489 NE 101 St (10)Permit Noj e 0V
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 herewitl{ 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 Dopy of approved plans and specifications must be kept at
building during progress of work.
-Sr
Owner's Name and Address 4 ?c \ h1 No L LV t Street..)"
Registered Architect and /or Engineer
—
Employing Pl s No.. ..—..K. U/
� �/ (- --._._.... .. y ... � . Itrwt.._ G . ) 2-f � I ^ A E I ')"
Y a$o�"ana / L;egal ° ) c rlptio Lot. j7 A Block e/ subdlvwon/ 1P
Street and Number where work L to be performed —No
State work to,be performed and purpose of building (By Foors) G? 3 /Nt b a¢� 7 ._ ai 6 cP StOu6 //o ZNSi.,
Ut • .
New Building_._..._ _ __._.........._.. Remodeling____ ___.__ Addition... _ ..__ Repair No. of Stories 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
Amount of Permit $
STATE OF FLORIDA, µ
COUNTY OF DADE.
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 Ilan com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort• to he
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 arP
required by the Act. The undersigned agrees to employ only such sub-contra oo work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned author a notary puklic, dul authori ath
administer omits and take acknowledgments, personally appeared
c
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the._.__ w`'' �
\'
of the above described construction, that he has carefully read the foregoing application, and thee be did' sign the same, and that all facts
therein by him stated a vj POSLIC BTATB 0? MOM __ _
NY COMMISSION IMP. NAR.28.1994
�m ,iNS, ti1tD
My Com ion Notary 1P iI4Ic, $tats of Plnrfda
(Signed) _ -4
(Signed)
Date..._. 90
Street..jo
9f
Muter Plumber.
NOTE: A re- inspection fee of $1.00 will be roads whoa droll n-htspeotlas Y Naar Demur, by fm'proper stories for inspection, or faulty
materials and /or worl®anship.
CLOSETS
BATH
TUBS
SHOWER•
LAVA•
TORIES
SINK•
SLOP
SINKS
LAUHORY
Tuts
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
P11T11RES
CONTI!.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAM
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
H EATER
Mar
WELL
SPRKLR.
SYSTEM
SW IM
POOL
CONTII.
LIST
CHICK
Permit Noj e 0V
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewitl{ submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of. Miami Shores Village shall be complied with, whether herein specified or not. A Dopy of approved plans and specifications must be kept at
building during progress of work.
-Sr
Owner's Name and Address 4 ?c \ h1 No L LV t Street..)"
Registered Architect and /or Engineer
—
Employing Pl s No.. ..—..K. U/
� �/ (- --._._.... .. y ... � . Itrwt.._ G . ) 2-f � I ^ A E I ')"
Y a$o�"ana / L;egal ° ) c rlptio Lot. j7 A Block e/ subdlvwon/ 1P
Street and Number where work L to be performed —No
State work to,be performed and purpose of building (By Foors) G? 3 /Nt b a¢� 7 ._ ai 6 cP StOu6 //o ZNSi.,
Ut • .
New Building_._..._ _ __._.........._.. Remodeling____ ___.__ Addition... _ ..__ Repair No. of Stories 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
Amount of Permit $
STATE OF FLORIDA, µ
COUNTY OF DADE.
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 Ilan com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort• to he
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 arP
required by the Act. The undersigned agrees to employ only such sub-contra oo work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned author a notary puklic, dul authori ath
administer omits and take acknowledgments, personally appeared
c
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the._.__ w`'' �
\'
of the above described construction, that he has carefully read the foregoing application, and thee be did' sign the same, and that all facts
therein by him stated a vj POSLIC BTATB 0? MOM __ _
NY COMMISSION IMP. NAR.28.1994
�m ,iNS, ti1tD
My Com ion Notary 1P iI4Ic, $tats of Plnrfda
(Signed) _ -4
(Signed)
Date..._. 90
Street..jo
9f
Muter Plumber.
NOTE: A re- inspection fee of $1.00 will be roads whoa droll n-htspeotlas Y Naar Demur, by fm'proper stories for inspection, or faulty
materials and /or worl®anship.
Amount of Permit $ - -2.
, .„ f44i!
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Date..._.._.._ -/ .l. - • •-- - - - -.—
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su fitted 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.
