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900 NE 100 St (9)DING , aECTRICAL PLUMBING f 7 Owner of Building ' Architect r Contractor f 1 1 , j or Builder . / 4 , Legal , ( .. ,/l, i :.V Description MIAMI SHORES VILLAGE, FLORIDA i) 194 O Contractor's Work to be performed und/r this Permit/ .., - ,., PERMIT N . 3112 /' License No. �, re 2 DATE Address of "7" . ,.. 1 1 „, +• Value of Amt. of j �.-- ,e ' f '' Project Permit f Building - f // '4r This permit is granted to the contractor or builder naified 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,drawinks n or in the statement`s or.rspecifications and that he assumes responsibility for work done by his agents, servants or employees. '" " - P Y Y g r Signed • „ / r J 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 regula- tions 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. CONTRACTOR OR BUILDER BY ' res-4.. -.'5 AUTHORITY v�a �, -� MIAMI SHORES VILLAGE, FLORID BUILDING DAT. -: 194 — ELECTRICAL RMIT N9 3118 Contractor's L icense NQ: PLUMBING 4 Work to a performed under this Permit ' - 41 ii - (el ) P ` 47 --Oet6e, 0 Owner of Building Architect Contracto or Builder ' Legal Description CONTRACTOR OR BUILDE Bl. Subdi- vision af - -,-.. roject BY Amt. of j Permit .w. Address o ' 1 „ �i Building / �r 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 ordinatItys or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or udder s - + -ec ,a ove assu s the responsibility for a thorough o , -dge of the ordinances and regulations pertaining to the work covered hereby whetheshdwn on go " t►+•gw'CIY"3°fatetne "7>` . = <. ns and that he assumes responsibility for work done by his agents, servants or employ eqr Signe:'�:i�iPi '' By INSPECTOR In consideration of the issuance to me of this permit I agree to perform/the work cowed hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict c. ormity the plans, drawings,stStelpents or s etifications submitted to the proper authorities of Miami Shores Village. In acceg't i cing this I' �permit I as • , e responsibility for all work donetby Tither my my agent, servant or employee. V AUTHORITY /-/ APPLICATION `'FOR PLUMBING PERMIT Permit No Owner's Name and Address New Building Remodeling Amount of Permit $_ • -- The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Type of Tank . Capacity Gals._ (Signed) _ t s.r__�L= o ' authorized to administer Date B 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 .e co, plied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of v .l No._ t/ ; � - -�---� * Street--- _L' �V- �- --- z..-.��- Registered Architect and /or Engineer - __3_ _____ Emplo}p�g Plumber's Name_ Q Y. i_ No 61 1 } 1 Location and Legal Description Lot_ Block_ 17 0 ,�°� C S eet and Number where work is to be performed —No i ___i Street_N_ 2 __ 1______..'___ t State work to be erformed and purpose of building �d++/ P P P g (By Floors) - - -- -- - ���_'� tt�_�_4' ��1�_ C,_T - - -- -- � - r ...1-- El - - -ti - - --- -- � fir-- � L Subdivision_1_ i_' ____ Addition Repairs No. of Size Septic Tank Feet of Drain Tile_ Nature of Water Supply: City —Well. Size of Soakage Pit ___________________________ _______________________— Dist. Feet of Tank or Drain Field from Well Plumbing Ins tor. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work tP be perfomed under t ermit, as are oaths and take c. no' ledgments, 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 therein by him stated are true. the same, Notary Public. State of Florida Master Plumber. and that all facts 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 SOLAR H EATER M o w WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST V" CHECK /-/ APPLICATION `'FOR PLUMBING PERMIT Permit No Owner's Name and Address New Building Remodeling Amount of Permit $_ • -- The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Type of Tank . Capacity Gals._ (Signed) _ t s.r__�L= o ' authorized to administer Date B 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 .e co, plied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of v .l No._ t/ ; � - -�---� * Street--- _L' �V- �- --- z..-.��- Registered Architect and /or Engineer - __3_ _____ Emplo}p�g Plumber's Name_ Q Y. i_ No 61 1 } 1 Location and Legal Description Lot_ Block_ 17 0 ,�°� C S eet and Number where work is to be performed —No i ___i Street_N_ 2 __ 1______..'