970 NE 100 St1
C LOatTa
BATH
TU BS
6NOWERS
LAVA•
TORIES
6$NK•
SLOP
SINK•
LAUNORY
Tu••
URINALS
CATCH
BASIN
FLOOR DRINKING
DRAIN FOUNT' NB
TOT ...L
Fl RTI PIES
CONTR.
LI'T
CHECK
I
SEPTIC SEWER
TANK CONK.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H
DEEP
WELL
SPRKLR.
SYSTEM
SW IM' O
P001.
CONTR. ,
1- 900W /
On q ri. f+ -S55
-S6025
.
CNECK
PO &Kill
I'nnni; N u..7' 11
:.pphc:.tnm is hereby made for the approval of the detailed statement of the plans and specifications herewith subr.w. _71 for the building or other
structure herein described. This application is made In compliance and conformity with the Building Ordinance of Mk ! Shores Village, Florida,
did all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatir of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spet. must be kept at
. 3uilding during progress of work.
`.)vneis Name and Address ... RO}?eTt Benson No Street_ .._...._....
.egiu sred Architect and /or Engineer
imploying Plumber's Name Rose Septic Tank CO. 987 -5 �� 4 a, 8treet ....:........f.. ..
P.0.T7x 4 lTi_aleah 33011
Location and Legal Description Lot Bloat
Street and Number where work is to be performed —No 970 N.,__1QQt)1 S TE.2lreet
State work to be performed and purpose of building (By Floors)
New Building.----......_..-- -_ .............. Remodeling
Amount of Permit $
STATE OF FLORIDA, i
as.
COUNTY OF DADE.
11.75
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Addition
Repairs
Size Septic Tank_.._ — ..-- •- •---- •--- •------- - - - - -- ...Type of Tank
Feet of Drain Tile- .______ ______.___._Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well..___ _. ......_- .- ._- .-- _— .---- _- _.__ -. -Size of Soakage Pit
Capacity
( si "r 3 k lvpQ
Plumbing; Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a n, coyer of 'Rho
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent rum lement, and hay .'or .
t.lied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed 1 y him in r ,e 'A(rk r b�
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pub': notice T. no is 'r .+s a,?
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed lot this , r aril x: .0 .
licensed by Miami Shores Village.
(Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclvrowledgments, per;onat ; I plrrarrt.
..... ....._.. _...
Nc of Stoftes ....
My Commission Erpires Notary Public, State of Florida
Matta Plumber.
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 hrape on, faulty
materials and /or workmanship.