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
__
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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.