54 NE 101 St (9)WORK DESCRIPTION ICN / 2 4L itaa our) 2
Square Ft. Estimated Cost (value) `3OcD eb
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address c if Ng 10 1 Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenann i! A RR 'i P U AA A Master Permit # 13'6
Owners Address Phone C3 - 5 - t41
Contracting Co. . A 16 U IJ co P L OK I J I N C Address
Qualifier T(A:t(A C • q ss# ( - Phone 14) 43$- &I
' *rib f, 310D i� _ pe cy 2$Ins. Co.
State # municipal # Competency #�j� Ob02
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL ' LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
i> C
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNERS AP PIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the wor stat
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PE
APPROVED:
Zoning
Mechanical
r 6
RADON
1 NOTARY < ,C) ?) BOND
otary as ontract or er- : uilder u ate
My Commission Expireg
P�v„ FFICIAL NOTARY SEAL
6
ANGELA M BECKER
l'i ( fi r COMMISSION NUMBER
Q CC786697
y! MY COMMISSION EXPIRES
` f� NOV. 15,2002
Electrical
Structural Engineer
EM
TN TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
DET
LIGHT OUTLETS
CENTRAL HEATING
SHWASHER
1
RECEPTACLES
A/C (WIND)
S?OSAL
SERVICE TEMPORARY
A/C (CENTRAL)
.INKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
OCR DRAIN ;
SERVICE REPAIR/METER CHANGE
REFRIGERATION
EASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
TERCEPTOR
RANGE TOP
UNDERGROUND TANKS
.VATORY
2
OVEN
ABOVE GROUND TANKS
JNORY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
.OTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
CNER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
NK, POT /3 COMP.
MOTORS OVER 3- 5 If
MECHANICAL VENTILATION
NK, RESIDENCE
i
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
NK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
:6PORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
1INAL
MOTORS OVER 25-100 HP
COOLING TOWERS
.TER CLOSET
2
MOTORS OVER 100 If
VIOLATION
DIRECT WASTES .
1
A/C WINDOW
REINSPECTION
;TER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
.
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIIIIING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
:WER CONNECTIONS
SIGN TRANSFORMERS
'ILITY -SEWER
SIGN TIME CLOCK
j
'ILITY -WATER
FIXTLRES
:PTIC TANK
ANTENNA .
:LAY
TELEVISION OUTLETS
tAINFIELD, 4' TILE/RES.
VIOLATION
,14" S ABANDON SEPTIC TANK
REINSPECTION
)AKAGE PIT CU. FT.
;TCH BASIN
'SCHARGE WELL
)MESTIC WELL
tEA MAIN
/OF INLET
)LAR WATER HEATER
RE STANDPIPE
)OL PIPING
;WN SPRINKLER SYSTEM
S RANGE
:TER SET (GAS)
.S PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
.N APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
)BTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
Date
Legal Description
Owner/Lessee / Tenant ( ►.-•A (L (( A R E
Owner's Address
Contracting Co.
Qualifier
State #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL
WORK DESCRIPTION Q- eouso WSJ
Square Ft. Estimated Cost (value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR II1IPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zo ' f.:: Furthermore, I authorize e I . ve -named contractor to do the work tated.
!or Condo Presi
FEES: PE
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 52/ IVe I 0 1 ST. Tax Folio
l- cT 4- to i' S. 5t 0 ms Sed
PS to P&10
RADON
APPROVED:
Zoning Building
Mechanical Plumbing
rl.Q/?/?if:vn
Municipal #
/0-'7- CO
Date
Historically Designated: Yes No t1
U AA- A Master Permit # 0771/ f
ddress 74'c7 /r!JGU q j CU.+% P
SS#
Competency #
Address
Address
Address
Phone 3 05- q7
MECHANICAL MECHANICAL ROOFING PAVING FENCE SIGN
W
+1 Iiirl. er -B , ilder
•
My ommmssion xpue
C.C.F. /' a 0 NOTARY 0 ' BOND
Electrical
it 3 )-n6 — 13 -
Ins. Co. . 26,12 -7 !1(.'G
TOTAL DUE
.,Sz� " 9J
to 0 0
Date
Oct
ate
Structural Engineer
ITEM
;ATM 1l6
UNIT
FEE
ITEM
SWITCH OUTLETS•
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FE E
IWET
LIGHT OUTLETS
CENTRAL HEATING
) I SHAS1f.R
RECEPTACLES
A/C (WIND)
1ISNOSAL OSAL
SERVICE TEhPCRARY
A/C (CENTRAL)
;R INKING FOUNTAIN •
SERVICE SIZE IN AhPS
DUCT WORK
LIM1 DRAIN
_
SERVICE REPAIR/)�TER CHANGE
_
REFRIGERATION
A EASE TRAP
APPLIANCE OUTLETS
PROCESS A AND PRESS PIPING
HTERCEPTOR
_ RANGE TOP
UNDERGRO TANKS
.AVATORY
OVEN
ABOVE (MOUND TANKS
AUNORY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
LOTHES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
IUKER •
'INK,
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
POT /3 COMP.
