490 NE 101 St (2)/1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No° 1 Date...- - -_ - -_
Application is hereby made for the approval of the detailed statement of the plans and Ramifications 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 Addr
Registered Architect and /or Engineer , ,�
Ealllo g it bar''s% 7 � ' , -
'lion and g al DescN ptidc Lot L B Cr treet and Number where work L to be performed —No. /y f.� / 7
State work to be performed and purpose of building (By Floors) __._._ _ .------ _-- _ - -• --
New Building.._... — _ _.._ _.. Remodeling__ ___ Addition.
No ___Z.2
Size Septic Tank— _Type of Tank__
C
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 8 " 620 (Sigaed
The undersigned applicant for this building permit does hereby certify that he understands and accepts
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Fl
plied with the provisions thereof, and will require similar compliance from all contractors or su
performed under this permit; and will post or cause to be posted' for inspection on the site
required by the Act. The undersigned agrees to employ only such sub - contractors,
licensed by Miami Shores Village.
My Commission Expires
(Signed)
Repairs No. of Stories
Fee 7
Street ._ ti L 10/
No„ 6
_. kV
.�Cb:_-1 y
Streetz(C. / + � c- -•• - --
Notary Public, State of Florida
Master Plum
Plumbing Inspector.
ations as an employer of labor
a Pennane t Supplement, and hie corn-
actors employed by him in the work to be
work such public ce notices as are
to be y orm " under wit, as are
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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of 81.80 will be made whoa snob rrispeotfata Y oede by improper notice for leespaectio , or faulty
materials and /or wort nanrhip.
STATE OF FLORIDA, as.
COUNTY OF DADE.
CLOSETS
BATH
TUNS
"OWES*
LAVA•
TORIES
SLOP
SINK[
LAUNDR
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FCUNT'NS
TOTAL
•11*TUR[s
CONTrI.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WILL
S
S M
SWING
POOL
CONTR.
LIST
CHECK
�
1
/1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No° 1 Date...- - -_ - -_
Application is hereby made for the approval of the detailed statement of the plans and Ramifications 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 Addr
Registered Architect and /or Engineer , ,�
Ealllo g it bar''s% 7 � ' , -
'lion and g al DescN ptidc Lot L B Cr treet and Number where work L to be performed —No. /y f.� / 7
State work to be performed and purpose of building (By Floors) __._._ _ .------ _-- _ - -• --
New Building.._... — _ _.._ _.. Remodeling__ ___ Addition.
No ___Z.2
Size Septic Tank— _Type of Tank__
C
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 8 " 620 (Sigaed
The undersigned applicant for this building permit does hereby certify that he understands and accepts
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Fl
plied with the provisions thereof, and will require similar compliance from all contractors or su
performed under this permit; and will post or cause to be posted' for inspection on the site
required by the Act. The undersigned agrees to employ only such sub - contractors,
licensed by Miami Shores Village.
My Commission Expires
(Signed)
Repairs No. of Stories
Fee 7
Street ._ ti L 10/
No„ 6
_. kV
.�Cb:_-1 y
Streetz(C. / + � c- -•• - --
Notary Public, State of Florida
Master Plum
Plumbing Inspector.
ations as an employer of labor
a Pennane t Supplement, and hie corn-
actors employed by him in the work to be
work such public ce notices as are
to be y orm " under wit, as are
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 he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of 81.80 will be made whoa snob rrispeotfata Y oede by improper notice for leespaectio , or faulty
materials and /or wort nanrhip.
STATE OF FLORIDA, as.
COUNTY OF DADE.
MIAMI SHORES VILLAGE, FLA. N° 5112
JOB lL C A 7' .D "..9 � / � c� E` G . ter /e
ADDRESS
1-50 AL
INSPECTION D & ► l 1 ��
TIME READY PirtA
REMARKS:
/al
INSPECTOR DATE r 6 4
Village o of Miami Shores
N? 4854
JOB , 6 €��' l , c
ADDRESS 41 A oti l /eV
INSPECTION vt=) V ► F / M ,J .,
TIME READY
REMARKS
INSPECTOR 14 - 2 •A ? :
DATE �° L 7- 3t
7-
J
-J
4
N.�. 5 AVE.
:UILDING
:LECTRICAL
'LUMBING
:OOFING
timer of
. uilding - !
-ontractor
r Builder
egal
tescription
.ddress of
uilding
MIAMI SHORES VILLAGE. FLORIDA
❑ 9• t 195.6_
El DATF
❑ PERMIT N? 4205 �e tors 3
❑ °
rchitect
I
Lot
Work to be performed under this Permit
Bl
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
erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
=se 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
ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
Drtaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifi .. tions and that he assumes responsibility for work
one by his agents, servants or employees.
Signed.
C o c+ 7 e
Subdi-
vision
Value of
Proj ect $
A' t
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered he =under in compliance with all ordinances and regulations
ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submi ed to the proper authorities of Miami Shores Village. In ac-
-.pting this permit I assume responsibility for all work done by either, myself, my aver t, servant or employee.
oar.
..7
AUTHORITY
Amount of 0
$
Permit Noi`
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
Owner's Name and Address...
Registered Architect and /or E inee 4!
Employing Plumber's Name_ n !_ yV
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
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEN';:'
APPLICATION FOR PLUMBING 7 :L,AIT
No..
Block__
Addition..._ Repairs No. of Stories ... .......................
Size Septic Tank e of Tank_ Capacity Gals.
eet of Tank or Drain Field from Well
_Size of Soakage Pit
( Signed) -- C`
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 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- contracto p on k to be per orme g�er this permit, s are
licensed by Miami Shores Village.
(Signed)._
Date t L.1"
Street_
Street__
Subdivision
/4,14
STATE OF FLORIDA, t es.
COUNTY OF DADE.
Eefore 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
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
S INKS
SLOP
SINKS
LAUNDRY
Tues
URINALS
R INALB
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
SWIM'S
POOL
CONTR.
LIST
x
` —_—
CHECK
Permit Noi`
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
Owner's Name and Address...
Registered Architect and /or E inee 4!
Employing Plumber's Name_ n !_ yV
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
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEN';:'
APPLICATION FOR PLUMBING 7 :L,AIT
No..
Block__
Addition..._ Repairs No. of Stories ... .......................
Size Septic Tank e of Tank_ Capacity Gals.
eet of Tank or Drain Field from Well
_Size of Soakage Pit
( Signed) -- C`
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 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- contracto p on k to be per orme g�er this permit, s are
licensed by Miami Shores Village.
(Signed)._
Date t L.1"
Street_
Street__
Subdivision
/4,14
STATE OF FLORIDA, t es.
COUNTY OF DADE.
Eefore 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
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.