O Name and Address Paul Bullwillcel
Registered Architect and /or Engineer ACME GAS CORP 1 NE 130 ST
$ /t Pi b Q ACZIE oAS CORP [ Z
/ Location and' Legal Description Lot of ` 3 �Elo�� 9'L
Street and Number where work performed—No to be performed—No 1 489 NE 01 STREET Street_.
State work to be performed and purpose of building (By Fkrors) _-1N.STALL _100 LB T . T. F L.P GAS CY L FOR CKG
New Building - -__._ _ .. Remodeling____......- ..__.. —_ Addition.. _ Repairs No. of Stories ............
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.
101 street
No. Street..
1489 NE
( Signed) _tA SO
I' - 3 93
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 !tax com-
piled with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work co 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- contractor, on work to be performed under this permit, as are
licensed by Miami Shores Villages
(Signed)
Master Plumber.
STATE OF FLORIDA, r
1
te' ' G E 2 r C o �. ► — u 0 o 0 4 p
COUNTY OF DADE. ..1)///01
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
( A w 1 n� E/5-/tN (C ( n/
to me well known, and who, being by me first duly sworn, upon oath deposes and soya that be it
therein by him stated are true. ___
of the above described construction. that h has carefuliy lead the foregoing application, and that be did sign the same, and that all facts
ARY PUBLIC ST OF FLORIDA��
COgrISS10N Gyp, MAR lo ND.
My pE Notary Public, State of Florida
ffjiYtMENERAI INS. UND.
NOTE: A re•inspection fee of 11.00 will be made when mob se•Inapeotian it snade by improper notice kw Inspection, or faulty
materials and/or walmaaship.
CLOSETS
BATH
Tus.
SHOWERS
LAVA•
TORIES
/INKS
SLOP
SINKS
LAUNDRY
Tugs
URINAL/
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N•
GAS - I, GAS
RANGE LINE
TOTAL
',slums,
--
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
MEATIER
DRIP
WILL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
-
r
Amount of Permit $ - -2.
, .„ f44i!
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Date..._.._.._ -/ .l. - • •-- - - - -.—
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su fitted 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.
O Name and Address Paul Bullwillcel
Registered Architect and /or Engineer ACME GAS CORP 1 NE 130 ST
$ /t Pi b Q ACZIE oAS CORP [ Z
/ Location and' Legal Description Lot of ` 3 �Elo�� 9'L
Street and Number where work performed—No to be performed—No 1 489 NE 01 STREET Street_.
State work to be performed and purpose of building (By Fkrors) _-1N.STALL _100 LB T . T. F L.P GAS CY L FOR CKG
New Building - -__._ _ .. Remodeling____......- ..__.. —_ Addition.. _ Repairs No. of Stories ............
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.
101 street
No. Street..
1489 NE
( Signed) _tA SO
I' - 3 93
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 !tax com-
piled with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work co 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- contractor, on work to be performed under this permit, as are
licensed by Miami Shores Villages
(Signed)
Master Plumber.
STATE OF FLORIDA, r
1
te' ' G E 2 r C o �. ► — u 0 o 0 4 p
COUNTY OF DADE. ..1)///01
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
( A w 1 n� E/5-/tN (C ( n/
to me well known, and who, being by me first duly sworn, upon oath deposes and soya that be it
therein by him stated are true. ___
of the above described construction. that h has carefuliy lead the foregoing application, and that be did sign the same, and that all facts
ARY PUBLIC ST OF FLORIDA��
COgrISS10N Gyp, MAR lo ND.
My pE Notary Public, State of Florida
ffjiYtMENERAI INS. UND.
NOTE: A re•inspection fee of 11.00 will be made when mob se•Inapeotian it snade by improper notice kw Inspection, or faulty
materials and/or walmaaship.
ACME GAS.CORP
1419 130K-
•\ A .;) ) 1 / 1 17-• 1 , q 1 ..cZ 2 C7 •
• /o/ s
0 Cr
F 0/0
/ /
./ 4> Pi'
'
/
r?
z/ PAUL BOLLWINKEL
489 N1,E. Ii ST
miA MI 51--1 OgF.S
F
Permit No 3 __ Z® __ Date 1
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.