MOTORS OVER 3- 5 FP
MECHANICAL VENTILATION
INK, RESIDENCE
MOTORS OVER 5- 8 FP
TRANSPORTING ASSEMBLIES
INK, SLOP
MOTORS OVER 8- 10 FP
ELEVATORS/ESCALATORS
R INAL RY WATER CLOSET
MOTORS OVER 10- 25 FP
0
FIRE SPRINKLER SYSTEMS
RINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
ATER CLOSET
MOTORS OVER 100 FP
VIOLATION
ADIRECT WASTES
A/C WINDOW
RE INSPECT ION
ATER SUFPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
F IRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
HEATER
GENERATORS TRANSFORMERS
- REPLACE
laxN
-- -�
GENERATORS TRANSFORARS
SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
:WER CONNECTIONS
.ILITY
SIGN TRANSFORMERS
-SEWER
ILITY
SIGN TIME CLOCK
-WATER
PT
FIXTLRES
IC TANK
ANTENNA
LAY
TELEVISION CUTLETS
AINFIELO, 4' T1LE/RES. -.
VIOLATION •
4 & ABANDON SEPTIC TANX
4KAGE
RE INSPECT ION
PIT CU. FT.
rcH BASIN
IARGE WELL
4ESTIC WELL
:A GRAIN
)F INLET
0
.AR WATER HEATER
-�
IE STANDPIPE
-
►---
IL PIPING
.
N SPRINKLER SYSTEM
RANGE
---
ER SET (GAS)
r—�--
P IP RG
PLUMBING
urev ! Ca AJ
Huutivuum iu BUiLUINU PERMIT APPLIUAI•IUN
(AN APPLICATION FOR BUILDING PERMIT RUST ACCOMPANY THIS ADDENDUM. IF A RASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
ELECTRICAL
MECHANICAL
CLOSETS
BATH
TUB•
SHOWERS
LAVA•
TORIE/
SINK/
SLOP
SINK[
LAUNDR
TU /S
URINAL/
CATCH
SAWN
FLOOR
DRAIN
°PUNKIN°
FOUNT'N/
TOT..L
PI[TI RES
CONTR.
LI'T
r - �
'
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H
DEEP
WELL
SPRKLR.
SY STEM
SWIM'°
POOL
I
C o. NTw
LIFT
..-"-' 'W1
HT •••+"
CHECK _
n /
l il
.
1'enni: No...
Amount of Permit
State work to be performed and purpose of building (By Floors)
STATE OF FLORIDA, }
ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
:,,' it III is Lerch) made for the approval of the detailed statement of the plans and specifications herewith subr.i :",..-1 for the building or other
; herein described. This application is made in compliance and conformity with the Building Ordinance of Mi.:- ••t Shores Village, Florida,
a,:d all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic- of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec fications must be kept at
'auilding during progress of work.
`.)vner's Name and Address ....
•�2S�'
.egi,t Architect and /or Engineer
mploying Plumber's Name
n � No v20 . .Y .: Street. .=.,W'
Location and Legal Descrip on Lot Block ' � Subdivision
Street and Number where work is to be performed —No.s� �� E1. (1 %, .2 eet
New Building Remodeling___ ..... Addi ion
Size Septic Tan_-. -- -- .---- •• - - -• -- 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
-- ----- ----- - - - - -- --
��%�' <'�
Plu mbing; Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a ndlover of 1a101
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent fupi lenient, and ha, , .�n �•
i with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed 1 y him in t ,! 'F! rk r b.
