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356 NE 102 St (8)BUILDING ELECTRICAL PLUMBING ROOFING Owner of ,„,.1!' Building t"/, Architect Contractor - or Builder Legal Description Address of Building Lot 1 , t • k • CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 6086 Bl 4, Subdi- vision Value of Project $ ePS DATE. Contractor's License No. 4. Work to be performed under this Permit .011POW 19 Amount of Permit $ BY AUTHORITY fr . if .... „, c 7 Go 1 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 specification g and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. -`" ' • — INSPECTOR ' In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with ; &11 ordincmcftems” d regulations 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 all work done by either, myself, my agent, servant or employee. ABBOT 0 Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING °°'';RMI9' 6/2o/6o Date — _. ..... _..._ 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. 356 N.E. 102nd St. Owner's Name and Address Jo F No. Street_ Registered Architect and /or Engineer ... _- -._--_ •--- _- -.-- __ - -- S W .Hialeah Employing Plumber's Name �03e e�t�C Tank No. -_. �552 --- . - - - -- Street_ - . _ 3� Ave. Fla. r Location and Legal Description Lot____— ___._ .... ______ ..... _ ______ 35 66 Block__ Subdivision ..._.__-------• -- -- - - Street and Number where work is to be performed —No Street N.E. 102nd St. State work to be performed and purpose of building (By Floors) _______.__.___._____._._ New Building Remodeling______ Addition Repairs No. of Stories Size Septic Tank 321e Type of Tank Feet of Drain Tile Dist. Feet 'of Tank or Drain Field from Well Nature of Water Supply: City —Well. Amount of Permit $___..... STATE OF FLORIDA, COUNTY OF DADE. __Size of Soakage Pit (Signed)_ Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob {'. tions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin nt Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e oyed 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 s ; ' public notice or notices as are required by tlie 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. Master Pltnnber... 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. CLOSETS BATH TUBS SHOWERS LAVA• TORIES SINKS SLOP SINKS LAUNDRY Tues 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 N EATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK 0 Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING °°'';RMI9' 6/2o/6o Date — _. ..... _..._ 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. 356 N.E. 102nd St. Owner's Name and Address Jo F No. Street_ Registered Architect and /or Engineer ... _- -._--_ •--- _- -.-- __ - -- S W .Hialeah Employing Plumber's Name �03e e�t�C Tank No. -_. �552 --- . - - - -- Street_ - . _ 3� Ave. Fla. r Location and Legal Description Lot____— ___._ .... ______ ..... _ ______ 35 66 Block__ Subdivision ..._.__-------• -- -- - - Street and Number where work is to be performed —No Street N.E. 102nd St. State work to be performed and purpose of building (By Floors) _______.__.___._____._._ New Building Remodeling______ Addition Repairs No. of Stories Size Septic Tank 321e Type of Tank Feet of Drain Tile Dist. Feet 'of Tank or Drain Field from Well Nature of Water Supply: City —Well. Amount of Permit $___..... STATE OF FLORIDA, COUNTY OF DADE. __Size of Soakage Pit (Signed)_ Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob {'. tions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin nt Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e oyed 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 s ; ' public notice or notices as are required by tlie 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. Master Pltnnber... 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. 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 s building during progress of work. Owner's Name and Address Street and Number where work is to be performed —No i ' State work to be performed and purpose of building (By Floors)._ New Building _- _- .----- - - -• -- . Remodeling_- _ -_ - -- Addition Size Septic Tank < e "-- e 9 Feet of Drain Tile__ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date.. ,2 . ._ fled or not. A copy of approved plans and specifications must be kept at No. e Street. _ Type of Tank- ef.-z'.:. _Dist. Feet of Tank or Drain Field from Well . Registered Architect and /or En Employing Plumber's Name_ -.(,.Y --lam 4 - � F _____ No. - Street. Location and Legal Description Lot- Block__ Street -./04=2 1 - Repairs No. of Stories Capacity Gals Nature of Water Supply: City — Well._____ _______ of Soakage Pit Amount of Permit $ (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 Perm : f S • .lment, and has com- plied with the provisions thereof, and will require' similar compliance from all contractors or sub - tractors ' ploye • " y t im in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the wor , `u h . ic4otice r notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on . to .� erf rd this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ackno edgments, 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 s: • e, and that all facts therein by hirr ated are true. My Commission Expires Notary Public, State of Florida • A re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURE$ 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 - J 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 s building during progress of work. Owner's Name and Address Street and Number where work is to be performed —No i ' State work to be performed and purpose of building (By Floors)._ New Building _- _- .----- - - -• -- . Remodeling_- _ -_ - -- Addition Size Septic Tank < e "-- e 9 Feet of Drain Tile__ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date.. ,2 . ._ fled or not. A copy of approved plans and specifications must be kept at No. e Street. _ Type of Tank- ef.-z'.:. _Dist. Feet of Tank or Drain Field from Well . Registered Architect and /or En Employing Plumber's Name_ -.(,.Y --lam 4 - � F _____ No. - Street. Location and Legal Description Lot- Block__ Street -./04=2 1 - Repairs No. of Stories Capacity Gals Nature of Water Supply: City — Well._____ _______ of Soakage Pit Amount of Permit $ (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 Perm : f S • .lment, and has com- plied with the provisions thereof, and will require' similar compliance from all contractors or sub - tractors ' ploye • " y t im in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the wor , `u h . ic4otice r notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on . to .� erf rd this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ackno edgments, 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 s: • e, and that all facts therein by hirr ated are true. My Commission Expires Notary Public, State of Florida • A re- inspection fee of $1.00 will be made when such re- inspection is made 'necessary by improper notice for inspection, or faulty and /or workmanship. MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE "`' 3T 195 • ELECTRICAL ❑ PERMIT N° 14739 Contractor s PLUMBING License No ROOFING ❑ Work to be performed under this Permit Owner of Building Architect Contractor ! or Builder ,,. • Legal Lot II BI. Description Address of Building ( 7 1 L 1 CONTRACTOR OR BUILDER Signed: Subdi- vision Value of Project $ BY INSPECtOR BY Amt. of Emit $ AUTHORfrY 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. In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications subm tted to the proper authorities of Miami Shores Village. In accepting this permit I assume respo " i1ity for all work done by either, myself, my a ent, servo or employee. ` ;, i! ,? ... fit• r Cam. .'ff ,t;' r° C z.