1150 NE 102 St (8)Permit No.
Date 1443.,t- .14155
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 GUM ..Hi-C.k111411- _ No. Street
Registered Architect and/or Engineer —
Employing Plumber's Name M 3ttj. T Ink Tx, . No. Street.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No.3d 50 Street RAY—. .10.2nd....at
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories.
Size Septic Tank 4,'!X.7LG! Type of Tank Pre-Cast _ Capacity Gals. sop.
Feet of Drain ..... Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well
Amount of Permit $
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 bus com
plied with the provisions thereof, and will require similar compliance from all contractor s 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 of the 'rk such p notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contracto work be e fo e.J under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, I
se.
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-
materials and/or wor
I '
41..1 •
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size of Soakage Pit
(Signed)
Notary Public, State of Florida
n fee of $1.00 will be made when such re-inspection is made •necessary by improper notice for inspection or faulty
p.
CLOSrf 15
BATH
TUBS
SHOWERS
LAVA-
Tomas
SINKS
SLOP
SINKS
LAUNDRY
Tues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
Copan.
LIST
CHUCK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW I M • G
POOL
Cormi.
LIST
CHECK
.
_
Permit No.
Date 1443.,t- .14155
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 GUM ..Hi-C.k111411- _ No. Street
Registered Architect and/or Engineer —
Employing Plumber's Name M 3ttj. T Ink Tx, . No. Street.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No.3d 50 Street RAY—. .10.2nd....at
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories.
Size Septic Tank 4,'!X.7LG! Type of Tank Pre-Cast _ Capacity Gals. sop.
Feet of Drain ..... Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well
Amount of Permit $
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 bus com
plied with the provisions thereof, and will require similar compliance from all contractor s 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 of the 'rk such p notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contracto work be e fo e.J under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, I
se.
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-
materials and/or wor
I '
41..1 •
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size of Soakage Pit
(Signed)
Notary Public, State of Florida
n fee of $1.00 will be made when such re-inspection is made •necessary by improper notice for inspection or faulty
p.