PLUMBINGBUILDING
ELECTRICAL
PLUMBING
ROOFING
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
ra
Owner of r
Building
CONTRACTCR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA ,
PERMIT N° 5749
❑ Work to be performed under this Permit
B1
y " `a
Signed. - <4;
Subdi-
vision
Value of
Project $
DATE
Contractor's = a O
License No.
L f
1951—
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 application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wi11 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 thoroughowledge 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.
BY
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 regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, m get, servant or employee.
. 1#
AUTHORITY
6
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
D — /7
Permit No /! # Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for th .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 S 0 / $ �t No " Street/7 L ,C 0 2.
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
Size Septic Tank
Feet of Drain Tile
Registered Architect and /or Engineer
Employing Plumber's Name '
Location and Legal Description Lot
Nature of Water Supply: City —Well
Amount of Permit $ _�
No
Block
3 Sr c.
Street -- - -- `
Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from 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 5968, 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- contractool ' grt ,yro to bit„ r rte p rfo yyrtl 't4is permit, as are
licensed by Miami Shores Village.
2$1 ,-
(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.
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
TKNK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
D — /7
Permit No /! # Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for th .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 S 0 / $ �t No " Street/7 L ,C 0 2.
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
Size Septic Tank
Feet of Drain Tile
Registered Architect and /or Engineer
Employing Plumber's Name '
Location and Legal Description Lot
Nature of Water Supply: City —Well
Amount of Permit $ _�
No
Block
3 Sr c.
Street -- - -- `
Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from 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 5968, 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- contractool ' grt ,yro to bit„ r rte p rfo yyrtl 't4is permit, as are
licensed by Miami Shores Village.
2$1 ,-
(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.
1 /0
Date 4J tjLry
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the uilding or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shore 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 AddressJG
Registered Architect and /or Engineer___
��
Employing Plumber's Name _ _; . No. .�'� Street
Location and Legal Description Lot a. ___ '1 0 41 7 _ Blobk 9 / Subdivision
Street and Number where work is to be performed —No
Permit No
Amount of Permit $
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pi
( Signed) _
I/ 4 -
My Commission Expires Notary Public, State of Florida
.t.
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
Nature of Water Supply: City —Well.
Plumg Inspect r.
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.
Master Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
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.
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
l e"
lie"
-7.5
SEPTIC SEWER
TANK CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G�
POOL
,...
Z
,1020....._
LIST
/ �S
.
CHECK
1 /0
Date 4J tjLry
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the uilding or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shore 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 AddressJG
Registered Architect and /or Engineer___
��
Employing Plumber's Name _ _; . No. .�'� Street
Location and Legal Description Lot a. ___ '1 0 41 7 _ Blobk 9 / Subdivision
Street and Number where work is to be performed —No
Permit No
Amount of Permit $
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pi
( Signed) _
I/ 4 -
My Commission Expires Notary Public, State of Florida
.t.
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
Nature of Water Supply: City —Well.
Plumg Inspect r.
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.
Master Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
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.
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.
BUILD NG
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
This permit is granted to the contractor or iuil. -r named above to c
cation herefor in strict compliance with all ordinances pertaining thereto .an
plans, drawings, statements or specifications that may have been submitt
at any time if the work is not done in compliance with such ordinances or ' th
permit is granted is the understanding that the contractor or builder named ab
regulations pertaining to the work covered hereby whether shown on the plan
sibility for work done by his agents, servants or emplo
C45
In consideration of the issuance to me o
pertaining thereto and in strict conformity with the p an ,
In accepting th' erm" I assume responsibility for all work done
MIAMI SHORES VILLAGE, FLORIDA
DATE 19
_ PERMIT N? 7133
Work to be performed under this Permit
Value of
Project
install the equipment or device describe
at the work will be performed in compliance
unicipal authorities. This Permit may be rev
without
thorization. A further condition upon whicl
responsibilit
for a thorough knowledge of the or. ' ' ; nc
to ents or cifications and t
e appli-
any
Signed:
it I agree to perform th
s, statement
e pro
changed witl
es the respons
gsorinthes
Subdi- i'
vision
IN
0
Contractor's
License No
work covered hereunder in compliance wit all o . nances and reg
r specifications submitted to the proper autlftirritie of Miami Sar
elf, my agent, servant or employee.
