334 NE 101 St (6)Permit No
Amount of Permit $
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,2Z��____L11_ C �! �I__ °_ - _------ -• - - -- No. _ 'Y l_�' C Street_ /.&./ S/
Registered Architect and /or Engineer -__ _ -.___ - . __._T- .___.- jj __--- - - - - -_ - Y-- - - - -._
Employing Plumber's Name_ �l1 GS1_N11v r1�1'_7 <tie No..Y' F __ '- -. -_ -- Street- --ZO. C ._.- /7/AA-
Location and Legal Description Lot.___________________ Block_ Subdivision
Street and Number where work is to be performed -No Street.
State work to be performed and purpose of building (By Floors) -_ - - --
New Building - __._ ......... . Remodeling_---_ Addition Repairs K No. of Stories.
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.- ___._- _ ..... _....... __.___.___ ---___.____._Size of Soakage Pit
(Signed ) --
(Signed)
Date - Z
Plumbing' Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o "ions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per t Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors - - , oyed 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 tie 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.
STATE OF FLORIDA, 1
COUNTY OF DADE. )
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acicnowledgments , 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 worlcmanship.
GLOB➢!TB
BATH
TUBS
SHOWERS
LAVA.
TOR16S
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKI NO
FOUNT' NS
TOTAL
FI %TURES
.ter -- --
CONTR.
LIST
- -_
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
CONIR.
LIST
CHECK
Permit No
Amount of Permit $
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,2Z��____L11_ C �! �I__ °_ - _------ -• - - -- No. _ 'Y l_�' C Street_ /.&./ S/
Registered Architect and /or Engineer -__ _ -.___ - . __._T- .___.- jj __--- - - - - -_ - Y-- - - - -._
Employing Plumber's Name_ �l1 GS1_N11v r1�1'_7 <tie No..Y' F __ '- -. -_ -- Street- --ZO. C ._.- /7/AA-
Location and Legal Description Lot.___________________ Block_ Subdivision
Street and Number where work is to be performed -No Street.
State work to be performed and purpose of building (By Floors) -_ - - --
New Building - __._ ......... . Remodeling_---_ Addition Repairs K No. of Stories.
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.- ___._- _ ..... _....... __.___.___ ---___.____._Size of Soakage Pit
(Signed ) --
(Signed)
Date - Z
Plumbing' Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o "ions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per t Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors - - , oyed 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 tie 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.
STATE OF FLORIDA, 1
COUNTY OF DADE. )
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acicnowledgments , 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 worlcmanship.
lUILDING
=LECTRICAL
'LUMBING
Owner of
Huilding
Contractor
Dr Builder
Legal Lot
Description
Architect '
Address of % ,}} Value of Amt. of
Li
Huildin 4l. i Pr oject Permit si Y , .
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 with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to a-nd 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 skawingsk or in the stateints or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
", ....
Signed 'r. ky t ' By t k,.
die* . s- INSPEC +
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
DATE 1'
Contractor's
License No.
RMIT N? 4118
Work to be performed under this Permit
Bl.
Subdi-
vision
•
CONTRAC •R O' BUILDER BY AUTHORITY
7/1 194,S
'/ -