1351 NE 101 St (3)Permit No 1 104
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 regulation 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.
Owners Name and Address
Amount of Permit $
STATE OF FLORIDA,
sa.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
N /3s7 /VC: st .._. / _ a / S '
registered Architect and /or Engineer
r /� �.
',Employing Plumber's Name �� ` . = - �N e Pl l 7 E5. NO,. � 8tteeL.V�� / • : -a -3 313
Location and Legal Description Lot_ /nork Sub�d ...--- __.._- __ __.
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By rs )_ g / �_4'� 0.61'02 Z 4'4' L 41.0 AX U/fR,6( + £ L o e47'4e •
New Building Remodeling V - -__— Addition._ __._ Repairs No. of Stories
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
f ro (siened)`i, AB W6
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 £upi,lement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed I'y him in t! a work co b-
performed under this permit; and will post or cause to be posted' for inspection on the site of e work such p bit^ notice or noticcr as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on a to be perfo d �ca this p'rinit, ari
licensed by Miami Shores Village.
Date...- ......—
AP _7q
Capacity Gals. _
Mascot Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personal;; uppeared'
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 hire stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $L00 will be made when such re-iaspeetilan is made•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLO[Ra
BATH
TUB[
SHOW[Ra
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tugs
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT'Ne
TOTAL
FIXTURES
CONTR.
LINT
_—
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H
DEEP
WELL
SPRKLR.
SYSTEM
SWING
POOL
C ONTR.
LIST
—
CHECK
Permit No 1 104
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 regulation 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.
Owners Name and Address
Amount of Permit $
STATE OF FLORIDA,
sa.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
N /3s7 /VC: st .._. / _ a / S '
registered Architect and /or Engineer
r /� �.
',Employing Plumber's Name �� ` . = - �N e Pl l 7 E5. NO,. � 8tteeL.V�� / • : -a -3 313
Location and Legal Description Lot_ /nork Sub�d ...--- __.._- __ __.
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By rs )_ g / �_4'� 0.61'02 Z 4'4' L 41.0 AX U/fR,6( + £ L o e47'4e •
New Building Remodeling V - -__— Addition._ __._ Repairs No. of Stories
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
f ro (siened)`i, AB W6
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 £upi,lement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed I'y him in t! a work co b-
performed under this permit; and will post or cause to be posted' for inspection on the site of e work such p bit^ notice or noticcr as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on a to be perfo d �ca this p'rinit, ari
licensed by Miami Shores Village.
Date...- ......—
AP _7q
Capacity Gals. _
Mascot Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personal;; uppeared'
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 hire stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $L00 will be made when such re-iaspeetilan is made•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE, FLORIDA
.UILDING ❑ DATE l 4 c 19
rLECTRICAL ❑ PERMIT N? 15856
Contractor's
PLUMBING License No
ROOFING ❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
,J
CJi jZ w1' M rte'
44 i
..►' Subdi- '
,� vision i e : '(
°' r Value of Amt. of
{ jr . mot / J : ' ' Project $ Permit $ permit is granted to the contractor or builder named above to C,( nstruct 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\ drawings or irj the statements or specifications and th3; he ssume responsibility for work
done by his agents, servants or employees. ,, • ^°'"'°'""
Signed a a r f t _ .t`
INSPECTO
er° "t
w ork covered
hereunder In consideration of the issuance to me of this permit I agree t.: perform the compliance with all o dinances and regulations
pertaining thereto and in strict conformity with the plans, drawings ,statements or specifications submitted to the proper authorities • Miami Shores Village.
In accepting this permit I assume responsibility for all work• drntieliy either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
rte'
BY
AUTHORITY
BUILDING ❑
ELECTRICAL ❑ PERMIT
PLUMBING 1:1''
ROOFING
Owner of
Building
Architect
Contractor
or Builder �..
Legal Lot II Bf
Description
Address of
Building
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
N? 15048
Subdi-
vision
Value of
Project $ '/
DATE 195
Contractor's
License No
Amt.
Permit of $
BY AUTHORITY
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 • t_. L BY S "•'•
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 thereito 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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
I & '�
❑ , PERMIT N° 14824
❑ Work to be performed under this Permit
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
u
Subdi-
vision
Value of
Project $
DATE
Contractor's
License No.
Amt, of 91/
Permit $ / r '
195
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 accepting this permit I assume responsibility for all work done by either, myself, my agent servant or employee.
Permit No. /.5 4/e
Location and Legal Description Lot.
and Number where work is to be performed —No
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept ai
building during progress of work.
Owner's Name and Address. - - --- - 9' -- Y - _ - - - -- - ---- - - - - -- No.
Registered Architect and /or Eng
Employing Plumber's Name ^° - -- ,�"'
State work to be performed and purpose of building (By Fkrors)_- __...........
