PLUMBING PERMITPermit No. __ -_ A -.'
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date 171-4-41 7 /
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othin
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 Divisior
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 __ - • No. Street 7c5- 4 Ea •
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No. Street
Amount of Permit $
Block__
No. - -- - - - Street_ to. 7>1. w• T 3 -ett - •
Subdivision
State work to be performed and purpose of building (By Floors ) _
New Building___. Remodeling Addition____ Repairs No. of Stories
Size Septic Tank Type of Tank_ Capacity Gals..
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water S 1 •ply: City —Well. __ Size of Soakage Pit
My Commission Expires
�_. (Signed)_ t
Plumbing I nspector
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 undersigned agrees to employ only such sub- contractors, on work to be performed under this perniit, as art
licensed by Miami Shores Village.
(Signed) ---- •
STATE OF FLORIDA,
COUNTY OF DADE. f
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 Etc
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKI NO
FOUNT' NS
TOTAL
FIXTURE!
CONTR.
LIST
--
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No. __ -_ A -.'
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date 171-4-41 7 /
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othin
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 Divisior
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 __ - • No. Street 7c5- 4 Ea •
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot
Street and Number where work is to be performed —No. Street
Amount of Permit $
Block__
No. - -- - - - Street_ to. 7>1. w• T 3 -ett - •
Subdivision
State work to be performed and purpose of building (By Floors ) _
New Building___. Remodeling Addition____ Repairs No. of Stories
Size Septic Tank Type of Tank_ Capacity Gals..
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water S 1 •ply: City —Well. __ Size of Soakage Pit
My Commission Expires
�_. (Signed)_ t
Plumbing I nspector
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 undersigned agrees to employ only such sub- contractors, on work to be performed under this perniit, as art
licensed by Miami Shores Village.
(Signed) ---- •
STATE OF FLORIDA,
COUNTY OF DADE. f
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 Etc
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul
materials and /or workmanship.
ING
KCAL
PLUMBING
e r of
Building
/, g
Architect
;contractor
or Builder - , )k
Leg'. Lot
'ption
Address of
Building
This
EIS C-4i
CON R
Work to i be performed under this Permit
t.
€UIL
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 9073
r
Subdi-
vision.
Value of
Project $
DATF /),"/ .1 < , c� / 19S
Contractor's
License No.
Amt. of
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
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 # 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
gran is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
per • to the work covered hereby whether shown on the plans or drawings or in the statements,or specifications and that he assumes responsibility for work
done by agents, servants or employees. f ,/ /
Signed. r 't . /' i f' ;'' BY i i f r ,'
INSPECTOR
I In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. / LY Date__ (!l11 C _ � � ._ f L ! ■t-J g 1
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/ 6i- / 3 - }) s' 1 �- No 1' 1� =__ Street / 61) , / / Z 2_
Registered Architect and /or Engineer
Employing Plumber's Name No Street
Location and Legal Description Lot
Block
Subdivision
Street and Number where work is to be performed—No ........ __________________ Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Nature of Water Supply: City —Well
Amount of Permit $___ 0 J
ss.
_ (Signed)
No. of Stories__ -
Size Septic Tank Type of Tank_ Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he ufderstands and accepts his oblig3 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) - - -.ZL ,., !!_ 5fL.1.
. �f
Master Plurnber.
STATE OF FLORIDA, 1
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.
—
My Commission Expires Notary Public, State of Florida
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. ET
LIST
/
-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
• WELL
SPRKLR.
SYSTEM
SWIM'G
POOL '
/• e
,
/ 77��� G �� c..^�.�i+-t
P.
CONTR.
LIST
j�G(/l
CHECK
y�
c�'t
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. / LY Date__ (!l11 C _ � � ._ f L ! ■t-J g 1
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/ 6i- / 3 - }) s' 1 �- No 1' 1� =__ Street / 61) , / / Z 2_
Registered Architect and /or Engineer
Employing Plumber's Name No Street
Location and Legal Description Lot
Block
Subdivision
Street and Number where work is to be performed—No ........ __________________ Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Nature of Water Supply: City —Well
Amount of Permit $___ 0 J
ss.
_ (Signed)
No. of Stories__ -
Size Septic Tank Type of Tank_ Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he ufderstands and accepts his oblig3 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) - - -.ZL ,., !!_ 5fL.1.
. �f
Master Plurnber.
STATE OF FLORIDA, 1
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.
—
My Commission Expires Notary Public, State of Florida
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.
BUILDING
ELECTRICAL
PLUMBING
J CONTRAQTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORID
DATE °R
PERMIT N° 7990
Work to be performed under this Permit
Owner of Zri Bu ilding �� �-�'r �.� f. .. _, ,•
Architect j' f)
•
Contractor
or Builder„/ L." r / ` < ,�• ,, "... *k 4--; k.
S,
Legal Lot 4- Bl.
Description
Address of a'' 'f Value of Amt. oi -�
Building ? • _,, `, .. Pr oject Permit
This per nit is granted to the c ontractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed- • P ! ` . a .+, .B
INSPECTOR
In consideration of the issuance to me of this permit I agree to performeEh " e work covered hereunder in compliance with all o> itiances and regulations.
pertaining thereto and in strict conformity with the plans, drawings, statem t or specifications submitted to the proper authoriSO 'bf Miami Shok.e,s l,�get
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
.
Subdi-
vision
BY
• - t.. .
g r n tractor's
`cense No.
•
AUTHORITY
194
ST
LIST ��/
CHECK
SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G
TANK CONN. FIELD PIT TRAP H EATER WELL SYSTEM POOL '
CONTR.
