434 NE 102 StBUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Lot II Bl
r •
N° 4295
Value of
Project $
DATE
Contractor's
License No.
19 ''
Work to be performed under this Permit
Subdi-
vision
Amount of
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 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 specifications 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 all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. '
J.?
CONTRACTOR OR BUILDER BY
AUTHORITY
BOT
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewit subm(ed 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. n n
Owner's Name and Address -- /-
Registered Architect and /or En ineer_____ _______________
Employing Plumber's Name t D _ )
Location and Legal Description Lot-______ _____ __— _______
STATE OF FLORIDA, 18s.
COUNTY OF DADE.
Size Septic Tank _ --
Feet of Drain Tile
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) _: c 4 -0
New Building __ Remodeling__. __ ___ Addition__
Type of Tank_
Date
No. _ 3__.__ Street_.9 I 0
Block __.________ Subdivision
Street
(Signed)
( Signed) ____.
No._ _� - � - -__ Street. 221 16
Repairs
_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.______ ___ ____________------ _____________ ____Size of Soakage Pit
The undersigned applicant for this building permit does hereby certify that he understands and accepts h�.bligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida s manent Supplement, and leas com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contracto s 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.
v
•
2.
No. of Stories
Capacity Gals
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.
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
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
S
'
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIaT
CHECK
- --
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewit subm(ed 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. n n
Owner's Name and Address -- /-
Registered Architect and /or En ineer_____ _______________
Employing Plumber's Name t D _ )
Location and Legal Description Lot-______ _____ __— _______
STATE OF FLORIDA, 18s.
COUNTY OF DADE.
Size Septic Tank _ --
Feet of Drain Tile
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) _: c 4 -0
New Building __ Remodeling__. __ ___ Addition__
Type of Tank_
Date
No. _ 3__.__ Street_.9 I 0
Block __.________ Subdivision
Street
(Signed)
( Signed) ____.
No._ _� - � - -__ Street. 221 16
Repairs
_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.______ ___ ____________------ _____________ ____Size of Soakage Pit
The undersigned applicant for this building permit does hereby certify that he understands and accepts h�.bligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida s manent Supplement, and leas com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contracto s 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.
v
•
2.
No. of Stories
Capacity Gals
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.
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.
.............
C
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
'rues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N6
' �Cy,S
ti,
-n y �� a ,
om =
TOTAL
FI %TUREB
CONTR.
Liar
CIIZCK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
COHTR.
LIST
_.
CHECK
t c-
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s}rbmitted f4 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 !/ate_____ � .L ____ No.______<_ `S /___._f_`'! Street /e ' J
Registered Architect and /or Enginn / ____— _______
Employing Plumbei s Name ___. " � / � �
Location and Legal Description' Lot
Street and Number where work is to be performed —No
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
STATE OF FLORIDA,
COUNTY OF DADE. I
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
Street
State work to be performed and purpose of building (By Floors)_-- ____ -- - ------------- __ -_ -_
New Building___ Remodeling______ ______ Addition Repairs No. of Stories.
Type of Tank
_Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
D-Dt
Amount of Permit
i
(Signed)
Date
sR No.__' 4 $ Street___ l"
Subdivision
'/Z /a SS�
Capacity Gals.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employ
performed under this permit; and will post or cause to be posted' for inspection on the site of e work such pub
required by the Act. The undersigned agrees to employ only such sub- contractors, on wor co be performed and
licensed by Miami Shores Village.
Plumbing Ins s ector.
s as an employer of labor
pplement, and has com-
by him in the work to be
is notice or notices as are
permit, as are
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•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
l'onr.1+
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
I Lp3
Application is hereby :Hale for the approval of the detailed statement of the plans and specifications here h su 'mitted 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 0 _ - _ ___. , ___ .____ No._— .__________._ Street
Registered Architect and /or Engineer_-_-_--__________
Employing Plumber's Name__h. 0101 _ A) CA No._4.2 3 .4- .a4_49 Street--
��yy►► DD �5.�.�_ _
Location and Legal Description Lot_..SL._ � ___ _ Block 1 B -L' Subdivision ItS....efr. Y _ -
_
Street and Number where work is to be performed —No H l i 1 O. Street.
State work to be performed and purpose of building (By Floors)_._- _____ -____
New Building Remodeling_._._ ___._.__ Addition__
Repairs No. of Stories.
_Type of Tank
__Dist. Feet of Tank or Drain Field from Well
of Water Supply: it ell._______________:___________ _____Size of Soakage Pit
Size Septic Tank
Feet of Drain Tile
Amount of Permit $
My Commission Expires
(Signed) _
Capacity Gals
umbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat , : as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pernanen pplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo • . 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 )._ __. fl - i -- ..
Master Plumber
STATE OF FLORIDA,
COUNTY OF DADE. j
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_
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.
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
matrarials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TU88
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
{��
f I M
TOTAL
FIXTURES
CONTR.
LIST
1
I
1
f
CHECK
— +
--
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
J Q
1 `7 ..,
CONTR.
LIST
CHECK
- --
l'onr.1+
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
I Lp3
Application is hereby :Hale for the approval of the detailed statement of the plans and specifications here h su 'mitted 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 0 _ - _ ___. , ___ .____ No._— .__________._ Street
Registered Architect and /or Engineer_-_-_--__________
Employing Plumber's Name__h. 0101 _ A) CA No._4.2 3 .4- .a4_49 Street--
��yy►► DD �5.�.�_ _
Location and Legal Description Lot_..SL._ � ___ _ Block 1 B -L' Subdivision ItS....efr. Y _ -
_
Street and Number where work is to be performed —No H l i 1 O. Street.
State work to be performed and purpose of building (By Floors)_._- _____ -____
New Building Remodeling_._._ ___._.__ Addition__
Repairs No. of Stories.
_Type of Tank
__Dist. Feet of Tank or Drain Field from Well
of Water Supply: it ell._______________:___________ _____Size of Soakage Pit
Size Septic Tank
Feet of Drain Tile
Amount of Permit $
My Commission Expires
(Signed) _
Capacity Gals
umbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat , : as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pernanen pplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo • . 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 )._ __. fl - i -- ..
Master Plumber
STATE OF FLORIDA,
COUNTY OF DADE. j
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_
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.
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
matrarials and /or workmanship.
t
MI /'A