,. Date ,r,,4 Plumbi g Inspector. Master Plumber. ti 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 SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER ' SPRKLR. .WELL SYSTEM SWIM'G POOL • CONTR. LIST CHECK L'''' Permit No STATE OF FLORIDA, } COUNTY OF DADE. ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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. d__ . Street Street and Number where work is to be performed —No Registered Architect and /or Engineer , -� r Employing Plumber's Name ---' .___ No 'y / Street ) C" Block Subdivision ••' ' Location and Legal Description Ljot:162- ■• i '� State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals. 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) r �' (Signed) "�_� • Street 2 The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance.' from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. s Notary Public, State of Florida ,. Date ,r,,4 Plumbi g Inspector. Master Plumber. ti 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.