New Building . -_ Remodeling Addition Repairs.
Nature of Water Supply; City —Well
Date
Street
Street -
Subdivision ----------- - - - - --
��
street_
No. of Stories
Size Septic Tank Type of Tank_
of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed
Capacity Gals
Amount of Permit $ i-cIt — � __ (Signed)_ 1-.-
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as ail employer of labor
under the Florida Workmen's Compensation Act, being Section •5986, Compiled General Laws of Florida Permanent Supplement, and hi;..; :::in-
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 r -rmit, as are
$tensed by Miami Shores Village.
STATE OF FLORIDA, u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally . +ppeare
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 fat
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 Ltd
materials and /or workmanship.
CLOSETS
BATH
. TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINK.
LAUNDRY
TUeS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURE!
CONTR.
LIST
—
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHICK
Permit No. /.5 4/e
Location and Legal Description Lot.
and Number where work is to be performed —No
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept ai
building during progress of work.
Owner's Name and Address. - - --- - 9' -- Y - _ - - - -- - ---- - - - - -- No.
Registered Architect and /or Eng
Employing Plumber's Name ^° - -- ,�"'
State work to be performed and purpose of building (By Fkrors)_- __...........
New Building . -_ Remodeling Addition Repairs.
Nature of Water Supply; City —Well
Date
Street
Street -
Subdivision ----------- - - - - --
��
street_
No. of Stories
Size Septic Tank Type of Tank_
of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed
Capacity Gals
Amount of Permit $ i-cIt — � __ (Signed)_ 1-.-
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as ail employer of labor
under the Florida Workmen's Compensation Act, being Section •5986, Compiled General Laws of Florida Permanent Supplement, and hi;..; :::in-
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 r -rmit, as are
$tensed by Miami Shores Village.
STATE OF FLORIDA, u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally . +ppeare
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 fat
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 Ltd
materials and /or workmanship.
BUILDING PERMIT NO.
installation
SEPTIC TANK
NE[
INSTALLED BY
of:
OWNER OR CONTRACTOR
LOT NO.
ADDRESS OF WORK
DEPARTMENT OF PUBLIC 1 .7• KS
DIVISION OF PLUMING INSPECTION
PERMIT NO. P DATE
I herewith submit the following application for a permit covering the
7/fe,
SOAK E PIT
FEET OF DRAIN TILE
BUILDING HAS STORES
HOTPI, ROOMS
TYPE OF TANK INSTALL-ED
SIZE OF SOAKAGE PIT
ADDITIONAL INFORMATION
READY FOR INSPECTION: DATE
APPROVED BY
BLCCK
ADDRESS
CONDEMNED BY
NEW ' OLD STORY ADDITION REMODELED
STORE GARAGE APARTIV ENT HOTEL
OFFICE BLDG. DUPLEX RESIDENCE
GARAGE WASH FLOOR WASTE WATT, FRQ;I A
OFFICES APTS.
'BEDROOM
ADDRESS
SUBDIVISION
/ds - e - /Ai/ L /d/44
A tA f elTANK CAPACITY IN GALLONS
PURPOSE OF SAME
TIME
Permit No._,
v
Amount of Permit $
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi , ubnittted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordin.,j'e 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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept .i
building during progress of work.
Owner's Name and Address 11 ___ Caa __ No Street
Registered Architect and /or Engineer
Employing Plumber's Name 6. 8
Location and Legal Description Lot _- _- _ -_____ Block_ Y___ ___________.___________________ Subdivision
Street and Number where work is to be performed —No / 3 SY ___________ Street_ g / /
State work to be performed and purpose of building (By Floors) _
New Building Jr Remodeling Addition__. Repairs
Size Septic Tank Type of Tank_ _ Capacity Gals
Feet of Drain Tile
Nature of Water Supp
ell
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date " A
No 3 e / Street 5 « X- 4 .r t;`t.
No. of Stories
Dist. Feet of Tank or Drain Field from WeIL
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 performed under this permit, as an
licensed by Miami Shores Village. 3
Size of Soakage Pit
( Signed)-
(Signed) -
Plumbing nspector.
Master Plumber.
STATE OF FLORIDA, ) i 10
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 fat.
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 Paul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
kaZ
TOTAL
FIXTURE!
- -
CONTR.
LIST
/
`
3
/
/
CHECK
/
�
p
j�
j d�
�y/
(
qq�
��d®
c
74_
�J
/S ®
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
^ ^ DDEEP
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
9 �
CONTR.
A
r
4
LIST
CHECK
Permit No._,
v
Amount of Permit $
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi , ubnittted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordin.,j'e 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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept .i
building during progress of work.
