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268 NE 102 St (13)Date S v ,e �rreAAT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 1 _4 Job Address 2 6 g Ai 6. 0Z J Tax Folio Legal Description // Historically Designated: Yes /erk ki( �fEF1'c2 Owner/Lessee / Tenant ,ae9 IE‘ / Contracting Co. )/ /k (' 4h 4 Owner's Address Qualifier State # Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN MECHANICAL ROOFING PAVIN FENCE SIGN I,, WORK DESCRIPTION /D I !1(JL J2 / t-o�x, f /L / 27e • 61' Square Ft. Estimated Cost (value) ne 7Grt WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. • � IT e of o as O Notary Public wner and/or C c. o President Date azy My Cq FEES: PERMIT and/or Condo President • STEPHEN E COCKING State of Florida My Comm. Exp: 08/04/01 Comm#: CC669180 �nnnnneanr•ivv rannnnnnnA RADON APPROVED: Zoning Mechanical Plumbing Building ci- ac -cte ate Address ?-70 g qa2 7 7s Phone °Z 7 75' Address 'n9 5z -14-I. 2 , SS# Competency # Ins. Co. Address Signature of Contractor or Owner- Builder Notary as to Contractor or Owner - Builder Xtirenaefil E COCKING orida Notary Public C.C.F. /..`.0 NOTARY Master Permit # Electrical No Phone ,3" 78-5 no BOND TOTAL DUE 8 6 Engineering PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address 2668 Alt . / t Tax Folio Legal ption Historically Designated: Yes /� No Owner/Lessee / Tenant gi,„,,k f f� J�'� ' Master Permit # 4 70 g Owner's Address Contracting Co. Qualifier / /heti 6 Th c ir'� t/ State # Square Ft. ,26g de to L s 7 C j;4 f 2ro4 tt —7 9'R /Sign , ��f owner or Condo President Date 67o—`f7 — l 7/ Notary as My Co FEES: PERMIT TEPHEN E COCKlNC. State of Ftori3s My Comm. Exp: 08/04!0 Comm#: CC888180 RADON APPROVED: Zoning Building Mechanical Plumbing Phone Estimated Cost (value) /Oa Electrical 7$/ —x_,_3 Address /.99 4 i ' z 111 SS# . Phone «o ,5/ i(s Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address ' Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIP'T'ION o ge7/4e.g. of^^eL 2/2›.4'"f e Jet WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Contractor or Owner- Builder / 9j) Notary as to Contractor or Owner - Builder Date My C.01nrnission Exp', 5 Y P ee-a6i zte 4 � r� Q � MY COMMISSION EXP. AFIMITION 17,1 , 98 C.C.F. t ;1151 NOTARY o Vg//,' Date BOND 5 W TOTAL DUE400.6 0 Engineering PROPERTY ID #: L D FILL REQUIRED: [ ] INCHES 0 T H E R SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: ,` G G. s _ STATE OF FLORIDA PERMIT # DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID 4- ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $ CONSTRUCTION PERMIT RECEIPT # %� 3 Authority: Chapter 381, FS & Chapter 1OD -6, FAC CO�NyTRUCTION PERMIT TR: l /T [/V] New System [AI]/Existing System [ NJ }olding Tank Temporary/Experimental [)/ ] Repair [PI Abandonment [ /t]/Other(Specify) 11 ■ N, �,r D APPLICANT: J�_ / i""'/ �� / r✓07A 40.77 f AGEN 1'7 /, C S S� f T r PROPERTY STREET ADDRESS: 244 41,./E: 41,./E: /0 a �� � r LOT: /..)2 BLOCK: l f e i SUBDIVISION: [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. SYSTEM DESIgn_AND SFEgIFICATIONS r - - /Q./.'Q % ■ T [Qc0 ] GALLON >/ G ] SEPTIC TAN EROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] A [ ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ J PER 24 HRS NO. OF PUMPS: [ ] D [ / SQUARE FEE R [ ] •s FEET A TYPE SYSTEM: I CONFIGURATION: F LOCATION OF BENCHMARK: /� r � / H/'1 I ELEVATION OF PROPOSED SYSTEM SITE [fO, E BOTTOM OF DRAINFIELD TO BE [ $ RIMARY DRAINFIELD SYSTEM SYSTEM [ ] STANDARD [ ] FILLED [ ] MOUND [ ] TRENCH HRS Form 4016, Mar 92 (Obsoletes previous editions which may not .be.: used) .._ (Stock Number: 5744 - 001 - 4016 - 0) [lED [ ] 1" [INCHES /FT] [ABOVE /BELOW] BENCH RK/REFERENCE POINT INCH /FT] [ABOVEZ811 O BENCHMAR EFERENCE POINT EXCAVATION REQUIRED: [ a ] INCHES TITLE: TITLE: EXPIRATION DATE: 7 p ee APPLICANT [ Page INSTRUC T :ONS: PERMIT NUMBER: Permit tracking number assigned by CPI$U. APPL :CATKCN FOR: Check type of permit, if "Oche." specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT: Property owner's legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY ID#: 27 character id number for property. (CPHU may require property appraiser ID 0 or section /township /range /parcel number) SYSTEM DESIGN AND SPECIFICATIONS: TANX: Minimum specifications from Chapter 1OD -6, FAC. DRAINFIELD: Minimum specifications from Chapter 10D -6, FAC. OTHER: Other specifications, such as operating permit requirements, low-volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED 3Y: County Public Health Unit (CPHU) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CPHU. