400 NE 100 St (12)MIAMI SHORES VILLAGE
BUILDING DEPARTM
305- 795 -2204
Building Inspection Requ - st f
Dat7 ` O Time
Type Insp'n ♦
Permit No
Name
Address
Company
Phone # t ,
For Inspector(
Approved
Correction
Re- Insp'n Fee
Permit No /3Z4 I
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fof 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
Amount of Permit $_
STATE OF FLORIDA, }
COUNTY OF DADE.
Registered Architect and /or Engin r
Employing Plumber's Name__- Pie (ee0 c /`.___ ��
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
EL' A l -- - -- - No.
Location and Legal Description Lot____ ______ _ __._ _ Block Subdivision
Street and Number where work is to be performed —No — Q_ re Street
State work to be performed and purpose of building (By Floors)._
New Building _ Remodeling _ __ __ __— Addition_
Size Septic Tank__ ______ Type of Tank__ Capacity Gals.__
Feet of Drain Tile ___ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.______— _______.____________ ____._ of Soakage Pit
(Signed)_
(Sign
Repairs No. of Stories
Date
_l 'eet
Me Street /vo- ' /._- -_ - - -_ _._.. .
Plumbing Inspector.
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, and Ilas 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 - s are
required by tlie Act. The undersigned agrees to employ only such sub - contractors, on worn to be performe• der this permi , as are
licensed by Miami Shores Village.
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 of Florida
Master 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
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
d®/Z/Jez
5evl
C
7 A 1�#
F - "
TOTAL
I %TORES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
CONTR.
LIST
CHECK
Permit No /3Z4 I
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fof 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
Amount of Permit $_
STATE OF FLORIDA, }
COUNTY OF DADE.
Registered Architect and /or Engin r
Employing Plumber's Name__- Pie (ee0 c /`.___ ��
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
EL' A l -- - -- - No.
Location and Legal Description Lot____ ______ _ __._ _ Block Subdivision
Street and Number where work is to be performed —No — Q_ re Street
State work to be performed and purpose of building (By Floors)._
New Building _ Remodeling _ __ __ __— Addition_
Size Septic Tank__ ______ Type of Tank__ Capacity Gals.__
Feet of Drain Tile ___ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.______— _______.____________ ____._ of Soakage Pit
(Signed)_
(Sign
Repairs No. of Stories
Date
_l 'eet
Me Street /vo- ' /._- -_ - - -_ _._.. .
Plumbing Inspector.
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, and Ilas 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 - s are
required by tlie Act. The undersigned agrees to employ only such sub - contractors, on worn to be performe• der this permi , as are
licensed by Miami Shores Village.
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 of Florida
Master 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.
Permit No._ -- -- . - --
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.
"' `OD J✓— /00 ST.
Owzer's Name and Address Y✓ M' _--- C/ -•. -.. No. ? _•-__ --_ Street_
Registered Architect and /or Engineer _2 446 / e.G_4!V ___ P _ _ R /AI K E/C Co ,
Em M to Plumbers Name !_ _____ No.._ I _.. / - S _ •
Employing ' 3 7 0 !V'
treat_ -!� YE
Location and Legal Description Lot 1716 O /(f E /O U S % • Block Subdivision_
Street and Number where work is to be performed —No ge) D ME / o 0 ' Street.
State work to be performed and purpose of building (By Floors) _- _.___L_4 !✓_._.__ / N /C- C E R
New Building _--__.. Remodeling _ ___ __..____ Addition_
Size Septic Tank - _ Type of Tank__ Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well
E X / 'T / __Size of Soakage Pit
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)_
(Signed)._
Repairs
Date d ° I
Plumbing Inspector.
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 Flgrlda 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 permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
No. of Stories
STATE OF FLORIDA,. 1 es.
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.
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.
GL05IITS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
I NAS
CATCH
BASIN
FLOOR
DRAIN
DRINK! NO
FOUNT' NS
TOTAL
FI %TURES
CONT P..
