SEPTICMIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No ___ . - � !_ _ ___- Date ! 14 iN t 1 � /,9
Application i- hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 Di"'sion
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. q
Owner's Name and Address_ .......... —_— street_ ' v / ® r
Registered Architect and /or Engineer .. _
Employing Plumber's Name M t /1111L _ J)i e 1 /. No._ _ __ ____]_21.1....... /1A t Street . 1
Location and Legal Description Lot_______.___ __.—__._._.____..— -_.— Block_.___ ._ Subdivision. -_ . .._-
Street and Number where work is to be performed —No Street _ _ _ .. _. -.
State w o r k to be performed and purpose of building (By Floors) _ _ . - _ Re- C 1 . •_ A ► A L : f e ( 2-S 15 L-®C Z .
New Building _ -____ - _ -_ -- -- -.__ -- Remodeling —_ -- - -_ - Addition____ - - - - - - - - - - - -R e p a i r s . v- - - _ ___ No. of Stories . ..
Size Septic Tank_ -_ _ -
Feet of Drain Tile__ - _ -_- -• - -_ -- -_
Nature of Water Supply. City—Well.
Amount of Permit $ -
__Dist. Feet of Tank or Drain Field from Well._
_- _ _ Si -e of Soakage Pit
(S
.Capacity Gals.
Ph-mbmg In:pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an enployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanen upplement, :+nil 1 as .om•-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e . oyed y hin in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the iti the work ch pub notice or no ices as are
required by tlie Act. The undersigned agrees to employ only such sub - contractors, k to b = perfo. n: e this per nit, as are
licensed by Miami Shores Village. ,
l
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgu ents, personall appeared
Plumber.
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 Conunission 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.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
S INKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUZT'NS
TOTAL
F KTURES
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
CHICK
_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No ___ . - � !_ _ ___- Date ! 14 iN t 1 � /,9
Application i- hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 Di"'sion
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. q
Owner's Name and Address_ .......... —_— street_ ' v / ® r
Registered Architect and /or Engineer .. _
Employing Plumber's Name M t /1111L _ J)i e 1 /. No._ _ __ ____]_21.1....... /1A t Street . 1
Location and Legal Description Lot_______.___ __.—__._._.____..— -_.— Block_.___ ._ Subdivision. -_ . .._-
Street and Number where work is to be performed —No Street _ _ _ .. _. -.
State w o r k to be performed and purpose of building (By Floors) _ _ . - _ Re- C 1 . •_ A ► A L : f e ( 2-S 15 L-®C Z .
New Building _ -____ - _ -_ -- -- -.__ -- Remodeling —_ -- - -_ - Addition____ - - - - - - - - - - - -R e p a i r s . v- - - _ ___ No. of Stories . ..
Size Septic Tank_ -_ _ -
Feet of Drain Tile__ - _ -_- -• - -_ -- -_
Nature of Water Supply. City—Well.
Amount of Permit $ -
__Dist. Feet of Tank or Drain Field from Well._
_- _ _ Si -e of Soakage Pit
(S
.Capacity Gals.
Ph-mbmg In:pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an enployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanen upplement, :+nil 1 as .om•-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e . oyed y hin in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the iti the work ch pub notice or no ices as are
required by tlie Act. The undersigned agrees to employ only such sub - contractors, k to b = perfo. n: e this per nit, as are
licensed by Miami Shores Village. ,
l
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgu ents, personall appeared
Plumber.
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 Conunission 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.
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL Date�> 1 19t
PLUMBING 0 PERMIT N9 9743 Contractor's
ROOFING ❑ License No. C: " `. �/
Owner of
Building
)
Architect
•
Work to be performed under this Permit
Contractor
or Builder � Gi ; (4 .e`�±� Gt:✓ / , 4' �' 1...:
Legal Lot
Description I I I B1
Address g 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 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. J t
Si
i d ,
.l . L aft _ .- r . L � fit +�
/ U s l (INSPECTOR) BY ! ‘,,,t',,,
uance to me of this perm
conformity with the plans,
neJ�spoy�bility for all k
In consideration of t
pertaining theret d in
In accepting thiJ`.`. it
CON RACTOR or BUI BY
Subdi-
vision
Sq. Ft.
