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230 NE 102 St (10)Permit No. .. 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 the progress of work. se 1) No. 30 Street N k / 02^ Owner's Name and Address � V �' N • Registered Architect and/or En sneer in Pt Ma V ` C*W k 04071 Lk Employing Plumber's Name 0 I 4' A E�1071 G / ��• No. New Building Street and Number where work is to be performed — No. Street State work to be performed and purpose of building (By Floors) MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Remodeling Addition Date 4- /A 1 /9 � Street � f �S N ,1 Ve._) Location and Legal Description Lot Block Subdivision 23o Ivy 102-t S,7 Repairs No. of Stories Size Septic Tank 2 Type of Tank Capacity Gals. /� Feet of Drain Tile J Off./ 17 Nature of Water Supply: City - Well e. 00 Amount of Permit $ �+ Dist. Feet of Tank or Drain Field from Well (Signed) (Signed Size of Soakage Pit i.rws_RDR_A Aimal 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 d has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work .. a pe formed 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 : • required b e . The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Mi: .res V' /9 1� Master Plumber. STATE OF F RIDA, COUNTY 0 • .ADE. 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 $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNTAINS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G. POOL CONTR. UST CHECK Permit No. .. 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 the progress of work. se 1) No. 30 Street N k / 02^ Owner's Name and Address � V �' N • Registered Architect and/or En sneer in Pt Ma V ` C*W k 04071 Lk Employing Plumber's Name 0 I 4' A E�1071 G / ��• No. New Building Street and Number where work is to be performed — No. Street State work to be performed and purpose of building (By Floors) MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Remodeling Addition Date 4- /A 1 /9 � Street � f �S N ,1 Ve._) Location and Legal Description Lot Block Subdivision 23o Ivy 102-t S,7 Repairs No. of Stories Size Septic Tank 2 Type of Tank Capacity Gals. /� Feet of Drain Tile J Off./ 17 Nature of Water Supply: City - Well e. 00 Amount of Permit $ �+ Dist. Feet of Tank or Drain Field from Well (Signed) (Signed Size of Soakage Pit i.rws_RDR_A Aimal 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 d has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work .. a pe formed 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 : • required b e . The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Mi: .res V' /9 1� Master Plumber. STATE OF F RIDA, COUNTY 0 • .ADE. 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 $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. Permit No. Amount of Permit $ 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 (Abel 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 Divisior 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. (L �/ Owner's Name and Address A - _-_ -. . _ No Street Registered Architect and /or Engineer A A SEPTIC TANK CO. INC. 1123 E. 23rd :...T. HIALEAH Employing Plumber's Name _.___ No.__ Street Location and Legal Description �.) - Lot____ 881114 88- 49'Sl .__._____ � Subdivision Street and Number where work is to be performed —No 3 0 c / 6' '- ''Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling Addition Repairs t No. of Stories Size Septic Tank Type of Tank___ Capacity Gals Feet of Drain Tile /a u eat Dist. Feet of Tank or Drain Field from WeIL Nature of Water Supply: City —Well ___.____Size of Soakage Pit (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 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 1 - J 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 appeare 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 fac 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 faul materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TU BS URINALS CATCH BASIN FLOOR DRAIN DRINKI FOUNT' N5 TOTAL FIXTURE, CONTR. LIST -- CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No. Amount of Permit $ 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 (Abel 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 Divisior 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. (L �/ Owner's Name and Address A - _-_ -. . _ No Street Registered Architect and /or Engineer A A SEPTIC TANK CO. INC. 1123 E. 23rd :...T. HIALEAH Employing Plumber's Name _.___ No.__ Street Location and Legal Description �.) - Lot____ 881114 88- 49'Sl .__._____ � Subdivision Street and Number where work is to be performed —No 3 0 c / 6' '- ''Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling Addition Repairs t No. of Stories Size Septic Tank Type of Tank___ Capacity Gals Feet of Drain Tile /a u eat Dist. Feet of Tank or Drain Field from WeIL Nature of Water Supply: City —Well ___.