___ t State work to be erformed and purpose of building �d++/ P P P g (By Floors) - - -- -- - ���_'� tt�_�_4' ��1�_ C,_T - - -- -- � - r ...1-- El - - -ti - - --- -- � fir-- � L Subdivision_1_ i_' ____ Addition Repairs No. of Size Septic Tank Feet of Drain Tile_ Nature of Water Supply: City —Well. Size of Soakage Pit ___________________________ _______________________— Dist. Feet of Tank or Drain Field from Well Plumbing Ins tor. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work tP be perfomed under t ermit, as are oaths and take c. no' ledgments, 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 therein by him stated are true. the same, Notary Public. State of Florida Master Plumber. and that all facts 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. Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT X/ 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 must be kept at building during progress of work. Owner's Name and Address i 1Q_A Registered Architect and /or Engineer ,(�J G Emploging Plrttmber's Name _ / , ,x Location and Legal Description Lot__ 1_ // 2b / Block /7 Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building . _A A) L L No.---/ - - , IA!. /L Q _ 4 - -c` nrt A.12 C r No 9rb N E Remodeling Addition Repairs ____ No. of Stories Size Septic Tank__________' B o Type of Tank ._ D EA- 2 e 97 Nf Street_ __ Subdivision_A_R±U__ Street_ _ -.1 0 t Capacity Gals.___ 2_ _____ Feet of Drain Tile________Z_._ ______ Dist. Feet of Tank or Drain Field from Well ry Nature of Water Supply: City —Well. 8s. Amount of Permit $_ r O (Signed) My Commission Expires Size of Soakage Pit (Signed) f' lumping 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under thi permit, as are licensed by Miami Shores Village. /J - STATE OF FLORIDA, 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. Notary Public. State of Florida Master (f 04-4 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. ST 3 3 / — / / // CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST 7 DD i 26 CHECK Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT X/ 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 must be kept at building during progress of work. Owner's Name and Address i 1Q_A Registered Architect and /or Engineer ,(�J G Emploging Plrttmber's Name _ / , ,x Location and Legal Description Lot__ 1_ // 2b / Block /7 Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building . _A A) L L No.---/ - - , IA!. /L Q _ 4 - -c` nrt A.12 C r No 9rb N E Remodeling Addition Repairs ____ No. of Stories Size Septic Tank__________' B o Type of Tank ._ D EA- 2 e 97 Nf Street_ __ Subdivision_A_R±U__ Street_ _ -.1 0 t Capacity Gals.___ 2_ _____ Feet of Drain Tile________Z_._ ______ Dist. Feet of Tank or Drain Field from Well ry Nature of Water Supply: City —Well. 8s. Amount of Permit $_ r O (Signed) My Commission Expires Size of Soakage Pit (Signed) f' lumping 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under thi permit, as are licensed by Miami Shores Village. /J - STATE OF FLORIDA, 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. Notary Public. State of Florida Master (f 04-4 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. M( rft41'(.14 . ; . e) )r e J< 1 9 6 M /c! // Permit No .3/1 1 Street and Number where work is to be performed —No Size Septic Tank Nature of Water Supply: City —Well. Amount of Permit $_ _____ / 0 My Commission Expires c, MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date 3/2-0 U 1 _ y_____ 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. �) / TA Owner's Name and Address ___ Q_ - f /2-a A C k No ` , OO Il/ Y . Street____�1 Registered Architect and /or Engineer __ L• 1 4. / L e_l_ _1.1 L Employing Plumber's Name �-- /--- a ! 4- t_ (. l"t 6 7 No 9 / / v • E. Street_ CQ___��� _ — Location and Legal Description Lot_____ :__=___:_ ___ /_c____ ______ Block ( ?o Subdivision_ % ek^ <ES Street / O 8 _ �-- -- - -____ cc A/ State work to be performed and purpose of building (By Floors) - New Building _ Remodeling Addition Repairs No. of Stories_ _____ _______. Type of Tank .__f 61_L& e rapacity r Feet of Drain Tile_______l_� c r 7 _____ Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) Notary Public. State of Florida — Sined i ji(mss .d r ... / 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber .A STATE OF FLORIDA, 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. 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 / 2— / /�/ CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM 'G POOL CONTR. LIST CHECK Permit No .3/1 1 Street and Number where work is to be performed —No Size Septic Tank Nature of Water Supply: City —Well. Amount of Permit $_ _____ / 0 My Commission Expires c, MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date 3/2-0 U 1 _ y_____ 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. �) / TA Owner's Name and Address ___ Q_ - f /2-a A C k No ` , OO Il/ Y . Street____�1 Registered Architect and /or Engineer __ L• 1 4. / L e_l_ _1.1 L Employing Plumber's Name �-- /--- a ! 