PLUMBING PERMITPermit No ....... _ C
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 wi hether 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/ f y ' -
Registered Architect and /or Engineer
�nng� __ ---
Employing Plumber's Name./.A,
Location and Legal Description Lot_
New Building Remodeling
Amount of Permit $—.7
STATE OF FLORIDA, l µ
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
.,,..�.Z. .�. .: Street-2 L-S?
Block
Subdivision____________.
Street and Number where work is to be performed —No Street L a / 5�
State work to be performed and purpose of building (By Floor) _._-- - - � � ° _ - �./- - - - -.— i� _L- Q..CI- L
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
(Signed)
Date
No._ 4 S treet - nd ! z ......101.._..._.
Capacity Gals
Addition 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
under the Florida Workmen's Compensation Act, being Section 5988, 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 > • oyed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the of the wor public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, k to • - own , er this permit, as are
licensed by Miami Shores Village.
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 fads
therein by him stated are true.
My Commission Expo Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when much re- inspection b made•neeeasary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSE S
BATH
TUBS
SHOWERS
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuve
URINAL{
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURE{
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
CHECK
Permit No ....... _ C
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 wi hether 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/ f y ' -
Registered Architect and /or Engineer
�nng� __ ---
Employing Plumber's Name./.A,
Location and Legal Description Lot_
New Building Remodeling
Amount of Permit $—.7
STATE OF FLORIDA, l µ
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
.,,..�.Z. .�. .: Street-2 L-S?
Block
Subdivision____________.
Street and Number where work is to be performed —No Street L a / 5�
State work to be performed and purpose of building (By Floor) _._-- - - � � ° _ - �./- - - - -.— i� _L- Q..CI- L
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
(Signed)
Date
No._ 4 S treet - nd ! z ......101.._..._.
Capacity Gals
Addition 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
under the Florida Workmen's Compensation Act, being Section 5988, 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 > • oyed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the of the wor public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, k to • - own , er this permit, as are
licensed by Miami Shores Village.
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 fads
therein by him stated are true.
My Commission Expo Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when much re- inspection b made•neeeasary by improper notice for inspection, or faulty
materials and /or workmanship.