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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.