LIST
CHECK
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications here 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 ,ll1G�t ��_�a cam- -� - �' ` - No � Street • 7 /0
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
Employing Plumber's Name '71-44 6% y_ —� t -- = • • • •• /. • • -- - �e No Street
Location and Legal Description Lot- .21.4 1 W. 11 ._tf }_�✓_______ Block ____!.l Subdivision_ S S .
Street and Number where work is to be performed —No 7 Street . 7 Le 1 / •
State work to be performed and purpose of building (By Floors) 1
New Building __- _.____J" Remodeling Addit;on Repairs
Size Septic Tank Type of Tank
Feet of Drain Tile
Nature of Water Suppl
Amount of Permit $
ss.
Dist. Feet of Tank or Drain Field from Well
ell Size of Soakage Pit
(Signed) e -` = ---t ''� •
Date. - te ."•�'.-- /& ---- t .
subm
No. of Stories
Capacity Gals.
The undersigned applicant for this building permit does hereby certify that h'u and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled eneral 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 - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
�iCGt. r
(Signed) ' - _ •
t f i Master Plumber.
My Commission Expires Notary Public, State of Florida
Plumbing Inspector.
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 T
BATH L
SHOWERS T
LAVA- S
SINKS S
SLOP L
LAUNDRY C
URINALS B
CATCH F
FLOOR D
DRINKING O
OLT'S, "
" T
TOTAL
CONTR. 1
1 /
/ ,
, —
-
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications here 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 ,ll1G�t ��_�a cam- -� - �' ` - No � Street • 7 /0
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
Employing Plumber's Name '71-44 6% y_ —� t -- = • • • •• /. • • -- - �e No Street
Location and Legal Description Lot- .21.4 1 W. 11 ._tf }_�✓_______ Block ____!.l Subdivision_ S S .
Street and Number where work is to be performed —No 7 Street . 7 Le 1 / •
State work to be performed and purpose of building (By Floors) 1
New Building __- _.____J" Remodeling Addit;on Repairs
Size Septic Tank Type of Tank
Feet of Drain Tile
Nature of Water Suppl
Amount of Permit $
ss.
Dist. Feet of Tank or Drain Field from Well
ell Size of Soakage Pit
(Signed) e -` = ---t ''� •
Date. - te ."•�'.-- /& ---- t .
subm
No. of Stories
Capacity Gals.
The undersigned applicant for this building permit does hereby certify that h'u and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled eneral 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 - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
�iCGt. r
(Signed) ' - _ •
t f i Master Plumber.
My Commission Expires Notary Public, State of Florida
Plumbing Inspector.
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.
P I
,
S Noui )A.
A l
LA (
kr ■-
L
4"
Permit No (2 - 7 Aj
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 comp 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
Registered Architect and /or Engineer____
Employing Plumber's Name1 _Jl_ / 4.1_ _al 21
Location and Legal Description Lot
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block Su
and Number where work is to be performed—No. __ 7 - _ —. Street
State work to be performed and purpose of building (By Floors) __ -_ i__. f
Size Septic
My Commission Expires
_.Type of Tank
_Dist. —
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 $ 1 o 5-2 (Signed) -- �
Date - v' J 77 5 - I.. !__ ---.----- /
Street
-6 .. C No..__.. / _ S Street __ S S
New Building _ —. __..___ Remodeling____ Addition Repairs L.
to/ ,s/
u bdivision
/0/6
2 Loc. .
No. of Stories . . .............. .
Capacity Gals
tubing 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 ' -. nanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all .,,... • s or sub - contra or employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the si of the o such public notice or notices as are
required by the Act. The undersigned agrees to employ only such su• •�,`rs, on .� : •e po •' under this permit, as are
licensed by Miami Shores Village.
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.
Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for insp•..' In, or faulty
materials and /or workmanship.
CLOBETB
BATH
TUBE
SHOWERS
LAVA-
TORIES
INKB
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
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 - G
POOL
CONTR.
LIST
CHECK
Permit No (2 - 7 Aj
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 comp 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
Registered Architect and /or Engineer____
Employing Plumber's Name1 _Jl_ / 4.1_ _al 21
Location and Legal Description Lot
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block Su
and Number where work is to be performed—No. __ 7 - _ —. Street
State work to be performed and purpose of building (By Floors) __ -_ i__. f
Size Septic
My Commission Expires
_.Type of Tank
_Dist. —
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 $ 1 o 5-2 (Signed) -- �
Date - v' J 77 5 - I.. !__ ---.----- /
Street
-6 .. C No..__.. / _ S Street __ S S
New Building _ —. __..___ Remodeling____ Addition Repairs L.
to/ ,s/
u bdivision
/0/6
2 Loc. .
No. of Stories . . .............. .
Capacity Gals
tubing 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 ' -. nanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all .,,... • s or sub - contra or employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the si of the o such public notice or notices as are
required by the Act. The undersigned agrees to employ only such su• •�,`rs, on .� : •e po •' under this permit, as are
licensed by Miami Shores Village.
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.
Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for insp•..' In, or faulty
materials and /or workmanship.
BUILDING ❑
ELECTRICAL
PLUMBING ❑
ROOFING
Owner of
Building
Architect
Contractor
or Builder j
Legal Lot II Bl.
Description
Address of
Building 1S 1
MIAMI SHORES VILLAGE, FLORIDA
❑ PERMIT N° 14372
❑ Work to be performed under this Permit
Subdi-
vision
Value of
Project $
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
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 or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • � "` :�... �� BY /
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
DATE -
Contractor's
License No
Amt. of
Permit $
BY AUTHORITY
195