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date issued. STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCT t� /7M Permit Application Number /� PART II - SITE PLAN Scale: Each block represents 5 feet and 1 inch = 50 feet. /01< - miP.T_fizsmw r irr-} .. ( i r ( I Agolut a C✓ N Site Plan submitted by. ""- Plan Approved By SIGNATURE • Not Approved ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC'HEALTH UNIT HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744- 002- 4015.6) County Public Unit Page 2 of 3 Permit No. _ --_ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or otlwi 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. Owner's Name and Address. -. Registered Architect and /or Engineer Employing Plumber's Name_ ! - No. -__.._ .. Location and Legal Description Lot---- ---.-••- - .......... __ ..... -_ -._ _ -- Block_____.._ _...- -_ - - -- Subdivision 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 -. Size Septic Tank._ ._ Type of Tank__ Feet of Drain Tile _ Dist. Feet of Tank or Drain Field from Well -_- Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (: (Signed). - • • Date No._ Street Street Capacity Gals. - street - No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as all employer of labor under the Florida Workmen's Compensation Act, being Section 5988, 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 an licensed by Miami Shores Village. ■ (Signed).: STATE OF FLORIDA, } ss, 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 tau• 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 foul materials and /or workmanship. CLOSETS BATH TUBS SHOW[R6 LAVA- TORIES 61NK6 SLOP SINKS LAUNDRY TU58 URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS 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. _ --_ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or otlwi 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. Owner's Name and Address. -. Registered Architect and /or Engineer Employing Plumber's Name_ ! - No. -__.._ .. Location and Legal Description Lot---- ---.-••- - .......... __ ..... -_ -._ _ -- Block_____.._ _...- -_ - - -- Subdivision 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 -. Size Septic Tank._ ._ Type of Tank__ Feet of Drain Tile _ Dist. Feet of Tank or Drain Field from Well -_- Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (: (Signed). - • • Date No._ Street Street Capacity Gals. - street - No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as all employer of labor under the Florida Workmen's Compensation Act, being Section 5988, 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 an licensed by Miami Shores Village. ■ (Signed).: STATE OF FLORIDA, } ss, 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 tau• 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 foul materials and /or workmanship. B1.11LVING ELECT'R GA PLUMBING ROO NG Owner o Building Architect Contractor <. ,,, or Builder Legal Description, Address of Building MIAMI SHORES VILLAGE, O FLRI �DA Amt. of Permit Work to he :performed tinder this Permit DATE //to 1„,•1‘,. 3 :195 deb' • �' _ _, g 9 p ppj •on This � erntt is ranted Co the conC•ractor ok ; �tlder. named , a'12o� �' eansttuct the - building or to install e • ui meat or device deseti�ed, in the a ltcat berefor in strict compliance «rith -all ord nces pertaining, ulatio s thereto the understanding :that the work. wit performed in compliance vY-iCh plans g p l d su�tn�"tted t'4 an a -cd ,by proper manic% pal authorities. This Permit ma4/ be revdked at any rawtn s Stat ements 'or. s eciftcatio � that • � hake been,, n i . P3' Changed i. o . ouh A, koowledge of the p his permit is Cbe� ens are risen ed without authoza�atx"ozi. A further condition upon which t time nted. the understanding a tha a o t a tot u an sd! a the r p oiT s ht a t y f hz .ordinances and re g b ibr g : t he plans orr drawings- or in tie st.=tements or specsficatiop`s and that he Ames res s ' rbtlity for wd k o d n by e eots, s ants e or hereby' ern t o e shawzA on , y g P Y '� ' t Signe- In .consideration of the sssu'a �ce too° t Oh of s; pert. i t 1 a 4 e. , "`, orm w the ork covered hereunder ` . In c pli.ance with all ordinances and regulations pertain` e • thereto and in strict co fdmtnity ro�ith tie ,plans, drawi0gs state tints or 'specifications bmitted to the !proper authorit'es oP Miami Shores Village. In ac ^ ,'ing this permit I assu responsibility ,for ,all work done .b ither, self, my age erv.st or,em oyee. Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitt 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 I the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall lie building during progress of work. Owner's Name and Addre APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Eng __________ alf Employing Plumber's Name _'�: /W Location and Legal Description Street and Number where work is State work to be performed and New Building plied with the provisions thereof, performed under this permit; and required by the Act. The under licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss. NOTE: A re- inspection fee materials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT complied with, whether herein specified or not. A copy of aRP yed. ,pia n s... and . - specifications- .m-ust be kept..at, .4(e o.- - Z U Street- A 2 44 2L _________________ ____r___ Subdivision__ to be performed —No. purpose of building (By Floors) Remodeling Addition Repairs________________ No. of Stories Size Septic Tank_ - _ _ Type of Tank . Capacity Gals.--_-_-_- _______. Feet of Drain Tile---- �__v_____ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit Amount of Permit ____________________________________ (Signed) A The undersigned applicant for this building permit does hereby certify that he understan a nd 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 corn- and will require similar compliance from all contractors or sub - contractors employed by him in the work to be will post or cause to be posted for inspection on the site of the work such public notice or notices as are signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are (Signed) Date__ Street My Commission Expires Notary Public. State of Florida Plumbing Inspector. 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. of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty 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 CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitt 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 I the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall lie building during progress of work. Owner's Name and Addre APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Eng __________ alf Employing Plumber's Name _'�: /W Location and Legal Description Street and Number where work is State work to be performed and New Building plied with the provisions thereof, performed under this permit; and required by the Act. The under licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss. NOTE: A re- inspection fee materials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT complied with, whether herein specified or not. A copy of aRP yed. ,pia n s... and . - specifications- .m-ust be kept..at, .4(e o.- - Z U Street- A 2 44 2L _________________ ____r___ Subdivision__ to be performed —No. purpose of building (By Floors) Remodeling Addition Repairs________________ No. of Stories Size Septic Tank_ - _ _ Type of Tank . Capacity Gals.--_-_-_- _______. Feet of Drain Tile---- �__v_____ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit Amount of Permit ____________________________________ (Signed) A The undersigned applicant for this building permit does hereby certify that he understan a nd 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 corn- and will require similar compliance from all contractors or sub - contractors employed by him in the work to be will post or cause to be posted for inspection on the site of the work such public notice or notices as are signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are (Signed) Date__ Street My Commission Expires Notary Public. State of Florida Plumbing Inspector. 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. of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE 194 Contractor's License No. 1 0 0 .I 0 );3 ERMIT N9 3475 Work to be performed under this Permit l 1 Bl. Subdi- vision Was,,:It:bl: TM" tons;{ticuon may eta. Wa, Production Board General Limitations :, You are cautioned to consult your War P.oduc•ior Board office before starting . _the work_ authorized is 'this permit' . / /f Value of Amt. of /D yv Project Permit / BY . 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 dra i�}gs r in the statements o speeifica and that he assumes responsibility for work done by his agents, servants or employees 4' i*' Signed • d - = INSPECTOR if y In consideration of the issuance to me of this ermit I agree to perform the work covered hereunder in.com liance wit r r'{) P g P P dinances a � ��� ms -. tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the properrities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. AUTHORITY VWNER ;` OT BLOCK SUBDIVISION , e Issued to to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a story building at p e P e ,J/ . 2 t -i : Fixtures C Fi yr t.- s ue i 7J - -i14' ' f Ai li $ ewer ,, ' / C. $ / 4) d •tic Tank $ • Total $ / +d' e✓ iami chores9illage F L O B D A PLUMBING PERMIT N9 954 Village Plumbing Inspector Received Payment by