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253 NE 100 St (4)BUILDING ELECTRICAL PLUMBING Owner of , Building - MIAMI SHORES VILLAGE, FLORIDA DATE :' 1 . ' s l f 195 "ERMIT N° 9089 Architect Contractor or Builder Legal Lot Bl. Description. Address of ) } Building ' f CONTRACTOR OR BUILDER Work to be rformed under this Permit Subdi- vision Value of Project $ Thl 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 statemen or specifications and that he assumes responsibility for work done by his agents, servants or employees. -"' BY INSPECTOR �,+•' w In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance wil(I 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. 41,1 i Signed • 1" ' BY Contractor's License No. Amt. of Permit AUTHORITY APPLICATION FOR PLUMBING PERMIT Permit No. _6 t Date Y - ) 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 v o l,. Owner's Name and Address__ Registered Architect and /or ngi Employing Plumber's Name. _ - -(/X � r ' x i — No Street Location and Legal Description Lot___ __ - I _ -g — ____ -- Block 2 / Subdivisio if._ __a I — e/1 I— Street//' :zt Street and Number where work is to be performed —No Amount of Permit $_ ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT State work to be performed and purpose of building (By Floors) New Building No It 3 �` _g Street Remodeling Addition Repairs No. of Stories Capacity Gals Size Septic Tank Type of Tank _L-1 t Feet of Drain Tile L/ `f ± Dist. Feet of Tank or Drain Field from Well V Nature of Water Supply: CI —Well Size of Soakage Pit (Signed) .i '' d. r " "` f _ • P1 i mbing Inspector. The undersigned applicant foithis building permit does hereby certify that he understands and accepts his obligations at an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed) f 'T2 e 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. My Commission Expires . Notary Public, State oI Florida I1 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 4 CONTR. LIST / 7 _ r J ! / CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP •Ereftitr& KGl1TER DEEP SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST � / f t +,�[. G . j l. r rip/ / CHECK APPLICATION FOR PLUMBING PERMIT Permit No. _6 t Date Y - ) 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 v o l,. Owner's Name and Address__ Registered Architect and /or ngi Employing Plumber's Name. _ - -(/X � r ' x i — No Street Location and Legal Description Lot___ __ - I _ -g — ____ -- Block 2 / Subdivisio if._ __a I — e/1 I— Street//' :zt Street and Number where work is to be performed —No Amount of Permit $_ ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT State work to be performed and purpose of building (By Floors) New Building No It 3 �` _g Street Remodeling Addition Repairs No. of Stories Capacity Gals Size Septic Tank Type of Tank _L-1 t Feet of Drain Tile L/ `f ± Dist. Feet of Tank or Drain Field from Well V Nature of Water Supply: CI —Well Size of Soakage Pit (Signed) .i '' d. r " "` f _ • P1 i mbing Inspector. The undersigned applicant foithis building permit does hereby certify that he understands and accepts his obligations at an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed) f 'T2 e 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. My Commission Expires . Notary Public, State oI Florida I1 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.