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302 NE 100 St (9)CLO {[T{ BATH TUBB SNOW [R{ LAVA• TORIES SINKS SLOP SINK{ LAUNDR TUBS URINAL{ CATCH eA {IN FLOOR DRINKING DRAIN FOUNT'N{ - � ' — I TOT L FIXTI R[{ T. CLw LIT CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD 6OAKAOI PIT GRIA {I TRAP SOLAR HEATER MEP WILL SPRKLR. 6 BWIN'O POOL __ � LIST __—_ CHICK Penni. NJ.' lit.,,iii.11 is hereby made for the approval of the detailed statement of the plans and specifications herewith subr.i,t...•1 for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mk Shores Village, Florida, act] all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic of the Building Division of Miami Shores Village shall be complied with, et ► herein specified or not. A iu ilding during progress of work. :kvnei s Name and Address..Y'I.'.11 rk __. .egist!red Architect and /or nginee_r Mrs per∎ ► iee smploying Plum s Name 4 Location and Legal Description Lot Street and Number where work is to be performed—No. __ . IQ 2 __.— Str E"100 State work to be performed and purpose of building (By Floors) ' e1R. __._ 7- VON New Building Remodeling _....._._ _..._ Repairs I No of Stones Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition Size Septic Tank_ _ .Type of Tank Feet of Drain Tile. _.___Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.___— ...... __...__..___.___._. Size of Soakage Pit _ . ,.a..., ,.: shee ..., . Block Capacity ^ .als... _... (Signed)_` _4. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an endloyei of /oho under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent rum lement, and ltd. ,vhri• t lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors : .toyed 1 y him in r ,: '..I rk performed under this permit; and will post or cause to be posted' for inspection on the site /f the work .uch 'publ: notice no icer •+s a; required by the Act. The undersigned agrees to employ only such sub- contractors, , k to per .rme. ' this � sl. ril ill • licensed by Miami Shores Village. (Sign 3 Date..._ ... My Commission Expires Notary Publlo, State of Florida Plumbing Inspector Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, per;urrl : l ppear..c. 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 tint all acts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re4nspectfoo is made•necessary by improper notice for faspeet'.on, ter foully materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building PERMIT N9 10690 Architect Contractor or Builder i Legal Lot Description � Bl Address of r r Building sibility for work done by his agents, servants or,employees. CONTRACTOl, or BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit 1 Date. - 19 Contractor's License No. Subdi- vision Sq Ft Value of 11 Amount of Project $ 11 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 applica- tion 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 respon- Signed • (INSPECTOR) BY 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- sesponsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORIT BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ PLUMBING ❑ PERMIT Np 9665 ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building 1 1 - 12 ft !l i C Architect Contractor (~ or Builder .` ! r / - �-dD Legal Lat H Subdi- Description 11 vision Sq Ft r Address of 7 r ' Value of Amount of !! Building �✓ 1 t • i f " Project $ 11 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 applica- tion 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 respon- sibility for work done by his agents, servants or employees. / t ...r,—,. ? Signed- ( 1 - 1--.. (INSPECTOR) BY In consideration of the issuance to me of this permit I agree to erform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, sta ments 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 ageftt, ervant or employee. ' t 1 IP ieilf Aft t. A: 7,I F f 0 • K i j I. rt, IAA / rO t (IA CONTRACTOR or BUILDER BY AUTHORITY Date Contractor's ,,-, License No • Permit No to ek 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 Registered Architect and /or Engin Employing Plumber's Name Location and Legal Description Street and Number where work is to be performed— No.________._-______. State work to be performed and purpose of building (By Floors)_ Amount of Permit $' My Commission Expires (Signed)_ (Signed). No-3_ '.1 2-1 / v 'ZStreet__ _ Date__ !px, l /968 New Building _- Remodeling____ _________ Addition Repairs No. of Stories. _ Capacity Gals 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 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli Lions 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 en y as are licensed by Miami Shores Village. aster 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. 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 faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINK6 SLOP SINKS LAUNDRY TUBE URINALS ALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•N6 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 Permit No to ek 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 Registered Architect and /or Engin Employing Plumber's Name Location and Legal Description Street and Number where work is to be performed— No.________._-______. State work to be performed and purpose of building (By Floors)_ Amount of Permit $' My Commission Expires (Signed)_ (Signed). No-3_ '.1 2-1 / v 'ZStreet__ _ Date__ !px, l /968 New Building _- Remodeling____ _________ Addition Repairs No. of Stories. _ Capacity Gals 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 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli Lions 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 en y as are licensed by Miami Shores Village. aster 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. 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 faulty materials and /or workmanship. Permit No ___ qcLs ___ _ _ __ _ _ _ - - -_ Date Application it hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buildng 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 th' 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 Engi neer Employing Plumber's Name � 1 ,[ — Location and Legal Description Lot--_-__ - -- ___M._.____. _. — ._._._ ^ Block_ _ Subdivision. Street and Number where work is to be performed —No 3 �' //i Off Street_ State w o r k to b e performed and purpose of building (By Floors) _ _ _ _ _ .. _. _ New Building_._ Size Septic Tank.. _ Feet of Drain Tile--__ _. -.® Nature of Water Supply: City —Well Amount of Permit $ -_ _ 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, rnd 1 .is ''om- 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 no' Ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo. ed under this per nit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition._-_ _ _ ___ ____ __._ Repairs_ __. _. _ _ _ _.. No. of Stories _ _ _ Type of Tank _ _l___Dist. Feet of Tank or Drain Field from Well _ Size of Soakage Pit __ (Signed).