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565 NE 101 St (3)ssds ct tie p 'daA ror to } tall the ecgtiptnetit or device delsof44+.ed.Fn 0A4 sbe wook.'ovitt be perfoemed sn ePzrc aviob • e •�x I }((ik]�ljlt� IId CYtL� Tbi5 Pej: . 4. d'r}�i be feel *0 a .00 04M e ' f 0 { �0 t4_ � s k tied the ' o �r !toes o do . o rA+CY 4 � 1F0 s a oFnek 3 fl a Y' e•. REQUEST FOR INSPECTION A i / t Company o r+ o Job Address Inspection Time Ready Date Ready 4 6 e'c'. :fit t �� ..• C.t f.,,t`�' ✓PHONE /IC Permit No 9 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 £ A 7 No v Street Registered Architect and /or Engineer /, Employing Plumber's Name___ e1RffC J T 1 • M$ f4 No 176 Street tr6 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) et A. / New Building Remodeling Addition____ Repairs ' No. of Stories Size Septic Tank Type of Tank Capacity Gals / Feet of Drain Tile /_f.l� Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Amount of Permit $ ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Block. Size of Soakage Pit ( Signed) ( Signed) Date ''1� c 2 ,_jZ$ • /I/,- /a/ s Subdivision Street ,vF 4 Notary Public, State of Florida • lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he j �� erstands and accepts his obligat'„}=', as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, 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. ter Plum STATE OF FLORIDA, 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. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT 'NS TOTAL FIXTURES CONTR. LIST -- CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST 1 CHECK Permit No 9 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address £ A 7 No v Street Registered Architect and /or Engineer /, Employing Plumber's Name___ e1RffC J T 1 • M$ f4 No 176 Street tr6 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) et A. / New Building Remodeling Addition____ Repairs ' No. of Stories Size Septic Tank Type of Tank Capacity Gals / Feet of Drain Tile /_f.l� Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Amount of Permit $ ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Block. Size of Soakage Pit ( Signed) ( Signed) Date ''1� c 2 ,_jZ$ • /I/,- /a/ s Subdivision Street ,vF 4 Notary Public, State of Florida • lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he j �� erstands and accepts his obligat'„}=', as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, 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. ter Plum STATE OF FLORIDA, 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. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tie building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, ether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. LI Owner's Name and Address ___. Registered Architect and /or Engineer Employing Plumber'si Name Location and Legal Description Lot________ —____ ___ __________________________Block Street and Number where work is to be performed —No State work to be perf• and purpose of building (By Floors) New Building__ I� _ -_ _ Remodeling Addition Size Septic Tank__: Feet of Drain Tile___ Amount of Permit ,$_ My Commission Expires _ (Signed) (Signed) _________ No. of Stories______ Date Nature of Water Supply: Cit Well Size of Soakage Pit 'Street ~ _ `��4 Subdivision__ 1' _ Type of Tank . ______Capacity Gals._____________________ Dist. Feet of Tank or Drain Field from Well______ - -_� Notary Public. State of Florida 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 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 under signed agrees to employ only such sub - contractors, on work to be •erformed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, t le undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared - -- — — — — -- — -- — -- I 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER DRAIN CONN. FIELD ) 1".' SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST CHECK Permit No. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tie building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, ether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. LI Owner's Name and Address ___. Registered Architect and /or Engineer Employing Plumber'si Name Location and Legal Description Lot________ —____ ___ __________________________Block Street and Number where work is to be performed —No State work to be perf• and purpose of building (By Floors) New Building__ I� _ -_ _ Remodeling Addition Size Septic Tank__: Feet of Drain Tile___ Amount of Permit ,$_ My Commission Expires _ (Signed) (Signed) _________ No. of Stories______ Date Nature of Water Supply: Cit Well Size of Soakage Pit 'Street ~ _ `��4 Subdivision__ 1' _ Type of Tank . ______Capacity Gals._____________________ Dist. Feet of Tank or Drain Field from Well______ - -_� Notary Public. State of Florida 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 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 under signed agrees to employ only such sub - contractors, on work to be •erformed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, t le undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared - -- — — — — -- — -- — -- I 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.