plumbingPermit No
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 Eng' eer____w-_
Employing Plumber's Name.... - QNo...7/
Location and Legal Description Lot_ N_._____... _-_-_-_----_ _ ___ Block
Street and Number where work is to be performed— No..______ .
State work to be performed and purpose of building (By Floors) _
New Building Remodeling__
Size Septic Tank
Feet of Drain Tile.
Nature of Water Supply: City —Well.
Amount of Permit $
STATE OF FLORIDA, t .
COUNTY OF DADE. E
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING '; .MIT
No.- —
Repairs
(Signed)_ - --
(Signed).
DateJD
Street
Street.- p"
Subdivision.
Street
Type of Tank_
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Capacity Gals.
Plumbing nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his � . igations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per anent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor- 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 wor 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.
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
No. of Stories.... ...........
Master Plumber.
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
INK
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
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'O.
POOL
CONTR.
LIST
-
CHECK
Permit No
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 Eng' eer____w-_
Employing Plumber's Name.... - QNo...7/
Location and Legal Description Lot_ N_._____... _-_-_-_----_ _ ___ Block
Street and Number where work is to be performed— No..______ .
State work to be performed and purpose of building (By Floors) _
New Building Remodeling__
Size Septic Tank
Feet of Drain Tile.
Nature of Water Supply: City —Well.
Amount of Permit $
STATE OF FLORIDA, t .
COUNTY OF DADE. E
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING '; .MIT
No.- —
Repairs
(Signed)_ - --
(Signed).
DateJD
Street
Street.- p"
Subdivision.
Street
Type of Tank_
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Capacity Gals.
Plumbing nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his � . igations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per anent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor- 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 wor 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.
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
No. of Stories.... ...........
Master Plumber.
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
❑ MIAMI SHORES VILLAGE. FLORIDA
DATE �' ° 1957
PERMIT N? 9399 Contractor's
License No "
P1
O
CONTRACTOR OR BUILDER
dr
Bl.
Work to be performed under this Permit
•
Subdi-
vision
Sq. Ft
Value of
Project $
1 r
Amt. of
Permit $
- rt kl d ,?
f
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 furth cofdjtion upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a, thor ugh knowle ge 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 t t he assumes responsibility for work
done by his agents, servants or employees. .$
Signed: r . F
l"� ~. � BY Rte.
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,4ervant or employee.
BY, AUTHORITY
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE
PLUMBING CI PERMIT N9 9037 0 3 T Contractor's
License No
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
t /.t4
baTRACTOR OR BUILDER
Bl.
Subdi-
vision
Sq. Ft
Value of
Project .'$
BY
0 1 e, N•r
Amt. of
Permit $
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 or specifications and that he assumes responsibility for work
done by his agents, servants or employees. t +„
Signed-
za
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.
AUTHORITY
17
Permit No r�
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. /, (- / �f /� ,�
Owner's Name and Address ti /! ` '^' �t -tom✓ No. G l +1 L . Street �f L v � ""
Registered Architect and /or En -7/�
Employing Plumber's Name _ 1! _- l/A-44 41 p No. -_ -.1 . - ... Stree 1901-'41
Location and Legal Descrip • ,y Lot Bl Subdivision. _
Street C - ,17/ 46C
Street and Number where work is to be performed —No de 7 1 .5 - 4
State work to be performed and purpose of building (By Floors) _
New Building Remodeling _ _ __ Addition
Size Septic Tank _.--- _-- •--- _ - -_.._ _._...- _ -_- _-Type of Tank
Amount of Permit 8
STATE OF FLORIDA, ( a.
COUNTY OF DADE. I
yam
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING P sY MiT
(S)-
( signed >._.!. -_✓__.
Date
Repairs No. of Stories.
Capacity Gals
Feet of Drain -- - - -___ __ _ ._Dis�t.�Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. '�'4 -4!S1 ..__________ _..Size of Soakage Pit ................... ________ ..............
_
P , , , ing 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 5968, 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 work to be performed under this permit, as are
licensed by Miami Shores Village.
My Conunission Expires Notary Public, State of Florida
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 hin, stated are true.
NOTE: A re- inspection fee of 81.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TU 86
SHOWERf
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TU{{
URINAL{
CATCH
DAAIN
FLOOR
DRAIN
DRINKING
FOUNT'NO
�/
J41
I
A ,
TOTAL
/IETUREf
- -_
CONTR.
LIST
�J
!/`\
f
1
--
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DUI
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
�.f
,
A• u��'sl�
�/ P"
/
CONTR.
L
/
CHECK
1 -
Permit No r�
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. /, (- / �f /� ,�
Owner's Name and Address ti /! ` '^' �t -tom✓ No. G l +1 L . Street �f L v � ""
Registered Architect and /or En -7/�
Employing Plumber's Name _ 1! _- l/A-44 41 p No. -_ -.1 . - ... Stree 1901-'41
Location and Legal Descrip • ,y Lot Bl Subdivision. _
Street C - ,17/ 46C
Street and Number where work is to be performed —No de 7 1 .5 - 4
State work to be performed and purpose of building (By Floors) _
New Building Remodeling _ _ __ Addition
Size Septic Tank _.--- _-- •--- _ - -_.._ _._...- _ -_- _-Type of Tank
Amount of Permit 8
STATE OF FLORIDA, ( a.