__ (Signed)_.. L No._ -------- -. -_ -- _ Street .Capacity Gals. Street. - - - - -- Plumbing In:pecto. - 7��>L - aster Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall 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 •acts 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 faulty materials and /or worlonanahip. CLOSETS TUBS TUBS SHOWER! LAVA TORIES SINKS SLOP SINKS LAUNDRY TUBS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL F XTUREB 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 Permit No ___ qcLs ___ _ _ __ _ _ _ - - -_ Date Application it hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buildng 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 th' 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 Engi neer Employing Plumber's Name � 1 ,[ — Location and Legal Description Lot--_-__ - -- ___M._.____. _. — ._._._ ^ Block_ _ Subdivision. Street and Number where work is to be performed —No 3 �' //i Off Street_ State w o r k to b e performed and purpose of building (By Floors) _ _ _ _ _ .. _. _ New Building_._ Size Septic Tank.. _ Feet of Drain Tile--__ _. -.® Nature of Water Supply: City —Well Amount of Permit $ -_ _ 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, rnd 1 .is ''om- 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 no' Ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo. ed under this per nit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition._-_ _ _ ___ ____ __._ Repairs_ __. _. _ _ _ _.. No. of Stories _ _ _ Type of Tank _ _l___Dist. Feet of Tank or Drain Field from Well _ Size of Soakage Pit __ (Signed).__ (Signed)_.. L No._ -------- -. -_ -- _ Street .Capacity Gals. Street. - - - - -- Plumbing In:pecto. - 7��>L - aster Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall 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 •acts 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 faulty materials and /or worlonanahip. APPLICATION FOR PLUMBING PERMIT + . Permit No. ' , � D - -___ A pplication is hereby made for the approval of the detailed statement of the plans and specifications herewith su iiitted 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. , 'D y%`1 Owner's Name and Address r° ri; ' _____i l;�______, _ _ _1 - . No , ,, Registered Architect and /or Engineer Employing Plumber's N t ,;44 iI __ ___ _ .= , _ R�_ f I6 71/4( .4 cif trees 7-1 Location and Legal Description I..ot ..I/ "'_,/ _ ► Block __ Subdivision. - New Building Remodeling Amount of Permit $ STATE OF FLORIDA, ss. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Size Septic Tank Type of Tank Street 2i c Street and Number where work is to be performed —No. tiE_ Q_ State work to be performed and purpose of building (By Floors) Addition Repairs. No. of Stories _ Capacity Gals. _ ____ fi Feet of Drain Tile_ ti Dist. Feet of Tank or Drain Field from Well m Nature of Water Supply: City —`t> .1J... Size of Soakage Pit. `''Street Plumbing Inspector. / %' The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as4n 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. Notary Public, State of Florida 114,0 (Signed) 7- 4 -r-' • aster 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 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 DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK APPLICATION FOR PLUMBING PERMIT + . Permit No. ' , � D - -___ A pplication is hereby made for the approval of the detailed statement of the plans and specifications herewith su iiitted 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. , 'D y%`1 Owner's Name and Address r° ri; ' _____i l;�______, _ _ _1 - . No , ,, Registered Architect and /or Engineer Employing Plumber's N t ,;44 iI __ ___ _ .= , _ R�_ f I6 71/4( .4 cif trees 7-1 Location and Legal Description I..ot ..I/ "'_,/ _ ► Block __ Subdivision. - New Building Remodeling Amount of Permit $ STATE OF FLORIDA, ss. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Size Septic Tank Type of Tank Street 2i c Street and Number where work is to be performed —No. tiE_ Q_ State work to be performed and purpose of building (By Floors) Addition Repairs. No. of Stories _ Capacity Gals. _ ____ fi Feet of Drain Tile_ ti Dist. Feet of Tank or Drain Field from Well m Nature of Water Supply: City —`t> .1J... Size of Soakage Pit. `''Street Plumbing Inspector. / %' The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as4n 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. Notary Public, State of Florida 114,0 (Signed) 7- 4 -r-' • aster 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. Permit No. New Building / Size Septic Tank Feet of Drain Tile Nature of Water Supply: Amount of Permit $_ SS. My Commission Expires Street and Number where work is to be performed —No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 6 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su]rfttitted 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 Registered Architect and /or Engineer , Employing Plumbers N ' xrnC. -A—.; _ • No 6 Street --�= Location and Legal Description Lot ___ / State work to be performed and purpose of building (By Floors) Remodeling Addition Repairs No. of Stories Type of Tank.Z Block a Subdivision _L • • • ," • Street Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit. (Signed) r'++- / Date Capacity Gals.____!y bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a 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. (Signed) 1 <' .. 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 Street ) ---- aster 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 SIN 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 HEATER DEEP WELL SPRKLR. SYSTEM SWIM 'G POOL CONTR. LIST CHECK Permit No. New Building / Size Septic Tank Feet of Drain Tile Nature of Water Supply: Amount of Permit $_ SS. My Commission Expires Street and Number where work is to be performed —No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 6 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su]rfttitted 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 Registered Architect and /or Engineer , Employing Plumbers N ' xrnC. -A—.; _ • No 6 Street --�= Location and Legal Description Lot ___ / State work to be performed and purpose of building (By Floors) Remodeling Addition Repairs No. of Stories Type of Tank.Z Block a Subdivision _L • • • ," • Street Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit. (Signed) r'++- / Date Capacity Gals.____!y bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a 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. (Signed) 1 <' .. 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 Street ) ---- aster 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.