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825 NE 100 St (4)Permit No.___ Size Septic Tank 6v-t7 AS Feet of Drain Tile_ Nature of Water Supply: City —Well Amount of Permit $ S STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed)_ Date 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 ust be kept at building during progress of work. % / CZ ��� s Co,,.t -7 S-- Owner's Name and Address /�� __ ' -- — ____ -- __ -� _ ' `� �'w _ Street. Registered Architect and /or En en. - ��_____ ____ Employing Plumber's Name - ', � - - -_� -- - _— - - - -_ _- l[Q - - - Qo, Street____ — Location and Legal Description Lot_ -____ ..... _______ _ ____ �j __ _...e li _ Subdivision Street and Number where work is to be performed —No Q� `� I "LOLL_ street State work to be performed and purpose of building (By Floors)___.------------ .-------- __. .... _____ New Building ____ _.. Remodeling Addition..______.__.__ Repairs No. of Stories. Type of Tank___ Capacity Gals . Feet of Tank or Drain Field from Well __Size of Soakage Pit ( signed) --- 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 employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanent 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. Master Plumber. 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 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 U CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST • CHECK -- SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'S POOL CONTR. LIST ` CHECK Permit No.___ Size Septic Tank 6v-t7 AS Feet of Drain Tile_ Nature of Water Supply: City —Well Amount of Permit $ S STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed)_ Date 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 ust be kept at building during progress of work. % / CZ ��� s Co,,.t -7 S-- Owner's Name and Address /�� __ ' -- — ____ -- __ -� _ ' `� �'w _ Street. Registered Architect and /or En en. - ��_____ ____ Employing Plumber's Name - ', � - - -_� -- - _— - - - -_ _- l[Q - - - Qo, Street____ — Location and Legal Description Lot_ -____ ..... _______ _ ____ �j __ _...e li _ Subdivision Street and Number where work is to be performed —No Q� `� I "LOLL_ street State work to be performed and purpose of building (By Floors)___.------------ .-------- __. .... _____ New Building ____ _.. Remodeling Addition..______.__.__ Repairs No. of Stories. Type of Tank___ Capacity Gals . Feet of Tank or Drain Field from Well __Size of Soakage Pit ( signed) --- 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 employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanent 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. Master Plumber. 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 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.