BY
AUTHORITY
this
and
pon-
ations
lage.
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal
Description
Lot
7 .• ,
Owner of
Building
Address of - r '' 4.' Value of Amt. ofd r
Building /_ C.; > f � :-/ .. r - Project Permit
This p mit is grante to the contractor or builder named above to con truct the building or to install the equipment or device described in the appli-
cation 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 -wjuich this
permit is granted is the understanding that the contractor. or builder named above assumes respo sibtfity for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans drawin r in a statements or specifications a id t ft umes respon-
sibility for work done by his agents, servants or employees. - `
Signed 1; .7" !�� t'.tss�. ��/„ By
INSPECTOR i
In consideration of the issuance to me of this permit:I agree to perfon tl work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans; drawings, statem r specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit Tsui ponsibility for a work. done by either myself, my agent, servant or employee.
C r < ' /,
CONTRA * OR OR BriL974
PERMIT ITT° 7153
W ork to be performe this Permi
MIAMI SHORES VILLAGE, FLORIDA
DATE
BI.
Subdi-
vision
BY
Contractor's
License No.
AUTHORITY
19
REQUEST FOR INSPECTION
Inspection
Time Ready
Date Ready / C jam-
REQUEST FOR INSPECTION
Con7any
PHONE
Job
4
Address _...:, cyn ci2 / , ,1 , t ,
' 7 *
Inspection .....
Time Ready A.M. P.M.
Date Ready
Company
Job 4
Address
Inspection
REQUEST FOR INSPECTION
PHONE
Time Ready A.M. P.M.
Date Ready
BUILDING
ELECTRICAL
PLUMBING
Owner of ""
Building
Contractor
or Builder
Legal
Description
Address of
Building
1V
Architect ,r
Lot 4 r'
PERMIT N9 2527
Work to be performed under this Permit
1
MIAMI SHORES VILLAGE, FLORIDA
DATE
194 L
- 2 • <
Contractor's
License No �° 1
Subdi- 1 p
vision 1 T
p/ _
• +- Value of Amt. of 1
ra i 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.
Signed• By // a,. . :- -'e'
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 pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
f
BUILDING
ELECTRICAL
PLUMBING
M
•
•
Inspector's Report :
• ▪ WORK
•
• DONE BY:
•
• • :REQUESTED : WILL BE READY
•
• : , 1 1/ 0.A--- •
•
/
• ,t-4---
•
The following is ready for Inspection: -
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
7 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
Registered Architect and /or Engineer
Employing Plumber's Name ___________- _:_________ —_
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
No._
Bloc
New Building______ Remodeling __ Addition_
Size Septic Tank ____________________ ___ _____ —_____ Type of Tank
Feet of Drain Dist. Feet of Tank or Drain Field from Well______. ____________________ww
Nature of Water Supply: City —Well. Size of Soakage Pit
(Signed)
(Signed)
Street_
My Commission Expires Notary Public. State of Florida
Date -- .... – -- -- — –
Street___‘ .-- -- - - - -- – – — – - –
Subdivision_
i F
Street_ _. r r ._.____-____-.
Repairs No. of Stories
Capacity Gals.________________—
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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
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.
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
- -
��
i
^
-..t
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
7 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
Registered Architect and /or Engineer
Employing Plumber's Name ___________- _:_________ —_
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
No._
Bloc
New Building______ Remodeling __ Addition_
Size Septic Tank ____________________ ___ _____ —_____ Type of Tank
Feet of Drain Dist. Feet of Tank or Drain Field from Well______. ____________________ww
Nature of Water Supply: City —Well. Size of Soakage Pit
(Signed)
(Signed)
Street_
My Commission Expires Notary Public. State of Florida
Date -- .... – -- -- — –
Street___‘ .-- -- - - - -- – – — – - –
Subdivision_
i F
Street_ _. r r ._.____-____-.
Repairs No. of Stories
Capacity Gals.________________—
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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
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.
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.,c
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE. ss.
IAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
kPPLICATION FOR PLUMBING PERMIT
Date_ --_ —! c?../
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
Registered Architect and /or Engineer
Employing Plumber's Name J7
Location and Legal Description Lot..