4- t_ (. l"t 6 7 No 9 / / v • E. Street_ CQ___��� _ — Location and Legal Description Lot_____ :__=___:_ ___ /_c____ ______ Block ( ?o Subdivision_ % ek^ <ES Street / O 8 _ �-- -- - -____ cc A/ State work to be performed and purpose of building (By Floors) - New Building _ Remodeling Addition Repairs No. of Stories_ _____ _______. Type of Tank .__f 61_L& e rapacity r Feet of Drain Tile_______l_� c r 7 _____ Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) Notary Public. State of Florida — Sined i ji(mss .d r ... / 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber .A STATE OF FLORIDA, 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. 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. APPLICATION FOR PLUMBING PERMIT ' Permit No..____. C 4 , 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 a coi>;plied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of ork. }'p Owner's Name and Address c� +�'' —__ �!1!y.�,.�I� Registered Architect and /or Engineer Employing Plumber's Name_1CQ_ Q K Location and Legal Description Block__ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) ____ __� _Li_�� / 14 _ ? r +; New Building Remodeling Addition Repairs__ _________________ No. of Size Septic Tank Feet of Drain Tile_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT No'Z.`4 D Type of Tank . Capacity Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well .Size of Soakage Pit licensed by Miami Shores Village. Street_ is It 1f4 r ii !�V� Subdivision__L�Y�_ " "____ ✓__ � __— _________ Master Plumber. ✓ / r r 'Y -, ' + F - '' - 0 / . r Amount of Permit $ — tt - (Signed) - ---- - - - - -� ----= ..- - �Y= �� — = - -- � - - - --- 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under thin' permit, as are ' = (Signed) _ ]__- . . . : . . 1 . : • . - 'FATE OF FLORIDA, I - ,. *. ; . 4 ' JNTY OF DADE. 1 ss ' I ' ' '' a �.r .11„ before me, the undersigned authority, a notary public, duly authorized to administer oaths and take . .no edgments, personally known, and who, being by me first duly sworn, upon oath deposes and says that he is the. • described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts stated are true. My Commission Expires Notary Public. State of Florida 'spection fee of $1.00 will be made when such re inspection is made necessary by improper notice for inspection, or faulty 'anship. 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 SOLAR HEATER DOBP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST V CHECK APPLICATION FOR PLUMBING PERMIT ' Permit No..____. C 4 , 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 a coi>;plied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of ork. }'p Owner's Name and Address c� +�'' —__ �!1!y.�,.�I� Registered Architect and /or Engineer Employing Plumber's Name_1CQ_ Q K Location and Legal Description Block__ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) ____ __� _Li_�� / 14 _ ? r +; New Building Remodeling Addition Repairs__ _________________ No. of Size Septic Tank Feet of Drain Tile_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT No'Z.`4 D Type of Tank . Capacity Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well .Size of Soakage Pit licensed by Miami Shores Village. Street_ is It 1f4 r ii !�V� Subdivision__L�Y�_ " "____ ✓__ � __— _________ Master Plumber. ✓ / r r 'Y -, ' + F - '' - 0 / . r Amount of Permit $ — tt - (Signed) - ---- - - - - -� ----= ..- - �Y= �� — = - -- � - - - --- 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 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 under signed agrees to employ only such sub - contractors, on work to be performed under thin' permit, as are ' = (Signed) _ ]__- . . . : . . 1 . : • . - 'FATE OF FLORIDA, I - ,. *. ; . 4 ' JNTY OF DADE. 1 ss ' I ' ' '' a �.r .11„ before me, the undersigned authority, a notary public, duly authorized to administer oaths and take . .no edgments, personally known, and who, being by me first duly sworn, upon oath deposes and says that he is the. • described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts stated are true. My Commission Expires Notary Public. State of Florida 'spection fee of $1.00 will be made when such re inspection is made necessary by improper notice for inspection, or faulty 'anship.