PLUMBINGJ'enni, Nu. .-v' 1 '0
New Building .• -.•-•.-- •- •.---- -............ -. Remodeling
Size Septic Tank_
Feet of Drain Tile.. V
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
'.)vner's Name and Address.. e`Sa 5 ! _ No.
.cgist _red Architect and /or Engineer
:mploying Plumber's Name
No. 1? /.1?..,
Location and Legal Description Lot. Block
Street and Number where work is to be performed —No /( 1 &.
Addition
_ Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well. -__r..___. ._...___._____.________._. -Size of Soakage Pit
( Signed) .
.1
Street_
Subdivision.-_...
•
Street
State work to be performed and purpose of building (By Floors) _ ..... - ..... _...___._ ......
_
Repairs Na of Stones
My Cnnumission Expires Notary Public, State of Florida
:I i�phc.,t l,nl i. hereby made for the approval of the detailed statement of the plans and specifications herewith subrit• ... 1 for the building or other
nructure herein described. This application is made in compliance and conformity with the Building Ordinance of Mt ! Shores Village, Florida,
AA 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, whether herein specified or not. A copy of approved plans and spec ficatlons must be kept at
wilding during progress of work.
•
.Type of Tank '� �: -_ Capacity ^ .als... _ 6
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as on e n;rloyca of laho
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Cum lement, and has , env
lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed I y him in ' u ' .I rk v b-
performed under this permit; andrwill post or cause to be posted' for inspection on the site of the worms such pills!: notice r no icrr is al
requ'red by the Act. The undersigned agrees to employ only such sub - contractors, on work to ed ' a this J,rl.ti , at
licensed by Miami Shores Village.
t..a Plumber.
STATE OF FLORIDA, µ
COUNTY OF DADE. 1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, perwrrt ; , ppearet.
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.
NOTE: A re- inspection fee of $1.00 will be made when such re V made•neceuary by improper notice for inspection, tar fruity
materials and /or workmanship.
CLO /IT[
BATH
TUDI
SN [RS
LAVA•
TORIES
SINKS
SLOP
a1NKa
LAUNDRT
TU ••
URINAL[
CATCH
SA •IN
FLOOR
DRAIN
DRINKING
FOUNT•N•
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FI[Tl is
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CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAOI
PIT
G
TRAP
SOLAR
H
DEEP
WILL
SPRKLR.
5
SWIM'O
POOL
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J'enni, Nu. .-v' 1 '0
New Building .• -.•-•.-- •- •.---- -............ -. Remodeling
Size Septic Tank_
Feet of Drain Tile.. V
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
'.)vner's Name and Address.. e`Sa 5 ! _ No.
.cgist _red Architect and /or Engineer
:mploying Plumber's Name
No. 1? /.1?..,
Location and Legal Description Lot. Block
Street and Number where work is to be performed —No /( 1 &.
Addition
_ Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well. -__r..___. ._...___._____.________._. -Size of Soakage Pit
( Signed) .
.1
Street_
Subdivision.-_...
•
Street
State work to be performed and purpose of building (By Floors) _ ..... - ..... _...___._ ......
_
Repairs Na of Stones
My Cnnumission Expires Notary Public, State of Florida
:I i�phc.,t l,nl i. hereby made for the approval of the detailed statement of the plans and specifications herewith subrit• ... 1 for the building or other
nructure herein described. This application is made in compliance and conformity with the Building Ordinance of Mt ! Shores Village, Florida,
AA 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, whether herein specified or not. A copy of approved plans and spec ficatlons must be kept at
wilding during progress of work.
•
.Type of Tank '� �: -_ Capacity ^ .als... _ 6
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as on e n;rloyca of laho
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Cum lement, and has , env
lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed I y him in ' u ' .I rk v b-
performed under this permit; andrwill post or cause to be posted' for inspection on the site of the worms such pills!: notice r no icrr is al
requ'red by the Act. The undersigned agrees to employ only such sub - contractors, on work to ed ' a this J,rl.ti , at
licensed by Miami Shores Village.
t..a Plumber.
STATE OF FLORIDA, µ
COUNTY OF DADE. 1
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, perwrrt ; , ppearet.
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.
NOTE: A re- inspection fee of $1.00 will be made when such re V made•neceuary by improper notice for inspection, tar fruity
materials and /or workmanship.