Street and Number where work is to be performed —No
State work to be performed an purpose of building (By Floors)
New Building_____ _ Remodeling __ Addition Repairs
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.
My Commission Expires
No. Street.
(Signed)
Street.
Notary Public. State of Florida
– _T
Bock Subdivision�� ![____a
No. of Stories___ -1__.
Size Septic _____ Type of Tank Capacity Gals.-_____- __ _____ --
Feet of Drain Tile__._ — ._______ —__ _._ _ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit _____ ______
__
(Signed) -- – - - -- – – - --- _— — _— — -- —_
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors. on work to be performed under this permit, as are
. f
r
er 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.
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
CLlsT
LIST
�
_____Z___
--L / -
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
CHECK
Permit No.,c
Amount of Permit $_
STATE OF FLORIDA,
COUNTY OF DADE. ss.
IAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
kPPLICATION FOR PLUMBING PERMIT
Date_ --_ —! c?../
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
Registered Architect and /or Engineer
Employing Plumber's Name J7
Location and Legal Description Lot..
Street and Number where work is to be performed —No
State work to be performed an purpose of building (By Floors)
New Building_____ _ Remodeling __ Addition Repairs
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.
My Commission Expires
No. Street.
(Signed)
Street.
Notary Public. State of Florida
– _T
Bock Subdivision�� ![____a
No. of Stories___ -1__.
Size Septic _____ Type of Tank Capacity Gals.-_____- __ _____ --
Feet of Drain Tile__._ — ._______ —__ _._ _ Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit _____ ______
__
(Signed) -- – - - -- – – - --- _— — _— — -- —_
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors. on work to be performed under this permit, as are
. f
r
er 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.
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 APPLICATION FOR MIAMI SHORES VILLAGE
Date 2-16 -93 Job Address 466 NE 102 STREET Tax Folio/' ' b6 7
03 /
Legal Description fr -v
Owner / Lessee / Tenant MARK SMITH Master Permit 1 v
Owner's Address 466 NE 102 STREET, MIAMI SHORES 33138 Phone
Contracting Co. NORTH DADE SEPTIC TANK Address 800 NW 111 STREET
Qualifier DENNIS NEVILLE
State # 025836 -8
WORK DESCRIPTION
** *
SS#
phone 754 -3375
Ins .Co . AFCO
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
Square Ft. 200 Estimated Cost(value) $1000.00
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 co u .ion a ning. Furthermore, I
authorize the above -named contractor to do the work state
Sire f Contractor or Owner- Builder
Date:
FEES: PERMIT geed RADON C.C.F. ,..6 NOTARY TOTAL DUE,I.e
APPROVED: Fire Other
Zoning Building Electrical
Mechanical 'lumbin Engineering
ry as to trac •r or Owner- Builder
My Commissio xpires:
NOTARY PUBLIC; STATE OF F OMDA AT LARGE
MY COMMt :SION EX? RES 1U 1E 19, 1995
LGNDED THRU HUCIO.22 :IRRY & ASSOCIATES
* * * * * * *
**
I 'cnni: No.
Location and Legal Description Lot_
Size Septic Tank_.. -- ......... -___-__-------Type of Tank
Amount of Permit $
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
:Ipplic.eti , is hereby made for the approval of the detailed statement of the plans and specifications herewith subr.i :',.•71 for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of ML: t Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A Dopy of approved plans and spec.fications must be kept at
liuilding during progress of work. .®
;)carer's Name and Address No Street_.......
egist Bred Architect and /or Engmee..r _
:mploying Plumber's Name /if' t_-1 (kt G 1`'b-L' /;) No._ �,,.,�. BtJreet.../ J,..•.. ._. .
Block S _ _ --
Street and Number where work is to be performed -No._ _ — t _ _ 7et ...N.... 14 ---.__
State work to be performed and purpose of building (By Floor L. A.c f _ 1 C\ .
New Building Remodeling Addition Repairs L - No of Stones
Capacity ^ pals.
