429 NE 101 StDate -- - 2/ii 7 J
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submi ed 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.
Permit No 1 2 y�
Amount of Permit $ a
STATE OF FLORIDA, }
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Owner's Name and Address_
Registered Architect and /or Eng' eer
Employing Plumber's Name _ -- o.___-- __----- ___ -_— Street- /36 4 /- 2 / -.!L
Location and Legal Description Lot B Subdivision
Street and Number where work is to be performed —No _ _t ! Z ,7� �__—i'a Street
State work to be performed and purpose of building (By Floors) ___ ... ___ ... __________. -....
_
New Building . Remodeling — ______ Addition
_Type of Tank__ Capacity Gals
—Dist. Feet of Tank or Drain Field from Well
Size Septic Tank_ _
Feet of Drain Tile__
Nature of Water Supply: City — Well._____ _ _____ ____________Sip of So Pit
%a
- - 0/1) - -- - - - - --
(S� ed) -- - �z
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/wvrk to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed).
Repairs
Street_. K,7 ed/
Notary Public, State of Florida
No. of Stories ------------- ••-- - -_.
J
Plum in Inspec or.
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.
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 worl®anship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TU88
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT' NS
TOTAL
FI %TURFS
CONTR.
LIST
_
CHECK
,
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
Date -- - 2/ii 7 J
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submi ed 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.
Permit No 1 2 y�
Amount of Permit $ a
STATE OF FLORIDA, }
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Owner's Name and Address_
Registered Architect and /or Eng' eer
Employing Plumber's Name _ -- o.___-- __----- ___ -_— Street- /36 4 /- 2 / -.!L
Location and Legal Description Lot B Subdivision
Street and Number where work is to be performed —No _ _t ! Z ,7� �__—i'a Street
State work to be performed and purpose of building (By Floors) ___ ... ___ ... __________. -....
_
New Building . Remodeling — ______ Addition
_Type of Tank__ Capacity Gals
—Dist. Feet of Tank or Drain Field from Well
Size Septic Tank_ _
Feet of Drain Tile__
Nature of Water Supply: City — Well._____ _ _____ ____________Sip of So Pit
%a
- - 0/1) - -- - - - - --
(S� ed) -- - �z
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/wvrk to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed).
Repairs
Street_. K,7 ed/
Notary Public, State of Florida
No. of Stories ------------- ••-- - -_.
J
Plum in Inspec or.
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.
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 worl®anship.
Permit No. 9.2.a5
. .
Size Septic Tank...
Feet of Drain Tile_
Nature of Water Supply: City —Well. _ ___. -__
Amount of Permit $---3 .00 - -- - - —
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Repairs_
_.. Size of Soakage Pit
(Signed).
( Signed)
Date 3-22-68
Type of Tank _____ -- _ -- .- .------- _ -•_ -- _ -•- _ ._ -- _ -. __ . _Capacity Gals..
__Dist. Feet of Tank or Drain Field from Well ..
My Commission Expires Notary Public, State of Florida
Application is 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 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_ BO}L_5tQ No._ ___ N.E. — 101tratt
Registered Architect and /or Engineer _ - .. —_ - -. __—___- - -.
Employing Plumber's Name Rose Septic _lank Co. No. 8295 N.W. 93 s a d
Location and Legal Description Lot.____ — —__. —. —._ Block___ Subdivision -• -- - •-- .- .- .•--------- -- . - - - -_
Street and Number where work is to be performed —No 1 129 N.E 18l_st._ Street-._ __ _ _ __ _ __ _ __ _
State work to be performed and purpose of building (By Floors). _ __ - -.. -_
New Building Remodeling__._ __ ___. Addition_
... No. of Stories _
PLmbf:,g In pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accep s his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, . nd I as 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 no as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo..:ed under this per nit, as are
licensed by Miami Shores Village.
ti, - -
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall - 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 .acts
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 worlananship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
IAS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
F' %TURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM 'G
POOL
CONTR.
