210 NE 102 St (11)OP- 2 /7 7
Penni; Nu...
is hereby made for the approval of the detailed statement of the plans and specifications herewith subr.r:...1 for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi. ••! Shores Village, Florida,
...d
all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec flcations must be kept at
•�uilding during progress of work.
'.?wner's Name and Address
.egist Architect and /or Engin
?mploying Plumber's Name
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
Size Septic Tank______ Type of Tank
Feet of Drain Tile..____ __ —___ —_ —Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City—Well. . -- — .----•-- --- --- •---- •--- -- - --- --..Size of Soakage Pit
Amount of Permit S- ..
STATE OF FLORIDA, }
as.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Remodeling___ _ _ Addition
No.•'¢ g/adv r L! ,.,.. Street.
Block �_ Subdivision __.
0/D Nie.
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a n;,loyer of lefooi
under the Florida Workmen's Compensation Act, being Section 54188, Compiled General Laws of Florida Permanent rum lement, and has . tn•i•
.lied with the provisions thereof, and will require similar compliance from all contractors or s , .. •tors employed 1 y him in ' 'AI ak v b-
perfenned under this permit; and will post or cause to be posted' for inspection on the s - ct. a work .uc Oil: notice T. no icer .+s a;
required by the Act. The undersigned agrees to employ only such sub - contractors, on wor "� be�tl:rmed ? a this i s sl.sil, :r .
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, per;orr: ' t ppear• c.
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 sane, anfl that all acts
therein by hirr, stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of 11.00 will be made when such re•iaspeetioo b made'neoessary by improper notice for inspection, (r unit)
materials and /or workmanship.
(Signed) _
No. —._ ___ _. - - -_ _ — Street. . . .
Date... ..... F '
Street
Repair, No of Stones l.. •
Capacity ^ .als..
Marta Plumber.
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OP- 2 /7 7
Penni; Nu...
is hereby made for the approval of the detailed statement of the plans and specifications herewith subr.r:...1 for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi. ••! Shores Village, Florida,
...d
all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec flcations must be kept at
•�uilding during progress of work.
'.?wner's Name and Address
.egist Architect and /or Engin
?mploying Plumber's Name
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
Size Septic Tank______ Type of Tank
Feet of Drain Tile..____ __ —___ —_ —Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City—Well. . -- — .----•-- --- --- •---- •--- -- - --- --..Size of Soakage Pit
Amount of Permit S- ..
STATE OF FLORIDA, }
as.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Remodeling___ _ _ Addition
No.•'¢ g/adv r L! ,.,.. Street.
Block �_ Subdivision __.
0/D Nie.
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a n;,loyer of lefooi
under the Florida Workmen's Compensation Act, being Section 54188, Compiled General Laws of Florida Permanent rum lement, and has . tn•i•
.lied with the provisions thereof, and will require similar compliance from all contractors or s , .. •tors employed 1 y him in ' 'AI ak v b-
perfenned under this permit; and will post or cause to be posted' for inspection on the s - ct. a work .uc Oil: notice T. no icer .+s a;
required by the Act. The undersigned agrees to employ only such sub - contractors, on wor "� be�tl:rmed ? a this i s sl.sil, :r .
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, per;orr: ' t ppear• c.
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 sane, anfl that all acts
therein by hirr, stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of 11.00 will be made when such re•iaspeetioo b made'neoessary by improper notice for inspection, (r unit)
materials and /or workmanship.
(Signed) _
No. —._ ___ _. - - -_ _ — Street. . . .
Date... ..... F '
Street
Repair, No of Stones l.. •
Capacity ^ .als..
Marta Plumber.