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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.