229 NE 100 StAmount of Permit $
P. ^a to No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
IMP
( Signed )._
r
( Signed)- - -. - .6
-_ `. --
Date O -- -- 3 O 9 6 rY
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. //�u��
Ownbr's Name and Address _ - »! m . " No. __ C __ _- 4 /S Street__! 6 6 6 9
Registered Architect and /or Engineer - -_ _ ----•--------------- ,_------- _-_ •---- .-._.
Employing Plumber's Name M P_ 7 1? ® n1 b
No. _3 0 � _— _' " Street.._. S
Location and Legal Description Lot._-.-_---._-.____._. ___-- Block Subdivisio - - - -_ - -:
P
Street and Number where work is to be performed -No 2 2 1t ' 0 Street.. it 3
State work to be performed and impose of building (By Floors)_.__.___) '1 A . l dal._. P.g d4 Pk)
New Building - Remodeling____ - _______ Addition____ Repairs
Capacity Gals
My Commission Expires Notary Public, State of Florida
v
P t
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
Master Plumber.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennan� upplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl yed 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.
Plumbing Inspector.
STATE OF FLORIDA, I
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.
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.
CLosm3
BATH
TUBS
SHOWER[
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURE6
Comm.
LIST
CHICK
•�
SEPTIC
TANK
SEWER
CONN•
DRAIN
FIELD
SOAKAGE
PIT
GREASE'
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
BWIM'O
POOL
_ -
CONTR.
LIST
--
_ .
CHECK
Amount of Permit $
P. ^a to No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
IMP
( Signed )._
r
( Signed)- - -. - .6
-_ `. --
Date O -- -- 3 O 9 6 rY
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. //�u��
Ownbr's Name and Address _ - »! m . " No. __ C __ _- 4 /S Street__! 6 6 6 9
Registered Architect and /or Engineer - -_ _ ----•--------------- ,_------- _-_ •---- .-._.
Employing Plumber's Name M P_ 7 1? ® n1 b
No. _3 0 � _— _' " Street.._. S
Location and Legal Description Lot._-.-_---._-.____._. ___-- Block Subdivisio - - - -_ - -:
P
Street and Number where work is to be performed -No 2 2 1t ' 0 Street.. it 3
State work to be performed and impose of building (By Floors)_.__.___) '1 A . l dal._. P.g d4 Pk)
New Building - Remodeling____ - _______ Addition____ Repairs
Capacity Gals
My Commission Expires Notary Public, State of Florida
v
P t
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
Master Plumber.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennan� upplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl yed 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.
Plumbing Inspector.
STATE OF FLORIDA, I
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith suI fitted for The building or other
structure herein described. This application is made in compliance and confonnity 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.
New Building
Nature of Water Supply: City —Well
Amount of Permit $__
State work to be performed and purpose of building (By Floors)
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
No. a lrGr
Date 7 l / I__J 6
e
Street • a f dc-P
Owner's Name and Address
Registered Architect and /or Engi eer
Employing Plumber's Name_ i ___NIi + ____ -- No.963 "- 2 Street . O.A
� / .
' Location and Legal Description Lot_ __ _-y f ___A.__!__ Block 2.9 Subdivision.,.
Street and Number where work is to be performed —No _a
My Commission Expires Notary Public, State of Florida
Remodeling Addition Repairs No. of Stories
Size Septic Tank 4 Q -0 Type of Tank Capacity Cals.
Feet of Drain Tile 1__Q - - Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Inspector.
The undersigned applicant for this building permit does hereby certify that he ncerstands and accepts his obligations employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gneral Laws of Florida Permanent ip 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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as arc
licensed by Miami Shores Village.
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 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
ON
CTR. ST
LI
/
n i
/
_i___
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
/
CHECK
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith suI fitted for The building or other
structure herein described. This application is made in compliance and confonnity 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.
New Building
Nature of Water Supply: City —Well
Amount of Permit $__
State work to be performed and purpose of building (By Floors)
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
No. a lrGr
Date 7 l / I__J 6
e
Street • a f dc-P
Owner's Name and Address
Registered Architect and /or Engi eer
Employing Plumber's Name_ i ___NIi + ____ -- No.963 "- 2 Street . O.A
� / .
' Location and Legal Description Lot_ __ _-y f ___A.__!__ Block 2.9 Subdivision.,.
Street and Number where work is to be performed —No _a
My Commission Expires Notary Public, State of Florida
Remodeling Addition Repairs No. of Stories
Size Septic Tank 4 Q -0 Type of Tank Capacity Cals.
Feet of Drain Tile 1__Q - - Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Inspector.
The undersigned applicant for this building permit does hereby certify that he ncerstands and accepts his obligations employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gneral Laws of Florida Permanent ip 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 undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as arc
licensed by Miami Shores Village.
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 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.
Uti►n -r of
Bui1dling
Architect
c onttpctor
or Boulder
Lot
Deac iption.
1 MIAMI SHORES VILLAGE. FLORIDA
DATE
PERMIT 1V° 9637 Contractor's
License No
BL
Addr of Value of Amt. of
Build g Project $ Permit $ y'
This permit is gr lted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
heref• in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
d gs, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
timsts 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
is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
g 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
his agents, servants or employees.
Work to be performed under this Permit
Subdi-
vision
BY AUTHORITY
195
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
'ng thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
this permit I allUipe responsibility for all work done by either, myself, my agent, servant or employee.