____Size of Soakage Pit (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 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 1 - J 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 appeare 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 fac 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 faul materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building EJ.,I 4 p/.AJ tr. Lot MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 3662 6 — J 4...4 - B1 2 n Ai 4 / ©l 41 Signed. Work to be performed under this Permit LV Subdi- vision Value of Project $ INSPECTOR DATE S // 195 Contractors +y License No. dr Amount of Permit $ This permit is granted to the contractor or builder named above to construc 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 specific • ons and-that he assumes responsibility for work done by his agents, servants or employees. In consideration of the issuance to me of this permit I agree to perform the work covered here der in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitte• 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. 1 CONTRACTOR OR BUILDER BY AUTHORITY a STATE OF FLORIDA, COUNTY OF DADE. Permit No Disapproved (Signed) MIAMI SHORES VILLAGE P 2 " 4444 " 1- 7 : 3 7517 BUILDING INSPECTION DEPARTMENT APPLICATION FOR Application is hereby made for the approval of the detailed stateibin o •e plans an• s or other structure herein described. This application is made in compliance and conformity with Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Mia tions of the Building Division of Miami Shores Village shall be complied with, whether herein and specifications must be kept at building during progress of the work. Latrt,_ Date 1 Owner's Name and Address C > Registered Architect and /or Engineer_ Name and address of licensed t -t4 �� ls ' � Location and legal description of lot to be built op: Lot Block_ Subdivision Street and Number where work is to be d e r al J® ICE ue Id 7 State work to be done and purpose of bun y —,-_- . Date Date__ Building Inspector My Commission Expires PERMIT ations herewith submitted for the building e Building Ordinance of Miami Shores Shores Village and all rules and regula- ecified or not. A copy of approved plans ____ Street_ Read, Sworn to and Subscribed before me. Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member .__ Member — Council Approved_ Date bisapproved 19L� and for no other purpose. 4. ," New Build' Remodeling__ ___________ Addition To be constructed of_ _______ _ Kind of foundation__ Estimated Total cost of improvements $ ______Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 complied 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 subcontractors, on work . be perform d under this permit, as are licensed by Miami Shores Village. Remarks (Signed) ' Repairs No. of Stories Roof Covering__ 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. _—Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. ^ (Q3 a •gta 'tetra Y /,, - s, / � / - j �. / d,--- 7 BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder MIAMI SHORES VILLAGE, FLORIDA ERMIT N° 3533 Work to be performed under this Permit y_ iii . ii C"'.. rl.A .�i,�•'.,�. Signed• 0 :u h Construction may bi in v.ola ... , .t Z.:: 1: is ucls1 Subdi- vision CONTRACTOR OR BUILDER 13Y \c•u DATE Contractor's License No. a:. ii, t#.rd io consult your War ,oil Eo:,d oitc.: Decor* starting the work authorized in this permit. Legal Lot Bl. Description Address of j �. rj _ Value of Amt. of Building i?' tP L l L+f Project Permit 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 specifications and that he assumes responsibility for work done by his agents, servants or employees. 3 SPECTOR By « { . In consideration of thAjissuance to me of this permit I agree to perform the work cov- ed ereunder in compliance with a11.pmdinances and egy tionst?ertaining thereto and in strict conformity with the plans, drawings, statements or s. ations submitted to the proper aunties of Miami Ih&JeQ Village. In accepting thig permit I assume responsibility for all work done by either myself, my agent, servant or employee. AUTHORITY 194i_ BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder MIAM ERMIT Work to be performe . .L1 - CONTRACTOR OR BUILDER SHORES VILLAGE, FLORIDA DATE t _ 3 Contractor's License No N° 3537 under this Permit Subdi- vision Value of Project Wort"NGPThis Construction may be in Voiotia if 4: D ,. .._t:__ a and Genwrral Limitations Of d, You arc ( aur{onrd to consult your War Produc,ioii Sa.a.d aitice oefore starting the work authorized in this permit. Legal Lot ' Description Address of Building 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 cowered hereby whether shown on the ens or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed• In consideration of the issuance to me of this permit I agree to perform the work c ve'red hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In acceptipg.his permit I as me responnsibilit} for all work done ywhher myself, t agent, servant or employee. Amt. of Permit I. t By - .44.44/ ^ �0 C .