Plumbing' CLOSETS
OATH u o 8
5
TO1■11:;
SINK•
SLOP
SINKS
LAUNDRY
TUOS
URINALS
CATCH
BASIN
FLOOR DRINKING
DRAIN FOUNT' N0
TOT.-1.
FIST' RES
CONTR.
LIT
__
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLIII.
5
SWIIICO
POOL
i
CONTR.
LIST
H ! .
CHICK
% V)
Penni: No. .....
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date 9-8-80
is licreby made for the approval of the detailed statement of the plans and specifications herewith subr.tt!,..ri 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,
sad 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
ot Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spetlications must be kept at
wilding during progress of work. Edwin Green for Mr.Newberg
Dwneis Name and Address ......... ...—..—. Street_
.egist .red Architect and/or Engineer
employing Plumber's Name Rose otic Tank Co,
P C.Box 344 Hialeah 330
Loca tion and Legal Description :Lot.
395 N.E. 100th street
Street and Number where work is to be performed—No Street •
State work to be performed and purpose of building (By Floors) 6451 111/ M 1414 . , rthIP 0 0 1 7 6./A
New Building Remodeling— — ... Addition Repairs No of Stones .... .
.C300 sq..14e of Tank_ Size Septic Tank_. °° _9a fl Capacity ^ Ails.
PO&Abandon
Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well .
Nature of Water Supply: City—Well-_______._________Size of Soakage Pit — ................ - ......... -...-........
---------
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
xfix9taxx - 11 - 25
(Signed)_W
(Signed).
1. LLI?9 13
Plunbin3 Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an endloyet of labor
under the Florida NVorlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent :um lement, and lids VIE 1..
v.lied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed 1 y him in .• e
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pub!: notice T. no jeer .4s a.
requfred by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed l.ca this 011.sit, .
licensed by Miami Shores Village.
Masts,. Plumber. •
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acleiowledgments, po ppeam.
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 tnat all acts
therein by him stated are true.
My Conunission Expires Notary Public, State of Florida —
NOTE: A re-inspection fee of $1.00 will be made when such rspectioo is mede.necemary by improper notice for inspeeeon, tautly
materials and/or workmanship.