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1200 NE 102 St (11)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 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____Dr___- No.120.0. _ -� -EL --- -_ - - - -- Street_ 102 St Registered Architect and /or Engineer____________._________ Employing Plumber's Name_O__ __.4,1Oyd - Se-p.tic -Tank arvi' e__ No-8.80.1.1L11 22 AYEStreet_litami Fla 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)_____ New Building ____ _ -- Remodeling —___ _ __ _ Addition_ Size Septic Tank Feet of Drain Tile______ STATE OF FLORIDA, COUNTY OF DADE. 0 Amount of Permit $ _Type of Tank_ __Dist. Feet of Tank or Drain Field from Well Blorti Subdivision____ Street Repairs_Re.lay No. of Stories Capacity Gals. Nature of Water Supply: ....... _____Size of Soakage Pit (Signed) - __ C-t-'_l. % 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 permit, as are licensed by Miami Shores Village. (Signed) Date 11/19/64 Master Plumber. Plumbing Inspector. 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 worlmvanship. 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 CONK. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK 25 FT - - - - 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 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____Dr___- No.120.0. _ -� -EL --- -_ - - - -- Street_ 102 St Registered Architect and /or Engineer____________._________ Employing Plumber's Name_O__ __.4,1Oyd - Se-p.tic -Tank arvi' e__ No-8.80.1.1L11 22 AYEStreet_litami Fla 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)_____ New Building ____ _ -- Remodeling —___ _ __ _ Addition_ Size Septic Tank Feet of Drain Tile______ STATE OF FLORIDA, COUNTY OF DADE. 0 Amount of Permit $ _Type of Tank_ __Dist. Feet of Tank or Drain Field from Well Blorti Subdivision____ Street Repairs_Re.lay No. of Stories Capacity Gals. Nature of Water Supply: ....... _____Size of Soakage Pit (Signed) - __ C-t-'_l. % 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 permit, as are licensed by Miami Shores Village. (Signed) Date 11/19/64 Master Plumber. Plumbing Inspector. 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 worlmvanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of N. Building + ' Architect Contractor r' or Builder Legal Lot Description Address of Building • CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE it — 19 PERMIT B1 N9 5894 Work to be performed under this Permit - 4.L_ 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 applica- tion 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 respon- sibility for work done by his agents, servants or employees. r Signed. f 1 ' . 1 In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all aordinances`antregulatfons pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee. BY _ c 1 Th Subdi- vision Value of Project $ :t e Contractor's License No. Amount of Permit $ ; AUTHORITY Aceor .MIAIoII SHORES VILLAGE, FLA. N9 6416 JOB f o ADDRESS 1 U`l) ' / l o 2Yl� INSPECTION TIME READY REMARKS : V INSPECTOR DATE JOB: AD: f ,1!" 1/2. BUILDING Inspector's Report: • • ELECTRICAL • PLUMBING • • • • • • • • • • • • • • • • • • • • • WORK DONE BY: REQUESTED • • The following is ready for Inspection: { • • • • : WILL BE READY