LIST
�.
—.
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL.
SPRKLR.
SYSTEM
SW IPA' GI
POOL
CONTR.
LIST
CHECK
- - -_
-
Permit No._ -- -- . - --
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.
"' `OD J✓— /00 ST.
Owzer's Name and Address Y✓ M' _--- C/ -•. -.. No. ? _•-__ --_ Street_
Registered Architect and /or Engineer _2 446 / e.G_4!V ___ P _ _ R /AI K E/C Co ,
Em M to Plumbers Name !_ _____ No.._ I _.. / - S _ •
Employing ' 3 7 0 !V'
treat_ -!� YE
Location and Legal Description Lot 1716 O /(f E /O U S % • Block Subdivision_
Street and Number where work is to be performed —No ge) D ME / o 0 ' Street.
State work to be performed and purpose of building (By Floors) _- _.___L_4 !✓_._.__ / N /C- C E R
New Building _--__.. Remodeling _ ___ __..____ Addition_
Size Septic Tank - _ Type of Tank__ Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well
E X / 'T / __Size of Soakage Pit
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)_
(Signed)._
Repairs
Date d ° I
Plumbing Inspector.
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 Flgrlda 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 permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
No. of Stories
STATE OF FLORIDA,. 1 es.
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.
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building �. .
L] PERMIT N° 14 518 Contractor's
L], License No
Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot II BL
Description.
Address of
Building . l
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Signed:
Subdi-
vision
Value of
Project $ t
DATE
BY AUTHORITY
Amt. of
Permit $
BY
195
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 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 statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
INSPECTOR
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 responsibility for all work done by either, myself, my agent, servant or employee.
MIAMI SHORES VILLAGE, FLORIDA 6 e�
BUILDING DATE / 194 =
ELECTRICAL ERMIT N? 6697 Contractor's
PLUMBING Li ense No
'/ /-fi" 4 ` �
t ► Wo to be pert firmed under this Permit
Owner of
• Building
Architect
Contractor
or Builder
Legal
Description
Lot
Address of Value of Amt. of /0 *
Building t / �-�"' Project 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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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, ay 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 u on which this
permit is granted is the understanding that the contractor or builder named above assum�'s the respponsibility for a thorough knowledge /of th rdinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or ,in statements or, specifications and that he assumes respon-
sibility for work done by his agents, servants or employees." //
�
, 4 . Signed • - By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all!'ordinances ald irg attons
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoritiies of Miami Shores Village.
In ting this permit I assume 'et,onsibility for all work done byer myself, y agent, servant, r employee.
CONTRACTOR OR BUILDER
Bl.
e. /
Subdi-
vision
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
MIAMI SHORES VILLAGE, FLORIDA
DATE 194_
,PERMIT N° 6697
Work to be performed under this Permit
Contractor
or Builder
Legal Lot Bl.
Description
Address of
Building < <
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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 fhat he assumes respon-
sibility for work done by his agents, servants or employees.
Signed By
INSPECTOR
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 responsibility for all work done by either myself, my agent, servant or employee.
vl
CONTRACTOR OR BUILDER BY. AUTTHO RITY
Subdi-
vision
Value of
Project
Contractor's
License No.
Amt. of
Permit /I / •
Permit No
\Q:
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 Addres
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
k /i4/i/ 4 (1v�_6_/✓
Registered Architect and /or Engineer
Employing Plumber's Name_P- - i - ° No.
Location and Legal Description Lot � ,e� ° 0 '1 Block_
Feet of Drain Tile
Street and Number where work is to be performed —No.
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
State work to be performed and purpose of building (By Floors) .
New Building Remodeling Addition Repairs , / ' of Stories
Size Septic Tank____YbLI Type of Tank • k &S
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
( Signed)
No 7 e 0 Streeti i /0 e
Plumbing Inspector.
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, 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) _ _ • t -• -`
Date �!