Value of
Project $
II Amount of
II Permit $
agree to perform the work covered hereunder in compliance with all ordinances and regulations
rawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
rk done by either, myself, my agent, servant or employee.
AUTHORITY
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or oilier structure hereir described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws cf the State of Florida. all oidmances of Mi .mi Shores Village and all rules and
regulations of the Building Divi:.i•,ii of .liianu Shore -- 1 iilage shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kep! at building durinz progress of the work.
Owner's Name and Address
Registered Architect and /or Engineer._
Name and address of licensed contractor.' _. % _
Location and legal description of lot to be built on.
Lot_ Block
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
11.
New Building_ - Remodeling
To be constructed of
APPLICATION FOR BUILDING PERMIT
_._ Kind of foundation
Estimated T•:tal cost of improvements $__
Zone ^ubage r e q u i r e d . . .
Distance to next nearest building__ _ _
Maximum live load to be borne by each floor
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMEN`'
Subdivision - --
%?:2
and for no other purpose.
Addition_____ __ ___ _____ ___ Repairs_ _ _ _ No. of Stories
Date
Roof Covering._
Amount of Permit $_
_Plan Cubage
Size of Building Lot
Remarks_ __ _ (Sigried)._.k
No Street.
hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify chat he understands and accepts his obligations as an employer
of l:.bor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gem -al Laws of Florida, P:.raianenn Snpplc 'lent,
and h -s compl ed with he prov °ions thereof, and will require similar compliance from all contractors or sub - contractors emplo'.•ed by hint
in the wo k to be p rf .-med under this permit: and will post or cause to be posted for inspection o the site of the work such public notice
or notices as are requir-d by the Act. The undersigned agrees to employ only such s • •ntrr.c �Or�wor to be p 'forni' d under this
permit as are licensed by Miami Shores Village. �� //
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths z.nd take acknowledgments, personally ipp-
peared - _
PLANNING BOARD DATE
Chairman Member ..... .........
Member _____ .__ _._ .__.._ _._ __ _ Member
Member _ .__ . Member
Council Approved _Date Disapproved
-- •---- - - ---- -- - 19
to me well known,
and who, being by me first d:ly sworn, upon oath depofes and says that he is the
of th abov de.c. ibed • istruction t'l. t h. has carefully read the foregoing application, and that he did sign the same, and that all iacts
therein by him stated are true.
Permit No.______ ___ _. _T_ 9 - ._. Date__. - _ `z) o _ Read, Sworn to and Subscribed before me.
Disapproved i Date.
-
Notary Public State of Florida
(Signed) -
Buildinspector My Com:nission Expires_
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application .after approval li.is bcc n obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is m.:_le necessary by improper notice for imp( --t'■m or fin.ity
materials and /or workmanship.
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE
❑ PERMIT N? 15196
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
ID Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot II BI.
Description
Address of
Building
Subdi-
vision
Value of
Project $
Contractor's
License No
Amt. of
Permit $
HOW
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in thie 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.
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 st,uct conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit Vasiume responsibility fob all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILdER BY AUTHORITY
- +•
CLOSETS
BATH
TUBS
SNOW[RO
LAVA'
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
•
TOTAL
FIKTUREI
Comm
LIST
CHECK
SEPTIC
TAN
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM 0
POOL
CONTR.
LIST
CHECK
/1
build' during f k
mg uring progress o work.
Amount of Permit $-
Owners Name and Address .-- -. )14
Registered Architect and/or ngineer
Employing Plumber's N
and Legal Description Lot . -- l.._- ._ ....
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. 1 C.° / Date 7
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
1/?ii No._
Street and Number where work is to be performed —No .___.. ____ ___ _- __:.__ __.__... Street.
State work to be pefformed and purpose of building (By Floors)
New Building _ Remodeling Addition Repairs.
Type of T ank
Size Septic Tank
Feet of Drain Tile _._. - - Dist. Feet of T or Drain Field from Well_
Nature of Water Supply: City —Well s _.__.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 nl, employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has cren-
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 slab- contractors w. to performed under this remit, as an
licensed by Miami Shores Village. i
/
(Signed
4 A
Street -. .
No. of Stories ..... ........
Capacity Gals. -- v v•
Master Plumber.
STATE OF FLORIDA, as.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
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 f ac
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 Lel
materials aid /or workmanship.