171 NE 102 St (14)Permit No 3
MIAMI SHORES VILlAG
PLUMBING INSPECTION DEPARTMEiti' #'
APPLICATION FOR PLUMBING
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 o.ex_ i3.E_a2_.! t _ e>t_--- -- _.- __ -_ -- No.__ 7/ __ -A. E_____.____ Street
Registered Architect and /or Engineer __._— __—
Employing Plumber's Name 1 .1 41 No.
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
Amount of Permit $
Block_
(Signed)._ -kJ. e
(Signed).
Date —
Street.
Subdivision-- _- ---- ---- •-- -__
Street
Addition________._._.___ ____ -. Repairs 1( No. of Stories - -
Size Septic Tank Type of Tank_ Capacity GJls.
Feet of Drain Tile._______ - .... ---- •----- •-------- - - - - -- --Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well._______ ...... _ ....... ________.... _____________Size of Soakage Pit
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 leas 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.
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.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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 worl®anship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
I
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
- H CATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
-
_
CHECK
Permit No 3
MIAMI SHORES VILlAG
PLUMBING INSPECTION DEPARTMEiti' #'
APPLICATION FOR PLUMBING
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 o.ex_ i3.E_a2_.! t _ e>t_--- -- _.- __ -_ -- No.__ 7/ __ -A. E_____.____ Street
Registered Architect and /or Engineer __._— __—
Employing Plumber's Name 1 .1 41 No.
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
Amount of Permit $
Block_
(Signed)._ -kJ. e
(Signed).
Date —
Street.
Subdivision-- _- ---- ---- •-- -__
Street
Addition________._._.___ ____ -. Repairs 1( No. of Stories - -
Size Septic Tank Type of Tank_ Capacity GJls.
Feet of Drain Tile._______ - .... ---- •----- •-------- - - - - -- --Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well._______ ...... _ ....... ________.... _____________Size of Soakage Pit
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 leas 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.
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.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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 worl®anship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building 4 AZ l
Architect
Contractor
or Builder
Legal
Description
MIAMI SHORES VILLAGE, FLORIDA
❑ DATF
❑ PERMIT N° 3059
0
Lot
Contractor's
License No.
/ tr Z
195_
Work to be performed under this Permit
Subdi-
B1. vision
Signed:
2
O .J
Address of C. Value of I Amount of
Building f 1 t KJ C / r- 1 �- Project $ I Permit $
t►J <�L
-cb
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 Pecifieations and that he assumes responsibility for work
done by his agents, servants or employees.
BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work co red 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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
AUTHORITY
Permit No
Owner's Name and Address
Feet of Drain Tile._______
Nature of Water Supply: City —Well
Amount of Permit $
NOTE: A re-
materials and /or
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-_Dist. Feet of Tank or Drain Field from Well
(Signed)_
Date __._.._.L
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.
— - -- - No. -- — -- - — - _ Street
Registered Architect and /or En iri y ..___— __ - -__ —_
Employing Plumber's Name Ju ___ _
1 __ _ No._ _ Street-.
Location and Legal Description Lot.____________ ____ _ — B / Subdivision__- _______
y_1
Street and Number where work is to be performed —No 17 / e• ! t 7 Street_
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
_ Size of Soakage Pit
c
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 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 performej under this permit, as are
licensed by Miami Shores Village.
My ' • mmission Expires Notary Public, State of Florida
1
Master Plumber.
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.
on fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
lnnanship.
CLOSETS
BATH
TUBS
E
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE'
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWING
POOL
CONTR.
LIST
CHECK
/ 06
Permit No
Owner's Name and Address
Feet of Drain Tile._______
Nature of Water Supply: City —Well
Amount of Permit $
NOTE: A re-
materials and /or
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
-_Dist. Feet of Tank or Drain Field from Well
(Signed)_
Date __._.._.L
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.
— - -- - No. -- — -- - — - _ Street
Registered Architect and /or En iri y ..___— __ - -__ —_
Employing Plumber's Name Ju ___ _
1 __ _ No._ _ Street-.
Location and Legal Description Lot.____________ ____ _ — B / Subdivision__- _______
y_1
Street and Number where work is to be performed —No 17 / e• ! t 7 Street_
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
_ Size of Soakage Pit
c
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 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 performej under this permit, as are
licensed by Miami Shores Village.
My ' • mmission Expires Notary Public, State of Florida
1
Master Plumber.
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.
on fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
lnnanship.