515 NE 101 St (5)Permit No.._. _ 7
Location and Legal Description Lot
Street and Number where work is to be performed —No
a
Amount of Permit $ ��
My Commission Expires
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 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 RJ / 4,5 file's
s
Registered Architect and /or Engineer - ..... g _.... -
Employing Plumbaa's Name 9Ne ' )»2 P1 &"/ /3/1 4 Na._ � ........ l L�.. ..�. .a.s9. -
Bloom
State work to be performed and purpose of building (By ' Floors)
__.__
New Building - - -- -- - •- -..... -.. - -- Remodeling —_ 14. —__ Addition.
No � 0 Street.- . e A . ..
Subdividon
®...- .. - - - - --
Repairs No. of Stories... 2......
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
a o
0
(SI
Date ...l��rlJ�� 30
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 hat com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort• 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 be performed under this permit, as are
licensed by Miami Shores Village
STATE OF FLORIDA, 1 µ
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 be 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
Plumbing Inspector.
Muter PI
NOTE: A re- inspection fee of $1.00 will be wade wham arch attr•speodoa Is seeds.a'oaa'ry by (improper notice for bospectlon. or faulty
materials and /or worinaansbip.
CLOSETS
BATH
Tull
SHOWERS
LAVA.
TORIES
'INK[
SLOP
'INK[
LAUNDRY
Tua[
URINAL[
CATCH
'ASIN
FLOOR
DRAIN
DRINK NO
FOUNT' NS
TOTAL
FIXTURE[
CONTR.
LIST
-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE.
PIT
G
TRAP
SOLAR
HEATER
Deer
WELL
'PRKLR.
' M
SWIM'G
POOL
p y
�G /
CONTR.
/
LIST
CHECK
257
'.
Permit No.._. _ 7
Location and Legal Description Lot
Street and Number where work is to be performed —No
a
Amount of Permit $ ��
My Commission Expires
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 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 RJ / 4,5 file's
s
Registered Architect and /or Engineer - ..... g _.... -
Employing Plumbaa's Name 9Ne ' )»2 P1 &"/ /3/1 4 Na._ � ........ l L�.. ..�. .a.s9. -
Bloom
State work to be performed and purpose of building (By ' Floors)
__.__
New Building - - -- -- - •- -..... -.. - -- Remodeling —_ 14. —__ Addition.
No � 0 Street.- . e A . ..
Subdividon
®...- .. - - - - --
Repairs No. of Stories... 2......
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
a o
0
(SI
Date ...l��rlJ�� 30
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 hat com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort• 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 be performed under this permit, as are
licensed by Miami Shores Village
STATE OF FLORIDA, 1 µ
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 be 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
Plumbing Inspector.
Muter PI
NOTE: A re- inspection fee of $1.00 will be wade wham arch attr•speodoa Is seeds.a'oaa'ry by (improper notice for bospectlon. or faulty
materials and /or worinaansbip.
IFFP
/ � O
Permit No S 3 f e
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date.. -- 1104 _'!9 L / � a
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. P �q
Owners Name and Address _ - - No. S/ r Street_ ' / 1
Registered Architect and /or Engineer
Employing Plumber's Name /IA/ �` - Ir e _ —_ — ________.__ No._ Street_ ____l __d /a
Location and Legal Description Lot___ _ ______ —.___� _ _ Block Subdivision.
Street and Number where work is to be performed -No 5 d A� /MA
State work to be perf rmed and purpose_of_building (By Floors) __, L
New Building
Addition-------.- _ - -_ --
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.
Amount of Permit $_
._Size of Soakage Pit
(Signed) _
( Signed )—
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Sup'.iment, and has com-
plier with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by im in the work to be
performed under this permit; and will post or cause to be posted' for inspection on t)e -sit . . e w such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub -contra ors, o ` or to b under this permit, as are
licensed by Miami Shores Village.
P1
Master Plumber.
ing Inspector.
STATE OF FLORIDA, 1 as.
COUNTY OF DADE.
Before me, the ned}uthority, a notary public, u1y 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. P114 _ lN_ l( A_71_ tidy,
of the above described .construc ielitA gE1e fwfy tt the foregoing application, and that he did sigh the same, and that all facts
therein by him stated rr ON ExPiRES MAY 1. 19 4
sown by AmuscAN NRE & CASUALTY CO.
My Commission Expires Public, S e-of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice•fo's 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
FIXTURE6
CONTR.
LIST
ia
O
i
CHECK
,
__
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW I
POOL
CONTR.
LIST
CHECK
IFFP
/ � O
Permit No S 3 f e
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date.. -- 1104 _'!9 L / � a
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. P �q
Owners Name and Address _ - - No. S/ r Street_ ' / 1
Registered Architect and /or Engineer
Employing Plumber's Name /IA/ �` - Ir e _ —_ — ________.__ No._ Street_ ____l __d /a
Location and Legal Description Lot___ _ ______ —.___� _ _ Block Subdivision.
Street and Number where work is to be performed -No 5 d A� /MA
State work to be perf rmed and purpose_of_building (By Floors) __, L
New Building
Addition-------.- _ - -_ --
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.
Amount of Permit $_
._Size of Soakage Pit
(Signed) _
( Signed )—
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Sup'.iment, and has com-
plier with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by im in the work to be
performed under this permit; and will post or cause to be posted' for inspection on t)e -sit . . e w such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub -contra ors, o ` or to b under this permit, as are
licensed by Miami Shores Village.
P1
Master Plumber.
ing Inspector.
STATE OF FLORIDA, 1 as.
COUNTY OF DADE.
Before me, the ned}uthority, a notary public, u1y 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. P114 _ lN_ l( A_71_ tidy,
of the above described .construc ielitA gE1e fwfy tt the foregoing application, and that he did sigh the same, and that all facts
therein by him stated rr ON ExPiRES MAY 1. 19 4
sown by AmuscAN NRE & CASUALTY CO.
My Commission Expires Public, S e-of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice•fo's inspection; or faulty
materials and /or workmanship.