___ I/ F . ----Q 1 S /
Owner's Name and Address
-- - - - - -- -- No. - - - - -- �_ Street__ 1
- - --•
Registered Architect and /or Engineer__________________
_ 2
Employing Plumber's Name___ L J Q n i 243L _____- No.___` s52 0 Street_ —_11/ / _ tJ___ S
Location and Legal Description Lot________
Size Septic Tank
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
---- ...... _____________ 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__
T ype o f T - _ Capacity Gals ..
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.-_—_--- ....... -------- •---- ..... ---- -- - - -- -- -Size of Soakage Pit
(Signed )
Repairs No. of Stories
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as a oyer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supple - and has cmn-
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 wor to performed under this permit, as are
licensed by Miami Shores Village.
Street
Subdivision _
rs •�
Plumb Inspector.
Master Plumber.
STATE OF FLORIDA, 1
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.
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 workmanship.
CLOSETS
BATH
T _S
M
SHOWERS
I
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N5
TOTAL
FIXTURES
CONTR.
LIST
5 f
( (I
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL.
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
F
Permit No 3 __ Z® __ Date 1
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.
___ I/ F . ----Q 1 S /
Owner's Name and Address
-- - - - - -- -- No. - - - - -- �_ Street__ 1
- - --•
Registered Architect and /or Engineer__________________
_ 2
Employing Plumber's Name___ L J Q n i 243L _____- No.___` s52 0 Street_ —_11/ / _ tJ___ S
Location and Legal Description Lot________
Size Septic Tank
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
---- ...... _____________ 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__
T ype o f T - _ Capacity Gals ..
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.-_—_--- ....... -------- •---- ..... ---- -- - - -- -- -Size of Soakage Pit
(Signed )
Repairs No. of Stories
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as a oyer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supple - and has cmn-
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 wor to performed under this permit, as are
licensed by Miami Shores Village.
Street
Subdivision _
rs •�
Plumb Inspector.
Master Plumber.
STATE OF FLORIDA, 1
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.
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 workmanship.
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL ❑ Date 'R. ' "' % 19_47
PLUMBING DI PERMIT N? 8432 Contractor's
License 4 "
ROOFING ❑
Owner of j
Building C Ow 1 - 4 - .
71rrr
❑ Work to be performed under this Permit
Architect
Contractor ,�._
or Builder 1 • '•"► 4.11.1._<•••
Legal Lot
Description 1 BI
Address of 4 e7 t C / 0/ 6 ri
Building
!� • ...
`, l
S.., 1,
Subdi-
vision
Sq Ft
Value of I I Amount of �--
Project $ II 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 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 sh.wn on the plans or dra ings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, se a o loyees. F
Signed• r � � I•NST/e TOR) BY
In consideration of the issuance to me of this permit I agree to orm the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, star-ments or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by ither, myself, my agent, servant or employee.
9 • it ,r s
''� •
I C'i . ...
CONTRACTOR or BUILDER` BY AUTHORITY
l ��t.
P e r m i t No..-
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
,A Y (-
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address. L., No Street •
Registered Architect and/or Engineer._._.__..__
- -- -- __.
Employing Plumber's Name
No. Street..._
Location and Legal Description Lot.. . ___ Block _____ -------- _ -_ - -- Subdivision -_
Street and Number where work is to be performed -No I-Z - G , .____._ -- Street_ _.__.../ Z !'
State work to be performed and purpose of building (By Floors)__
New Building ___ Remodeling Addition__. __- Repairs No. of Stories
Size Septic Tank Type of Tank_
Feet of Drain Tile Dist. Feet of Tank or Drain Field from We_IL
:. Soakage Pit._.
Nature of Water Supply: City -Well.
Amount of Permit $
Capacity Cals.
(Signed)._
L
(Signed).- -. - -- �-�—
Plumbing Inspector.
The undersigned applicant for this ding permit does hereby certify that he understand and/accepts his obligations as an employer of labor
under the Florida Workmen's Comp sation Act, being Section 5968, Compiled General Laws -of'Florida Permanent Supplement, and hL,s cs ;,n-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work :o 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 art
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master Pluinber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 iac
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 feu)
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINK•
LAUNDRY
'rues
URINALS
I NALS
CATCH
BAaIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURE!
CONTR.