Penn, No...I =• .. I. 6
.egict red Architect and /or Engut /� p /�
:mploying Plumber's Name �!i ._._ !_tv fr "•3
Location and Legal Description Lot
Size Septic Tank_. - -•• --
Feet of Drain Tile.
Nature of Water Supply: City —Well
Amount of Permit $.
STATE OF FLORIDA, 6
u.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
. Type of Tank_
__Dist. Feet of Tank or Drain Field from Well .
— .----- •_-- •-- -...__ .- __ -. - Size of Soakage Pit
(Signed) `^!
(Signed)
Date
Capacity
4i phratll„ is hereby made for the approval of the detailed statement of the plans and specifications herewith subrat•.,.• 1 for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mia ! Shores Village, Florida,
and 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, whether heroin specified or not. A copy of approved plans and spec flcatlons must be kept at
building during progress of work.
)weer E Name and Address ..._.._. No Street.._...... .
.............. ..
No.. _ -2 Ia Sc,? Streeta .4,6 ,
Block SubdW
lvon.._..._.
Street and Number where work is to be performed —No is1, 6 ' / 0 / 4 Street
State work to be performed and purpose of bullding (By Floors) _. .... _ ..... __..___._. ..... _
New Building ........... ................ Remodeling —_ _....._. Addition..._..._ Repairs No of Stones
My Commission Expires Notary Public, State of Florida
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an e n;tloyer of IaFKn
under the Florida Workmen's Compensation Act, being Section 5960, Compiled General Laws of Florida Permanent rum lenient, and has e'cai•
v lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed 1 y him in ' e ',.1 rk b-
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publ: notice n no icer •rs as
requ±red by the Act.. The undersigned agrees to employ only such sub - contractors, on w to be performed ' n this ,r rrl x rr .
licensed by Miami Shores Village.
Massa Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pe- or. : +ppearrc.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the 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 re-inspection is mede'neoessary by improper notice for limpeetbn, or !suit,
materials and /os workmanship.
CLC[[T[
BATH
TUB[
SHDW [Ra
LAVA•
TORIES
61NKS
GLOP LAUNDRY
6MK[ +!�a!r
t
Iq(
URiNALa
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N•
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ry / e ' — [ '
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SEPTIC
TANK
SEWER
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DRAIN
FIELD
SOAKAGE
PIT
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TRAP
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HATER
DEEP
WELL
8
SYSTEM
SW IM'e
POOL
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LIST
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11 60 L _.
Penn, No...I =• .. I. 6
.egict red Architect and /or Engut /� p /�
:mploying Plumber's Name �!i ._._ !_tv fr "•3
Location and Legal Description Lot
Size Septic Tank_. - -•• --
Feet of Drain Tile.
Nature of Water Supply: City —Well
Amount of Permit $.
STATE OF FLORIDA, 6
u.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
. Type of Tank_
__Dist. Feet of Tank or Drain Field from Well .
— .----- •_-- •-- -...__ .- __ -. - Size of Soakage Pit
(Signed) `^!
(Signed)
Date
Capacity
4i phratll„ is hereby made for the approval of the detailed statement of the plans and specifications herewith subrat•.,.• 1 for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mia ! Shores Village, Florida,
and 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, whether heroin specified or not. A copy of approved plans and spec flcatlons must be kept at
building during progress of work.
)weer E Name and Address ..._.._. No Street.._...... .
.............. ..
No.. _ -2 Ia Sc,? Streeta .4,6 ,
Block SubdW
lvon.._..._.
Street and Number where work is to be performed —No is1, 6 ' / 0 / 4 Street
State work to be performed and purpose of bullding (By Floors) _. .... _ ..... __..___._. ..... _
New Building ........... ................ Remodeling —_ _....._. Addition..._..._ Repairs No of Stones
My Commission Expires Notary Public, State of Florida
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an e n;tloyer of IaFKn
under the Florida Workmen's Compensation Act, being Section 5960, Compiled General Laws of Florida Permanent rum lenient, and has e'cai•
v lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed 1 y him in ' e ',.1 rk b-
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publ: notice n no icer •rs as
requ±red by the Act.. The undersigned agrees to employ only such sub - contractors, on w to be performed ' n this ,r rrl x rr .
licensed by Miami Shores Village.
Massa Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pe- or. : +ppearrc.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the 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 re-inspection is mede'neoessary by improper notice for limpeetbn, or !suit,
materials and /os workmanship.