Owner's Name and Address 11 ___ Caa __ No Street
Registered Architect and /or Engineer
Employing Plumber's Name 6. 8
Location and Legal Description Lot _- _- _ -_____ Block_ Y___ ___________.___________________ Subdivision
Street and Number where work is to be performed —No / 3 SY ___________ Street_ g / /
State work to be performed and purpose of building (By Floors) _
New Building Jr Remodeling Addition__. Repairs
Size Septic Tank Type of Tank_ _ Capacity Gals
Feet of Drain Tile
Nature of Water Supp
ell
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date " A
No 3 e / Street 5 « X- 4 .r t;`t.
No. of Stories
Dist. Feet of Tank or Drain Field from WeIL
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 performed under this permit, as an
licensed by Miami Shores Village. 3
Size of Soakage Pit
( Signed)-
(Signed) -
Plumbing nspector.
Master Plumber.
STATE OF FLORIDA, ) i 10
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 fat.
therein by him stated are true.
- ----------------------------------------
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Paul
materials and /or workmanship.
Permit No
C 4'
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi submitted for the building or other
structure herein described. This application'4 made in compliance and conformity with the Building Ordii/ ce of Miami Shores Village, Florida,
and all provisions of the Laws of the State of 1orida, all or$i ances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shallye, wi specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. +
Owner's Name and Address__ . ..) __ _r- _
Registered Architect and /or Engineer .- .:.. _________.
Employing Plumber's Name____ ,L...1 '_tom No -- / 0 Street__✓ . -°. 5i.
Location and Legal Description Lot ,-- Block Subdivision
Street and Number where work is to be performed_NR L3 - Street 7/
State work to be performed and purpose of boring (B Floors)
New Building Remodpingt t.'') \ Addition Repairs
Amount of Permit
"• f' STATE OF FLORIDA,
COUNTY OF IbADE.
*`
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
Date__
/elJ
o Street
No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile A Dist. Feet o Tank or Drain Field from Well_.i ,
Nature of Water Supply: City —Well _ Size of Soakage it
(Sigyed')
Ther i3 plicant for this building permit does hereby certify that he un rstandt ailii ak3c.epts his obligations as an employer of labor
under the Florida ork n's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has corn-
plied with the pr isions ereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed un er this permit; d will posror cause to be posted for inspection on the site of the work such public notice or notices as are
required by The undIrsigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
sed by M1imf•Shores Village:\
Plumbing Inspector.
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 by me first duly sworn, upon oath deposes and says that he is the
of the above difscrilsed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hin e.stafed are Itu.
- Iy;.Commission Expires Notary Public, State of Florida
NOTi3: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or worlananship.
--f A .
CLOSETS
BATH
TUBS
SHOWERS
LAV,
TORIES
SINKS
SLO-
SINK
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
f
CHECK
.._. ti ..
+ ..: • - � n.. `[ o , : - .a...:
r,r•oyy.•e
"` ►�... ..,.,..
r . :w..,
.v
`
SEP IC
TA K
eSEV ESi
CONN.
Dpn`
FIELD'
SOAKAGE
PIT
GRE SE
TRAP
SOLAR
H EATER
DE P
W F ELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No
C 4'
Application is hereby made for the approval of the detailed statement of the plans and specifications herewi submitted for the building or other
structure herein described. This application'4 made in compliance and conformity with the Building Ordii/ ce of Miami Shores Village, Florida,
and all provisions of the Laws of the State of 1orida, all or$i ances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shallye, wi specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. +
Owner's Name and Address__ . ..) __ _r- _
Registered Architect and /or Engineer .- .:.. _________.
Employing Plumber's Name____ ,L...1 '_tom No -- / 0 Street__✓ . -°. 5i.
Location and Legal Description Lot ,-- Block Subdivision
Street and Number where work is to be performed_NR L3 - Street 7/
State work to be performed and purpose of boring (B Floors)
New Building Remodpingt t.'') \ Addition Repairs
Amount of Permit
"• f' STATE OF FLORIDA,
COUNTY OF IbADE.
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ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
Date__
/elJ
o Street
No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile A Dist. Feet o Tank or Drain Field from Well_.i ,
Nature of Water Supply: City —Well _ Size of Soakage it
(Sigyed')
Ther i3 plicant for this building permit does hereby certify that he un rstandt ailii ak3c.epts his obligations as an employer of labor
under the Florida ork n's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has corn-
plied with the pr isions ereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed un er this permit; d will posror cause to be posted for inspection on the site of the work such public notice or notices as are
required by The undIrsigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
sed by M1imf•Shores Village:\
Plumbing Inspector.
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 by me first duly sworn, upon oath deposes and says that he is the
of the above difscrilsed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hin e.stafed are Itu.
- Iy;.Commission Expires Notary Public, State of Florida
NOTi3: 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 worlananship.
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