1160 NE 102 St (2)MIAMI SHORES V
BUILDING DEPA
305- 795 -2204
Building Inspection Requ
Date f2)5. Time
Type Insp'n nlo aci n cle(c) .
Permit No. P I a CCU 3 - P.30 .
Name
Address MOO OO E_ tO a s- -
Company t- )( tow rc
Phone #
For Inspector: p\ 1 & Date
Approved
Correction
Re- Insp'n Fee ❑
Type Insp'n
Phone #
Inspection Date
Approved
Correction
Re-Insp'n Fee
z 4Z9
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui ding Inspection Request
Date 0 IS
Permit No. P) O r 2 5V
Name ( S.S X.� ff
Address 1 1(® I `1e (015
Company rn0 r low Plum
S
Permit No ' " 11
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date..._ . f. 'K5
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. Q �
Owner's Name and Address 4 A R S O' /" No I / G 0 Street_.N c /0Z Y° (7
Registered Registered Architect and /or Engingg
M t Is" t O PGII IC 7 ` /N'_
Employing Plumba�c's Name._.,$ - �� V �e i
Location and Legal Description Lot. Block Subdivision
Street and Number where work is to be performed —No / / ( 0 st k --- 0 Z $
State work to be performed and purpose of bulkling (By Floors )__.R 1./3x____2—.C!P S G! z'.._- fA I N
New Building - - -_._ _-- •-- .........._.. Remodeling-- .__.._.____ Addition.. __ —_..__ Repairs L.
No..._.. _ L. .. rtroot__ ..2A , . ►.
Size Septic Tank_ Type of Taf
Feet of Drain Tile Di Feet of Tank or Drain Field from
Nature of Water Supply: City—Well. ..04 Size of Soakage Pit.
Amount of Permit $ t S (Signed)_ . ...... : :.'.
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 5968, Compiled General Laws of Florida Permanent Supplement, and IIa' com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em oyed 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 c p .11c notice or notices as are
required by the Act. The undersigned agrees to employ only such sub -contr work to perf • • - this permit, as are
licensed by Miami Shores Village. '
------- - -•_ -- ... _-...__...Capacity
No. of Stories ..........
.1 of
STATE OF FLORIDA, I µ
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 be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
M C Expo Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made whom soak ss.bsep$ode Y Bsads•noo$asary by improper notice far fespectloa, or faulty
materials and /or workmanship.
BATH
TUSs
"ow".
LAVA.
TORIES
SIN"
GLOP
$INKS
LAUNDR
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
PIIITUR[•
Corm.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
BOLA-
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'
POOL
I !
Comm.
LIFT
I
.--
CHECK
Permit No ' " 11
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date..._ . f. 'K5
Application is Hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. Q �
Owner's Name and Address 4 A R S O' /" No I / G 0 Street_.N c /0Z Y° (7
Registered Registered Architect and /or Engingg
M t Is" t O PGII IC 7 ` /N'_
Employing Plumba�c's Name._.,$ - �� V �e i
Location and Legal Description Lot. Block Subdivision
Street and Number where work is to be performed —No / / ( 0 st k --- 0 Z $
State work to be performed and purpose of bulkling (By Floors )__.R 1./3x____2—.C!P S G! z'.._- fA I N
New Building - - -_._ _-- •-- .........._.. Remodeling-- .__.._.____ Addition.. __ —_..__ Repairs L.
No..._.. _ L. .. rtroot__ ..2A , . ►.
Size Septic Tank_ Type of Taf
Feet of Drain Tile Di Feet of Tank or Drain Field from
Nature of Water Supply: City—Well. ..04 Size of Soakage Pit.
Amount of Permit $ t S (Signed)_ . ...... : :.'.
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 5968, Compiled General Laws of Florida Permanent Supplement, and IIa' com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em oyed 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 c p .11c notice or notices as are
required by the Act. The undersigned agrees to employ only such sub -contr work to perf • • - this permit, as are
licensed by Miami Shores Village. '
------- - -•_ -- ... _-...__...Capacity
No. of Stories ..........
.1 of
STATE OF FLORIDA, I µ
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 be has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
M C Expo Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made whom soak ss.bsep$ode Y Bsads•noo$asary by improper notice far fespectloa, or faulty
materials and /or workmanship.