Lin
1
CHICK
39 f
Permit No. 9.2.a5
. .
Size Septic Tank...
Feet of Drain Tile_
Nature of Water Supply: City —Well. _ ___. -__
Amount of Permit $---3 .00 - -- - - —
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Repairs_
_.. Size of Soakage Pit
(Signed).
( Signed)
Date 3-22-68
Type of Tank _____ -- _ -- .- .------- _ -•_ -- _ -•- _ ._ -- _ -. __ . _Capacity Gals..
__Dist. Feet of Tank or Drain Field from Well ..
My Commission Expires Notary Public, State of Florida
Application is 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 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_ BO}L_5tQ No._ ___ N.E. — 101tratt
Registered Architect and /or Engineer _ - .. —_ - -. __—___- - -.
Employing Plumber's Name Rose Septic _lank Co. No. 8295 N.W. 93 s a d
Location and Legal Description Lot.____ — —__. —. —._ Block___ Subdivision -• -- - •-- .- .- .•--------- -- . - - - -_
Street and Number where work is to be performed —No 1 129 N.E 18l_st._ Street-._ __ _ _ __ _ __ _ __ _
State work to be performed and purpose of building (By Floors). _ __ - -.. -_
New Building Remodeling__._ __ ___. Addition_
... No. of Stories _
PLmbf:,g In pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accep s his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, . nd I as 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 no as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo..:ed under this per nit, as are
licensed by Miami Shores Village.
ti, - -
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall - 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 .acts
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 worlananship.
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑ Date „ `' 19
ELECTRICAL ❑
PLUMBING ❑ PERMIT N° 9805 Contractor's
License No
ROOFINLO , ❑
k i Work to be performed under this Permit
.
Owner of j d -q '' '`
Building - 1 " ,
Architect
Contractor
or Builder
Legal Lox
I � Subdi-
Description BI vision as Sg Ft.
Address of i ,, 4'y I. Value of Amount of �,.✓
Building t °' o Project $ 11 Permit $ E'er '"°
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 ho assumes respon-
sibility for work done by his agents, servants or employees.
>
Signed • l - :'. ` ''. ,� • (INSPECTOR) BY
In consideration of the issuance to me of this perms 1 agree to perform the work covered hereunder in compliance with all ordinances and regulation,
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, mi agent, servant or employee.
CONTRACTOR or BUILDER
BY AUTHORITY
Permit No.______7 ___l-___1 ___
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 - -- °------ ----- •_------- - -___ --
Registered Architect and /or Engineer___ _ __ ____ __ ___- _
Employing Plumber's Name- - -.dll r c� %
Size Septic Tank
Feet of Drain Tile
c T
Nature of Water Supply: City — Well.__
Amount of Permit $ - - - --
STATE OF FLORIDA, 1
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
No.
o._
Street.
Street
Location and Legal Description Lot ____.._______________________ __ Block_ Subdivision. ___
Street and Number where work is to be performed —No `T 7 v/ ' 1 Street_
State work to be performed and purpose of building (By Floors)_
New Building _._ Remodeling___ ___ ___ Addition__- _____._ Repairs No. of Stories
Capacity Gals
ain Field from Well
__Size of Soakage Pit
(Signed )-
( Signed) -- -- a; G ��
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob . gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Penn ent 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.
Notary Public, State of Florida
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.
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
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINK
LAUNDRY
TUBS
URINALS
I NALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NB
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•O
POOL
CONTR.
LIST
CHECK
Permit No.______7 ___l-___1 ___
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 - -- °------ ----- •_------- - -___ --
Registered Architect and /or Engineer___ _ __ ____ __ ___- _
Employing Plumber's Name- - -.dll r c� %
Size Septic Tank
Feet of Drain Tile
c T
Nature of Water Supply: City — Well.__
Amount of Permit $ - - - --
STATE OF FLORIDA, 1
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
No.
o._
Street.
