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REQUEST FOR INSPECTION
A
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Company o r+ o
Job
Address
Inspection
Time Ready
Date Ready
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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.