990 NE 100 St (4)Permit No
Registered Architect and /or Engineer
Employing Plumber's Name -
Location and Legal Description Lot_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Berk
New Building..__.._ — _.._.__...... -._ -- Remodeling____ ---- Addition
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) _ ALW.
Size Septic Tank —
Type of Tank
Feet of Drain Tile Dist- Feet of Tank or Drain Field from Well. .._.__..Y_
Nature of Water Supply: City—Well. Size of Soakage Pit_
Amount of Permit $__11) F 0
My Commission E:pins
( Signed) _
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Law
plied with the provisions thereof, and will require similar compliance from all contractors
performed under this permit, and will post or cause to be posted' for inspection on the si
required by tfie Act. The undersigned agrees to employ only such sub - contractor,
licensed by Miami Shores Village.
(Signed)
Subdivision.
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 wor . `r
Owner's Name and Address • Z.1211..6...
(;
l Ogils1>RY tkA 041 -....
Repairs No of Stories ..........
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
Florida Permanent Supplement, and Ilan cam-
; tractors employed by him in the work to be
ork such public notice or notices as err
performed under this permit, as are
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 be did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when wale r.ispeodoa fa msde.seo sorry by improper notice for inspection, or faulty
materials and/or workmanship.
CEDERS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINK[
'SLOP
a1NK[
LAUNDR
Tuns
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N•
TOTAL
FIXTURES
CONTR.
LIST
CHECK
+
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
NEATER
DEEP
WELL
SPRKLN.
S
SW IN'G
POOL
CONTR.
LIST
W Ti
.�
CHECK
Permit No
Registered Architect and /or Engineer
Employing Plumber's Name -
Location and Legal Description Lot_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Berk
New Building..__.._ — _.._.__...... -._ -- Remodeling____ ---- Addition
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) _ ALW.
Size Septic Tank —
Type of Tank
Feet of Drain Tile Dist- Feet of Tank or Drain Field from Well. .._.__..Y_
Nature of Water Supply: City—Well. Size of Soakage Pit_
Amount of Permit $__11) F 0
My Commission E:pins
( Signed) _
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Law
plied with the provisions thereof, and will require similar compliance from all contractors
performed under this permit, and will post or cause to be posted' for inspection on the si
required by tfie Act. The undersigned agrees to employ only such sub - contractor,
licensed by Miami Shores Village.
(Signed)
Subdivision.
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 wor . `r
Owner's Name and Address • Z.1211..6...
(;
l Ogils1>RY tkA 041 -....
Repairs No of Stories ..........
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
Florida Permanent Supplement, and Ilan cam-
; tractors employed by him in the work to be
ork such public notice or notices as err
performed under this permit, as are
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 be did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when wale r.ispeodoa fa msde.seo sorry by improper notice for inspection, or faulty
materials and/or workmanship.
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4
Permit No --
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 •' ., . • • ed or not. A copy of approved plans and specifications must be kept at
building during progress of wor t / j / r
Owner's Name and Address
Registered Architect and /or En
Employing Plumber's Name
Location and Legal Description Lot- 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—___ — _ Addition.
Size Septic Tank_.. —.__._.._..---- ---- -- ___...Type of Tank—
Feet of Drain Tile._.__
Nature of Water Supply: City — Well.-- ___ - - - - --
Amount of Permit $
(Signed)
No._
Date..._ (_ _ 2 ! ...L .. Z
?4 L Street_._ /1D
jatreet./..
Street
Repairs No. of Stories
Capacity Gab.
_Dist. Feet of Tank or Drain Field from Well
of Soakage Pit
(Signed)- _
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 5968, Compiled General Laws of Florida Permanent Supplement, and bus 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, • • k to be • y• - • und.. permit, as are
licensed by Miami Shores Village.
Master
STATE OF FLORIDA, I
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 be has carefully read the foregoing application, and that be did sign the same, and that all fads
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 r - inspection M made necessary by bnproper notice for inspection, or faulty
material and /as workmanship.
-�'
CLOSET S
BATH
TUB[
SHOWERS
LAVA-
TORIES
61NKS
SLOP
SINK[
LAUNDRY
TOSS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•N[
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
8
SW IM•G
POOL
CONTR.
LIST
CHECK
Permit No --
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 •' ., . • • ed or not. A copy of approved plans and specifications must be kept at
building during progress of wor t / j / r
Owner's Name and Address
Registered Architect and /or En
Employing Plumber's Name
Location and Legal Description Lot- 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—___ — _ Addition.
Size Septic Tank_.. —.__._.._..---- ---- -- ___...Type of Tank—
Feet of Drain Tile._.__
Nature of Water Supply: City — Well.-- ___ - - - - --
Amount of Permit $
(Signed)
No._
Date..._ (_ _ 2 ! ...L .. Z
?4 L Street_._ /1D
jatreet./..
Street
Repairs No. of Stories
Capacity Gab.
_Dist. Feet of Tank or Drain Field from Well
of Soakage Pit
(Signed)- _
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 5968, Compiled General Laws of Florida Permanent Supplement, and bus 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, • • k to be • y• - • und.. permit, as are
licensed by Miami Shores Village.
Master
STATE OF FLORIDA, I
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 be has carefully read the foregoing application, and that be did sign the same, and that all fads
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 r - inspection M made necessary by bnproper notice for inspection, or faulty
material and /as workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE (- / 195
❑ PERMIT N? 14536
❑ Work to be performed under this Permit
BL
Subdi-
vision
Value of
Project $
Contractor's
License No
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.
CONTRACTOR OR BUILDER
Signed
A 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 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