Street_ij ,(/
Subdivision 1-- `4
Street _N / ( �$�� J-/
Capacity Gals Ag f/ ‘
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 fo regoing application, and that he did sign the same, and that all facts
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 workmanship.
Master Plumber;
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
L
SIIINKp
SLOP
SINKS
LAUNDR
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT 'NS
� /�
T11/61%
- //
TOTAL
FIXTURES
CONTR.
o[°
/
` ?
T
CHECK
.
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
E�
},,
CONTR.
LIST
I
/
/
r •
CHECK
Permit No
\Q:
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 Addres
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
k /i4/i/ 4 (1v�_6_/✓
Registered Architect and /or Engineer
Employing Plumber's Name_P- - i - ° No.
Location and Legal Description Lot � ,e� ° 0 '1 Block_
Feet of Drain Tile
Street and Number where work is to be performed —No.
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
State work to be performed and purpose of building (By Floors) .
New Building Remodeling Addition Repairs , / ' of Stories
Size Septic Tank____YbLI Type of Tank • k &S
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
( Signed)
No 7 e 0 Streeti i /0 e
Plumbing Inspector.
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, 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) _ _ • t -• -`
Date �!
Street_ij ,(/
Subdivision 1-- `4
Street _N / ( �$�� J-/
Capacity Gals Ag f/ ‘
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 fo regoing application, and that he did sign the same, and that all facts
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 workmanship.
Master Plumber;
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othe'
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept ai
building during progress of work. r
Owner's Name and Address - Lisl Oil r" t'4 101 1, No._.___ D _. - .____ - -- Street - - -0. .. \ T v 5r
Registered Architect and /or Engineer
Employing Plumber's Name V t.) h i i� _ .--- _: _f I — , S No._ 2_,.. .._. Street 5.1.-4- . 0 'T i - i 3 T
Location and Legal Description Lot_.- _-- _______- ....... ___- _-- ____.. — Block__ _. _ . _.-- _ -_ - -_ Subdivision
--.-- .- _- _._ - --
Street and Number where work is to be performed —No °-± .__ . _ _____ __ Street- \ e t t) e., T. H Z '
State work to be performed and purpose of building (By Floors)____ -,' Ity? r! 0 �� elf ,-- ? TLf I ° l
New Building __._ ....... Remodeling Addition__ ___ .......... ____.__ Repairs No. of Stories
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)
Date
Capacity Cals.
Size Septic Tank Type of Tank___
Feet of Drain Tile Dist. Feet of Tank or Drain Field from WeIL
Nature of Water Supply; City —Well . — Size of Soakage Pit
(Signed) -
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of tabor
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 an
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 lac
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 foul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TU88
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIxTUREI
--
CONTR.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
NEATER
DEEP
WILL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othe'
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept ai
building during progress of work. r
Owner's Name and Address - Lisl Oil r" t'4 101 1, No._.___ D _. - .____ - -- Street - - -0. .. \ T v 5r
Registered Architect and /or Engineer
Employing Plumber's Name V t.) h i i� _ .--- _: _f I — , S No._ 2_,.. .._. Street 5.1.-4- . 0 'T i - i 3 T
Location and Legal Description Lot_.- _-- _______- ....... ___- _-- ____.. — Block__ _. _ . _.-- _ -_ - -_ Subdivision
--.-- .- _- _._ - --
Street and Number where work is to be performed —No °-± .__ . _ _____ __ Street- \ e t t) e., T. H Z '
State work to be performed and purpose of building (By Floors)____ -,' Ity? r! 0 �� elf ,-- ? TLf I ° l
New Building __._ ....... Remodeling Addition__ ___ .......... ____.__ Repairs No. of Stories
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)
Date
Capacity Cals.
Size Septic Tank Type of Tank___
Feet of Drain Tile Dist. Feet of Tank or Drain Field from WeIL
Nature of Water Supply; City —Well . — Size of Soakage Pit
(Signed) -
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of tabor
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 an
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 lac
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 foul
materials and /or workmanship.
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