•G G.a-e. °'s `r1+ Co tee Permit No. L i .5 J 9._- Date S q - ' c� Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othei 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 al building during progress of work Owner's Name and Address __- No._ Street ' Registered Architect and /or En eer - . Employing Plumber's Name _ No Street______ Location and Legal Description Lot--------- •- _--- •------ __-- - -___4 ock____ ___.. Subdivision _---___ -- Street and Number where work is to be performed —No. — 1 _S (n... . ...._._ Street- . 0 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. __.._. - 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 $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (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 empl by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site o the work such public n ire or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, :. work tb, be .erformed under this permit, as are licensed by Miami Shores Village. (Sign STATE OF FLORIDA, I 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. 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 bill materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tutu; URINALS CATCH BASIN FLOOR DRAIN DRINKI NO FOUNT'NE TOTAL FIXTUREI CON TR. LIST -_ CHECK - SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL COHTR. LIST CHECK • Permit No. L i .5 J 9._- Date S q - ' c� Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othei 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 al building during progress of work Owner's Name and Address __- No._ Street ' Registered Architect and /or En eer - . Employing Plumber's Name _ No Street______ Location and Legal Description Lot--------- •- _--- •------ __-- - -___4 ock____ ___.. Subdivision _---___ -- Street and Number where work is to be performed —No. — 1 _S (n... . ...._._ Street- . 0 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. __.._. - 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 $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (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 empl by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site o the work such public n ire or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, :. work tb, be .erformed under this permit, as are licensed by Miami Shores Village. (Sign STATE OF FLORIDA, I 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. 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 bill materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Lot MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 3441 Work to be performed under this Permit Legal Description Address of I � - Building ., / `/ Bl. Subdi- vision Value of Project DATE WARNING: This Construction may be In violation of War Production Board General Limitations Order L•41 You are cautionfd to conanit vow War P Board office before starting the work autaorized in this 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. Signed. By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions pertain g thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In this permit I assu e responsibility for all work done by either myse my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY Contractor's License No Amt. / Permit t 194_ APPLICATION FOR PLUMBING PERMIT Permit No Date_---___-_ —/" ....... f ( 4 . ‘P Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or '–& structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Floric1 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 w rk. '] h� Owner's Name and Add __K___ "i t No _____J 4! Street_ -_�O_� Registered Architect and /or _ ngineer Employing Plumber's N New Building MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Location and Legal Description .... — _w______ Block ______ _____�_____�______ —___ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) Remodeling Addition Repairs No. of Size Septic Tank____ —____ Feet of Drain Tile_____— _� Nature of Water Supply: City —Well _ Amount of Permit $_ Type of Tank The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only . such licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly appeared _ to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires _Capacity Gals Dist. Feet of Tank or Drain Field from _Size of Soakage Pit -(Signed) – — – – -- — – -- - - -- - -- – – –_ - -_– – Plumbing Inspector. rtify that he understands and accepts his obligations as an employer of labo' Compiled General Laws of Florida Permanent Supplement, and has corn from all contractors or sub - contractors employed by him in the work to b inspection on the site of the work such public notice or notices as an sub - contractors, on work to be performed under this permit, as art (Signed) Master Plumber. authorized to dminister oaths and take acknowledgments, ,personally l deposes and says that he is the . foregoing application, and that he did sign the same, and that all facts 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. 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. DRAI FIE SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL CONTR. LIST CHECK APPLICATION FOR PLUMBING PERMIT Permit No Date_---___-_ —/" ....... f ( 4 . ‘P Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or '–& structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Floric1 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 w rk. '] h� Owner's Name and Add __K___ "i t No _____J 4! Street_ -_�O_� Registered Architect and /or _ ngineer Employing Plumber's N New Building MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Location and Legal Description .... — _w______ Block ______ _____�_____�______ —___ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) Remodeling Addition Repairs No. of Size Septic Tank____ —____ Feet of Drain Tile_____— _� Nature of Water Supply: City —Well _ Amount of Permit $_ Type of Tank The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only . such licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly appeared _ to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires _Capacity Gals Dist. Feet of Tank or Drain Field from _Size of Soakage Pit -(Signed) – — – – -- — – -- - - -- - -- – – –_ - -_– – Plumbing Inspector. rtify that he understands and accepts his obligations as an employer of labo' Compiled General Laws of Florida Permanent Supplement, and has corn from all contractors or sub - contractors employed by him in the work to b inspection on the site of the work such public notice or notices as an sub - contractors, on work to be performed under this permit, as art (Signed) Master Plumber. authorized to dminister oaths and take acknowledgments, ,personally l deposes and says that he is the . foregoing application, and that he did sign the same, and that all facts 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. • • DATE ISSUED TO to install the following described plumbing, in accordance with the laws, statutes and `regulations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drain- age work done in Miami Shores Village, Florida, FOR A STORY BUILDING AT � �" k FIXTURES: SEP'T'IC TANK MIAMI SHORES VILLAGE PLUMBING PERMIT FIXTURES SEWER TOTAL VILLAGE PLUMBING INSPECTOR i s 10 N0. 610