COUNTY OF DADE. I
yam
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING P sY MiT
(S)-
( signed >._.!. -_✓__.
Date
Repairs No. of Stories.
Capacity Gals
Feet of Drain -- - - -___ __ _ ._Dis�t.�Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. '�'4 -4!S1 ..__________ _..Size of Soakage Pit ................... ________ ..............
_
P , , , ing 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 5968, 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 work to be performed under this permit, as are
licensed by Miami Shores Village.
My Conunission Expires Notary Public, State of Florida
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 hin, stated are true.
NOTE: A re- inspection fee of 81.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
3
i
4 �d
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Address of it, '
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE
° PERMIT
Owner of Z{
Building
Architect
Contractor'
or Builder �-+
Legal Lot
Description
CONTRACTOR OR BUILDER
Work to be performed under this Permit
t f La t ,
11 B
1
N9 5508
Subdi-
vision
BY
Value of
Project $
Contractor's
License No.
Amount of
Permit $
19
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 he assumes respon-
sibility for work done by his agents, servants or employees..p v9
1
Signed �C� t' � -. i " �
,+- SPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder compliance wi t all ordinances and re 'hstions
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoriti ls of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, mys ,, my- agent, servant or employee.
AUTHORITY ..9oT
Permit No. S -
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. _ ° 4__ �.
Registered Architect and /or E neer _____
_____� - - -___
Employing Plumber's Name_
Location and Legal Description Lot
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors) _
New Building _ Remodeling —_ -- �--- -_
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
09 G
No._
Block
Addition
(Signed)- —
Date__
Street__ _r f
Subdivision
Street
Repairs No. of Stories
Type of Tank
—Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pere, : rent 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.
(Signed) — -- -- — 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 1 }e 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 worlananship.
CLOSETS
BATH
TUBS
SHOWERS
O
LAVA.
TORIES
SI NKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
L
NAS
CATCH.
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N6
TOTAL
FIXTURES
CONTR.
LIST
_
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
5
°1
- --
-
-
-
Permit No. S -
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. _ ° 4__ �.
Registered Architect and /or E neer _____
_____� - - -___
Employing Plumber's Name_
Location and Legal Description Lot
Street and Number where work is to be performed —No.
State work to be performed and purpose of building (By Floors) _
New Building _ Remodeling —_ -- �--- -_
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
09 G
No._
Block
Addition
(Signed)- —
Date__
Street__ _r f
Subdivision
Street
Repairs No. of Stories
Type of Tank
—Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pere, : rent 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.
(Signed) — -- -- — 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 1 }e 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 worlananship.
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑ ,
ELECTRICAL El DAT 195*
PLUMBING o PERMIT N? 8968 License Contractor's
a No ^
ROOFING ❑
Architect
Contractor
or Builder
Legal
Description
Lot
Address of
Building
❑ Work to be performed under this Permit
Owner of
Building 4 u
e�.
CONTRACTOR OR BUILDER
Bl.
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 fufther 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 he assumes responsibility for work
done by his agents, servants or employees.
•
Signed: it' ! BY -'
INSPECTOR 4
r
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinattt$s and regulations
pertaining tl;eceto 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.
s L.° t y S .
BY
Amt. of
Permit $
AUTHORITY
4
t.
Permit No. n - G
Date -17
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 compl)ed 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 Archit - and /or Enngneer
Employing ' '. s ame
Location and Legal Description Lot_-- _---__ ........ __.____ 5 ___ —Block_ U
Street and Number where work is to be performed -No 1: ,' 6
State work to be performed and purpose of building (By Floors) __.__-_ _..
New Building __ ...-_ --- Remodeling __ Addition_ --
Size Septic Tank
Feet of Drain Tile 3
Nature of Water Supply: City-Well
Amount of Permit $
— M Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING ° `t•�IMI9'
No.__, /(oo o- Street. _?: a
Type of Tank 'n-o-? ' ' Gals
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
No
(Signed)
(Signed). C
Street
is /
Subdivision >
Street 7 z - / o / /S-4
Repairs No. of Stories
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations ay' . employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Su' ment, and has cOin-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed: 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 publi notice or notices as are
required by Elie 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
Plurp . g Inspector.
STATE OF FLORIDA, 1
COUNTY OF DADE. j
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 $1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N$
TOTAL
FIXTURE$
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
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WELL
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SW IM'GI
POOL
CONTR.
LIST
CHECK
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Permit No. n - G
Date -17
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 compl)ed 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 Archit - and /or Enngneer
Employing ' '. s ame
Location and Legal Description Lot_-- _---__ ........ __.____ 5 ___ —Block_ U
Street and Number where work is to be performed -No 1: ,' 6
State work to be performed and purpose of building (By Floors) __.__-_ _..
New Building __ ...-_ --- Remodeling __ Addition_ --
Size Septic Tank
Feet of Drain Tile 3
Nature of Water Supply: City-Well
Amount of Permit $
— M Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING ° `t•�IMI9'
No.__, /(oo o- Street. _?: a
Type of Tank 'n-o-? ' ' Gals
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
No
(Signed)
(Signed). C
Street
is /
Subdivision >
Street 7 z - / o / /S-4
Repairs No. of Stories
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations ay' . employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Su' ment, and has cOin-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed: 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 publi notice or notices as are
required by Elie 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
Plurp . g Inspector.
STATE OF FLORIDA, 1
COUNTY OF DADE. j
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.