*** �`INSY�GTOR BY AUTHORITY 19 4�1� Work done by When reacly Received by Date Time IZSPECTION Permit No. Z./ Adc of work 3 ozyfrL /0 Owner &:64,0 Aci„, Septic Tank zeri Drainfield /// Plumbing - Final Rough Top out AM . PM . 9 New Building ✓ STATE OF FLORIDA, COUNTY OF DADE. Permit No 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 __ No o Registered Architect and /or Engineer MIAMI SHORES VI .L GE PLUMBING INSPECTION DEPh ENT APPLICATION FOR PLUMB�I,DI'G PERMIT ss. / • Size Septic Tank 4 y a s w fr Type of Tank Y Capacity Gals. Feet of Drain Tile 1 _ ` - 4 3 f' - Dist. Feet of Tank or Drain Field from Well ' ""4 Amount of Permit $_ 4 �A (Signed) a Date Street Employing Plumber's Name fk 2 7 __ __ No. ? ` 4 iR 'Street — ( s Location and Legal Description Lot : Block 6 Subdivision A t Street and Number where work is to be performed —No 2 Street `Z.r State work to be performed and purpose of building (By Floors) Remodeling Addition Repairs No. of Stories ..__ N► a Nature of Water Supply: City - Size of Soakage Pit $lmbmg 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. -c 1d (Signed) -. — Master Plumber. 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 workmanship. / e CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK . SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST { CHECK New Building ✓ STATE OF FLORIDA, COUNTY OF DADE. Permit No 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 __ No o Registered Architect and /or Engineer MIAMI SHORES VI .L GE PLUMBING INSPECTION DEPh ENT APPLICATION FOR PLUMB�I,DI'G PERMIT ss. / • Size Septic Tank 4 y a s w fr Type of Tank Y Capacity Gals. Feet of Drain Tile 1 _ ` - 4 3 f' - Dist. Feet of Tank or Drain Field from Well ' ""4 Amount of Permit $_ 4 �A (Signed) a Date Street Employing Plumber's Name fk 2 7 __ __ No. ? ` 4 iR 'Street — ( s Location and Legal Description Lot : Block 6 Subdivision A t Street and Number where work is to be performed —No 2 Street `Z.r State work to be performed and purpose of building (By Floors) Remodeling Addition Repairs No. of Stories ..__ N► a Nature of Water Supply: City - Size of Soakage Pit $lmbmg 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. -c 1d (Signed) -. — Master Plumber. 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 workmanship. / e ■,1 r" 1 • MIAMI SHORES VILLAGE Permit No Application is hereby made for the approval of the detai ed 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 __�. R+'v'r Cir Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Loth F__ 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 Repairs —___ No. of Stories Size Septic Tank! _y_ t_t Type of Tank __ / Capacity Gals. _ _ --- ---- - - - -- -- - - - - - - -- Amount of Permit $- _________ i___ STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary appeared My Commission Expires PLUMBIN G INSPECTION'DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date , = 9 ' t Block 3_ " _ (Signed) No 1.1 a h. Street / 6 No. .___ _!._._1_:_L. Iv "S treet Subdivision___ .44 / – Street Notary Public, State of Florida Feet of Drain Tile _L___ ___ Dist. Feet of Tank or Drain Field from Well h___.!„L,NV Nature of Water Supply: City —Welt Size of Soakage Pit _____ –_________________________ ____________________ ______ _____ _ – __ - _ m ng Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed 0 ) a / / ♦ Iaster Plumber. a public, duly authorized to administer oaths and take acknowledgments, personally 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- 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 workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS 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 SWIM'G POOL CONTR. LIST CHECK MIAMI SHORES VILLAGE Permit No Application is hereby made for the approval of the detai ed 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 __�. R+'v'r Cir Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Loth F__ 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 Repairs —___ No. of Stories Size Septic Tank! _y_ t_t Type of Tank __ / Capacity Gals. _ _ --- ---- - - - -- -- - - - - - - -- Amount of Permit $- _________ i___ STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary appeared My Commission Expires PLUMBIN G INSPECTION'DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date , = 9 ' t Block 3_ " _ (Signed) No 1.1 a h. Street / 6 No. .___ _!._._1_:_L. Iv "S treet Subdivision___ .44 / – Street Notary Public, State of Florida Feet of Drain Tile _L___ ___ Dist. Feet of Tank or Drain Field from Well h___.!„L,NV Nature of Water Supply: City —Welt Size of Soakage Pit _____ –_________________________ ____________________ ______ _____ _ – __ - _ m ng Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations a 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed 0 ) a / / ♦ Iaster Plumber. a public, duly authorized to administer oaths and take acknowledgments, personally 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- 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 workmanship.