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publ; notice T. po icer •rs as
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed '.,a this > rl.li; ;u .
licensed by Miami Shores Village.
Date 6'
_ Street 4.4. . /o '
Capacity ^ .als
My Commission Expires Notary Public, State of Florida
Repairs No. of Stones
Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, per or,e; ' , ppeare .
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 ti1at all acts
therein by hin, stated are true.
NOTE: A re- inspection fee of $1.00 will be made when sins re- inspection Is mede•neoasary by improper notice for inspection, or fruit)
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No /9 Date..._. 73.17.7 ......
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 Edward B. Tait No.____ Street
Registered Architect and /or Engineer
Employing Plumber's Name Rose S s►p t i c T �n k Co P, 4 . �p�p,.,,,,], ,,. „ ,... ,,.,,..,< . -. ,
Location and Legal Description Lot- 887-5594 Bl ock ■
Street and Number where work is to be performed -No 54 N N. E E . 101 street Street.
State work to be performed and purpose of building (By Floors) __.____. - -..
N Building Remodeling___ __.___ Addition
Repairs No. of Stories..
Capacity Cals.
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 $ 4.00 - g
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 liar 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.
(Styled)
Master Plumber.
STATE OF FLORIDA, 1 µ
COUNTY OF DADE. 1
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 web raiospectioe is made. necessary by improper notice for Inspection, or fault'
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWER•
LAVA-
TORIES
SINKS
SLOP
SINK•
LAUNDRY
Tun•
URINAL•
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIIITUR[•
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
PILLD
SOAKAGE
PIT
GRIMM
TRAP
SOLAR
N
DEEP
WELL
BPRKLR.
SYSTEM
BWIM'O
POOL
CONTR.
25
(
LIST
1
I
CHICK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No /9 Date..._. 73.17.7 ......
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 Edward B. Tait No.____ Street
Registered Architect and /or Engineer
Employing Plumber's Name Rose S s►p t i c T �n k Co P, 4 . �p�p,.,,,,], ,,. „ ,... ,,.,,..,< . -. ,
Location and Legal Description Lot- 887-5594 Bl ock ■
Street and Number where work is to be performed -No 54 N N. E E . 101 street Street.
State work to be performed and purpose of building (By Floors) __.____. - -..
N Building Remodeling___ __.___ Addition
Repairs No. of Stories..
Capacity Cals.
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 $ 4.00 - g
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 liar 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.
(Styled)
Master Plumber.
STATE OF FLORIDA, 1 µ
COUNTY OF DADE. 1
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 web raiospectioe is made. necessary by improper notice for Inspection, or fault'
materials and /or workmanship.
Permit No
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 w ear}:.
Owner's Name and Address _ .______.__ -_ _"___ --- No Street__
Registered Architect and /or Engineer__ _-- //
Employing Plumber's N. , _ � - _ i � �
No. ___- -- _ .l'0 __ !__— Street -- -- _ s_ ---
7
Location and Legal Description Lot___ ______�_______ _ _ _ lock____ _! Subdivision
s -
Street and Number where work is to be performed— No.___ — __ —_ _ Street p a/ - C
State work to be performed and purpose of building (By Floors)
New Building Remodeling______ Addition • - Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
MIAMI SHORE'S, VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
Type of Tank____ Capacity Gals
Dist. Feet of Tank or Drain Field from Well
_Size of Soakage Pit
(Signed)_
Date
The undersigned applicant for this building permit does hereby certify that he understands and accep
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo
plied with the provisions thereof, and will require similar compliance from all contractors or sub -co
performed under this permit; and will post or cause to be posted for inspection on the site of
required by the Act. The undersigned agrees to employ only such sub- contractors, o
licensed by Miami Shores Village.
his obligations as ay em
Permanent Suppl m
actors employed by In
work uch public notice o
rfo ,e•, ;nder
• / � % //I
z7-/
Plumb
My Commission Expires Notary Public, State of Florida
loyer of labor
and has com-
e work to be
notices as are
permit, as are
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE. I
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
SHOWERS
LAVA-
TORIES
S
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
LIST
X
X
CHECK
Permit No
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 w ear}:.