LIST
CHECK
—
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
CHECK
-
P e r m i t No..-
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
,A Y (-
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address. L., No Street •
Registered Architect and/or Engineer._._.__..__
- -- -- __.
Employing Plumber's Name
No. Street..._
Location and Legal Description Lot.. . ___ Block _____ -------- _ -_ - -- Subdivision -_
Street and Number where work is to be performed -No I-Z - G , .____._ -- Street_ _.__.../ Z !'
State work to be performed and purpose of building (By Floors)__
New Building ___ Remodeling Addition__. __- Repairs No. of Stories
Size Septic Tank Type of Tank_
Feet of Drain Tile Dist. Feet of Tank or Drain Field from We_IL
:. Soakage Pit._.
Nature of Water Supply: City -Well.
Amount of Permit $
Capacity Cals.
(Signed)._
L
(Signed).- -. - -- �-�—
Plumbing Inspector.
The undersigned applicant for this ding permit does hereby certify that he understand and/accepts his obligations as an employer of labor
under the Florida Workmen's Comp sation Act, being Section 5968, Compiled General Laws -of'Florida Permanent Supplement, and hL,s cs ;,n-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work :o 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 art
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master Pluinber.
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 iac
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 feu)
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. ..._.. Date ... 1_-- - - .....................
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building dur-ng progress of work.
Owner's Name and Add' ess -..__ .. = . =" No _ -._.. Street
Registered Architect and /or En eer _ . _ _ ...... . - _-.. .
Employing Plumber's Name . No . Street- -._.___.
Location and Legal Description Lot.. -_ _ .._ . _ Bloclr Subdivision
Street and Number where work is to be performed —No 4 Street .__...--- - -.._
State work to be performed and purpose of building (By Floors)._ __..-- -_ - _--
New Building .. Remodeling __ Addition.__.._- ....- - -_ - -. Repairs ._- .__.._.._..__._...- _ - -.. No of Stories
- My Conunission Expire
Size Septic Tank - -.Type of Tank.. __. -. --------- .----- ..... - - -- ....-- •- • -_ -` -. - pac1ty Cals. _.......
Feet of Drain Tile._ .__.Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City— Well ._—. Size of Soakage Pit
Amount of Permit $ ( Signed)---_--_' _
Plumbing Inspector.
The undersigned appli • t for this building permit does hereby certify that he underst nd accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 6988, 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 Share Village.
STATE OF FLORIDA, i �.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the therein him stated t construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fat.
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 full
materials and /or worlmoanship.
CLOSETS
OATH
Tu..
SHOWERS
LAVA-
ToRiEs
SINK.
SLOP
SINK.
LAUNDRY
Tu..
URINAL.
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NE
TOTAL
FIXTURE:
—
CONTR.
LIsT
CHL'CK
TANK
CONN.
FIELD
SOAKAGE
PIT OE
GREASE
H E O ATKR
WELL
SYSTEM
Poo
/
C LIST
CHECK
't'
_ ._
v c
47/
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. ..._.. Date ... 1_-- - - .....................
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building dur-ng progress of work.
Owner's Name and Add' ess -..__ .. = . =" No _ -._.. Street
Registered Architect and /or En eer _ . _ _ ...... . - _-.. .
Employing Plumber's Name . No . Street- -._.___.
Location and Legal Description Lot.. -_ _ .._ . _ Bloclr Subdivision
Street and Number where work is to be performed —No 4 Street .__...--- - -.._
State work to be performed and purpose of building (By Floors)._ __..-- -_ - _--
New Building .. Remodeling __ Addition.__.._- ....- - -_ - -. Repairs ._- .__.._.._..__._...- _ - -.. No of Stories
- My Conunission Expire
Size Septic Tank - -.Type of Tank.. __. -. --------- .----- ..... - - -- ....-- •- • -_ -` -. - pac1ty Cals. _.......
Feet of Drain Tile._ .__.Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City— Well ._—. Size of Soakage Pit
Amount of Permit $ ( Signed)---_--_' _
Plumbing Inspector.
The undersigned appli • t for this building permit does hereby certify that he underst nd accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 6988, 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 Share Village.
STATE OF FLORIDA, i �.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the therein him stated t construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fat.
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 full
materials and /or worlmoanship.