Street
Location and Legal Description Lot ____.._______________________ __ Block_ Subdivision. ___
Street and Number where work is to be performed —No `T 7 v/ ' 1 Street_
State work to be performed and purpose of building (By Floors)_
New Building _._ Remodeling___ ___ ___ Addition__- _____._ Repairs No. of Stories
Capacity Gals
ain Field from Well
__Size of Soakage Pit
(Signed )-
( Signed) -- -- a; G ��
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob . gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Penn ent 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.
Notary Public, State of Florida
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.
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.
AMI SHORES VILLAGE, FLA. No 8305
JOB {zP
P
f`�
ADDRESS _
INSPECTION
TIME READY
REMARKS:
INSPECTOR
0
DATE
BUILDING
ELECTRICAL
PLUMBING
' ROOFING
❑
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
i• t ) i'
MIAMI SHORES VILLAGE. FLORIDA
DATE / #
Ez PERMIT N? 7891
CONTRACTOR OR "BUILDER
Bl.
Work to be performed under this Permit
Subdi-
vision
Sq. Ft
Value of
Project $
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 ofathe 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. a �/
Contractor's
License No
Amt. of
Permit $
19
Signed �. w,.
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.
BY
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Oontractor
or Builder
Legal
Description.
Address of
Building
Lot
.dt
Work to be performed under this Permit
MIAMI SHORES VILLAGE, FLORIDA
DATE ..._._ 195
Contractor's
License No
PERMIT N° 9477
Bl.
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 /specifications and that he assumes responsibility for work
done by his agents, servants or employees. f 1
f -/"."" ',
Signed. tW BY
i¢ INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance witl all fbrdinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper autl} rities of Miami Shores Village.
In accepting this permit I assume responsibility for a11.- work dons by either, myself, my agent, servant or employee.
,
f " ✓ ; 7' ` _ ` 7
/ AUTHORITY
Subdi-
vision
CONTRACTOR OR BUILDER BY
Value of
Project $
Amt. of
$
Permit Esj i
D ate `` - I ir Permit No t "' '` 4
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith. 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. ` ,
Y � * � I)
Owner's Name and Address s ' ° E ` ° 'No Street
Registered Architect and /or Engineer ., 4
0
I,
Employing Plumber's Name ___�!__ No .= Street �' " `
Location and Legal Description Lot 1 _, 0" ' Block___________ 1 Subdivision
Street and Number where work is to be performed— No. ______ — _� " _____ Street ��_`i ,f
State work to be performed and purpose of building (By Floors)
New Building 9.E' Remodeling _ Addition Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile
Amount of Permit $ "
Nature of Water Supply: City —Well
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
i1,
Capacity Gals
Type of Tank
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
!.
Plumbing Inspector.
The undersigned applicant for this building 'permit does hereby certify that he wife stands and accepts his obligat' s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Genf Laws of Florida Permane upplement, 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.
STATE OF FLORIDA, t
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.
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.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SQLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
,_ : j,,,�.
>'
D ate `` - I ir Permit No t "' '` 4
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith. 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. ` ,
Y � * � I)
Owner's Name and Address s ' ° E ` ° 'No Street
Registered Architect and /or Engineer ., 4
0
I,
Employing Plumber's Name ___�!__ No .= Street �' " `
Location and Legal Description Lot 1 _, 0" ' Block___________ 1 Subdivision
Street and Number where work is to be performed— No. ______ — _� " _____ Street ��_`i ,f
State work to be performed and purpose of building (By Floors)
New Building 9.E' Remodeling _ Addition Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile
Amount of Permit $ "
Nature of Water Supply: City —Well
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
i1,
Capacity Gals
Type of Tank
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
!.
Plumbing Inspector.
The undersigned applicant for this building 'permit does hereby certify that he wife stands and accepts his obligat' s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Genf Laws of Florida Permane upplement, 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.
STATE OF FLORIDA, t
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.
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.