Owner's Name and Address _ .______.__ -_ _"___ --- No Street__
Registered Architect and /or Engineer__ _-- //
Employing Plumber's N. , _ � - _ i � �
No. ___- -- _ .l'0 __ !__— Street -- -- _ s_ ---
7
Location and Legal Description Lot___ ______�_______ _ _ _ lock____ _! Subdivision
s -
Street and Number where work is to be performed— No.___ — __ —_ _ Street p a/ - C
State work to be performed and purpose of building (By Floors)
New Building Remodeling______ Addition • - Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
MIAMI SHORE'S, VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
Type of Tank____ Capacity Gals
Dist. Feet of Tank or Drain Field from Well
_Size of Soakage Pit
(Signed)_
Date
The undersigned applicant for this building permit does hereby certify that he understands and accep
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo
plied with the provisions thereof, and will require similar compliance from all contractors or sub -co
performed under this permit; and will post or cause to be posted for inspection on the site of
required by the Act. The undersigned agrees to employ only such sub- contractors, o
licensed by Miami Shores Village.
his obligations as ay em
Permanent Suppl m
actors employed by In
work uch public notice o
rfo ,e•, ;nder
• / � % //I
z7-/
Plumb
My Commission Expires Notary Public, State of Florida
loyer of labor
and has com-
e work to be
notices as are
permit, as are
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE. I
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.
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑ Date M 19 (°''
ELECTRICAL ❑
PLUMBING PERMIT NiD 8626 Contractor's
ROOFING ❑ License No. r , «7
Owner of
Building
❑ Work to be performed under this Permit
Architect
Contractor ,;!
or Builder :•; -� t ` . #,. i �aa.»t y t r t,t 14.
Legal Lot
Description 1 B1
Address of �•_
Building al ' ` t: lei I
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 shown on the plans br drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or mployeee(
Signed. — - _ . SPECTORJ +s BY
In consideratiop-;af the issu3 c #o dorm of this permit I agree tory orm the work covered ht'eunder in compliance with all ordinances and regulations
pertaining theretwand, co 'o' ity with the plans, drawings,)tat ents or specifications submitted to the proper authorities of Miami Shores Village.
I4ccepting s., mtt4#lssu 'res!.tl:ibility for all work done b tther, myself, my agent, servant or employee.
t I
moo wi 0_ TR A GTOR - o I.tB U I L D ER
BY AUTHORITY
41 L
,f
Subdi-
vision
Sq Ft ,pa+ '4
Value of �, 11 Amount of
Project $ ''" 11 Permit $
OWNER
LOT
BLOCK
SUBDIVISION
, j
f /M
y �
•
s,e
Date
Issued to
Fixtures $
Sewer ' $
Septic Tank $
aiami Jhores9llage
F L 0 fl 1 D A
PLUMBING PERMIT N9 _ 927
tb install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
Ot-
For a _story r r building at V:
Fixtures
Total $
Village Plumbing Inspector
Received Payment by
T
OWNER
LOT
BLOCK
SUBDIVISION
y
'
"
Date
Issued to
For a / story
iami r hbres — llage
F L 0 R 1 D A
PLUMBING, PERMIT
building at
N° 948
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
Fixtures
Fixtures $
Sewer $
Septic Tank $ '•
Total $
Village Plumbing Inspector
Received Payment by p`
OWNER
LOT
BLOCK
SUBDIVISION
Se ', , /3.
r.
Issued to 0
�hores
F L O A D A
PLUMBING PERMIT N9 948
to instA the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
24.
For a story ''" • building at
Fixtures
Fixtures $
Sewer $
O tic Tank $/ E' ,a
Total $ ,+'` Q !
Village Plumbing Inspector
,, . ate
Received Payment by
,�,: +dam 4 err).
OWNER
LOT
BLOCK
SUBDIVIS (1N
rf
r
1 w -`
t (j
�. j � I
F L 0 & 1 D A
Fixtures
Fixtures
Sewer
ddliami chores
PLUMBING PERMIT
e k e j 00
Issued to
I $ I / d 4
•tic Tank $
Total $ A ‘4(
Village Plumbing Inspector
Received Payment by
N° 927
'install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbjng and
drainage work done in Miami Shores Village, Florida.
For a. story building at ,j► /