Permit No. _/ Q se. 0,3
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__
Amount of Permit $__
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No
Registered Architect and /or Engineer
Employing Plumber's Name No Street
Location and Legal Description Lot Block / Subdivision
Street and Number where work is to be performed— I o __Q___ __ __ ____! O / Street
State work to be performed and purpose of building
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank_ Type of Tank_ Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed)
(Signed)
Date
� `
Street
re-L'
Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that '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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
I / J � Master Plumber. t�� �j
STATE OF FLORIDA, ss.
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.
My Commission Expires
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
HEATER
DEEP
WELL
SPRKLR .
SYSTEM
SWIM'G
POOL
CONTR.
IST
LIST
•
•CHECK
Permit No. _/ Q se. 0,3
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__
Amount of Permit $__
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No
Registered Architect and /or Engineer
Employing Plumber's Name No Street
Location and Legal Description Lot Block / Subdivision
Street and Number where work is to be performed— I o __Q___ __ __ ____! O / Street
State work to be performed and purpose of building
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank_ Type of Tank_ Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed)
(Signed)
Date
� `
Street
re-L'
Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that '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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
I / J � Master Plumber. t�� �j
STATE OF FLORIDA, ss.
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.
My Commission Expires
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Owner of
Architect
Contractor
or Builder i
Legal Lot
DeOcriptialt
sass of
cro
eilliveraiit is granted
heret in svEict co lras d i1
dew ings, €t tem&nts- or sp eofko'
time if the work is not don e
gaOte4 i the vadsystaild
pertaintog to the word e
done by his. agents, serval-Ai' o
In consideration of the r s s
'ertainiog thereto and in strict icon
n accepting this permit 1 assn,:e,-
i'
, Oi
(.
aX
r1,
to c t ct'she building
t dersta d g
Ole A:
Subd
vision
tie vcir cdr'et1 lie` t5nder i'ii compliance wi a ardi
o- specifications submitted to the proper authorities of Mt
self, my agent, se Tint or employee.
I'
or to -itai' the equipment or devise deserted iti dip apphcatibrri
eh.g: t sorb 'will be performed i'D coreptiancQ 47.4 any O
p et Iflpal 1orities Um* Permit may he y yoked' '4
a t� th$i d A further ea on won- this
t;
r,a� ns owled a t e ordtn a e -s
pe and that he aspizes resphhsi lty tar vror
CONTRACTO
�
6' 7
Permit No._ ___1 r"?
Owner's Name and Address
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. T us 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.
Registered Architect and /or Engin
Employing Plumber's. Name
L9cation and Legal Descripti.b n
Street and Number where work is to be performed —No
State work to be perforned and purpose of building (By Floors)
New Building . Remodeling
Amount of Permit $ - flt�rL
S ATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No lq--gf Street /i1 /
Date- -' e 14 „7 (
Block Subdivision
/ 07
Street .l_Y__
Addition A Repairs No. of Stories
Size Septic Tank i Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed)
Px _e (Signed) e1
b
Notary Public, State of Florida
Plumbing Inspector.
The undersigned appli c ( ant for this building permit does hereby certify that he u stands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene 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
perforned 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 I undersigned agrees to employ only such sub - contractors, on work to be performed under 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 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
ISHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
G UST
LIST
/
I
CHECK
' )
'`
L. 1
-
SEPTIC
TANK
SEWER
CONN.
I DRAIN
I FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
/
CHECK
•
�
6' 7
Permit No._ ___1 r"?
Owner's Name and Address
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. T us 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.
Registered Architect and /or Engin
Employing Plumber's. Name
L9cation and Legal Descripti.b n
Street and Number where work is to be performed —No
State work to be perforned and purpose of building (By Floors)
New Building . Remodeling
Amount of Permit $ - flt�rL
S ATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No lq--gf Street /i1 /
Date- -' e 14 „7 (
Block Subdivision
/ 07
Street .l_Y__
Addition A Repairs No. of Stories
Size Septic Tank i Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed)
Px _e (Signed) e1
b
Notary Public, State of Florida
Plumbing Inspector.
The undersigned appli c ( ant for this building permit does hereby certify that he u stands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene 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
perforned 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 I undersigned agrees to employ only such sub - contractors, on work to be performed under 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 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.