Feet of Drain Tile. _ — ._•_.•_Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City-Well ..__ - _..._- ___..___— _...Size of Soakage Pit
(Signed)- _l I..� - - -- .. CO' ft/
My Commission Expires Notary Public, State of Florida
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a ndloyei of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent rum lement, and lies �'o i••
v.licd with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed 1 y him in 1: •s rk v b�
performed under this permit; and will post or cause to be posted for inspection on the site of the such publ: notice no icer . +s to
required by the Act. The undersigned agrees to employ only such sub- contr on work be a orm d '.gin this ,r 'rl.rit, al
licensed by Miami Shores Village.
Mast,n Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pet *;OrrL ; ppear%
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 acts
therein by hin, stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is mede by improper notice for inspection, or fruity
materials and/or worlananship.
CLOSETS
BATH
TUae
SHOWERS
LAVA•
TORIES
SINKS
SLOP
SINK{
LAUNDRY
Toe{
URINAL{
CATCH
BASIN
FLOOR DRINKING
DRAIN FOUNT'Ne
• �OT..L
FIETI. RES
CONTR. ~
LI "T
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASS
TRAP
SOLAR
HEATER
DEEP
WILL
SPRKLR.
SYSTEM
SWIM•a
POOL
-..^.gip'
T
CONTR.
LIST
CHICK
I 'cnni: No.
Location and Legal Description Lot_
Size Septic Tank_.. -- ......... -___-__-------Type of Tank
Amount of Permit $
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
:Ipplic.eti , is hereby made for the approval of the detailed statement of the plans and specifications herewith subr.i :',.•71 for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of ML: t Shores Village, Florida.
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A Dopy of approved plans and spec.fications must be kept at
liuilding during progress of work. .®
;)carer's Name and Address No Street_.......
egist Bred Architect and /or Engmee..r _
:mploying Plumber's Name /if' t_-1 (kt G 1`'b-L' /;) No._ �,,.,�. BtJreet.../ J,..•.. ._. .
Block S _ _ --
Street and Number where work is to be performed -No._ _ — t _ _ 7et ...N.... 14 ---.__
State work to be performed and purpose of building (By Floor L. A.c f _ 1 C\ .
New Building Remodeling Addition Repairs L - No of Stones
Capacity ^ pals.
Feet of Drain Tile. _ — ._•_.•_Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City-Well ..__ - _..._- ___..___— _...Size of Soakage Pit
(Signed)- _l I..� - - -- .. CO' ft/
My Commission Expires Notary Public, State of Florida
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a ndloyei of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent rum lement, and lies �'o i••
v.licd with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed 1 y him in 1: •s rk v b�
performed under this permit; and will post or cause to be posted for inspection on the site of the such publ: notice no icer . +s to
required by the Act. The undersigned agrees to employ only such sub- contr on work be a orm d '.gin this ,r 'rl.rit, al
licensed by Miami Shores Village.
Mast,n Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, pet *;OrrL ; ppear%
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 acts
therein by hin, stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is mede by improper notice for inspection, or fruity
materials and/or worlananship.
Company
Job
Address
Inspection
Time Ready
Date Ready
REQUEST FOR
PECTION
A.M.
P.M.
MIAMI SHORES VILLAGE, FLA.
JOB e74 e, r Q a;�
INSPECTION J' ,, A- P v e c a TIME READY % z
ADDRESS 4' Q,
REMARKS •
INSPECTOR
N9 6332
DATE 1�,
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING Nir.MIT
S 7 Li
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.
Owner's Name and Address__ -_ °
Registered Architect and /or Engineer
Employing Plumber's Name _ - ` tdd... _ Street---_-_ ....... _.......
Location and Legal Description Lot_-_ _.-._ ........ _- ..... ____._.____ _ Subdivision
Street and Number where work is to be performed— No._
t2
Street
State work to be performed and purpose of building (By Floors) _____
New Building _- _ -- Remodeling_------ _------ -_____ Addition
Size Septic Tank •
/
Feet of Drain Tile___ I
Nature of Water Supply: City —Well.
Amount of Permit $
1
My Commission Expires
No.________ Street
Repairs No. of Stories
e of T�' _ Capacity Gals
eet o Tank or Drain Field from Well
.Size of Soakage Pit
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga
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 employed
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public
required by the Act. The undersigned agrees to employ only such sub- contract on rk to be perfrmed
licensed by Miami Shores Village.
umbing Inspector.
s as an employer of labor
upplement, and has com-
by him in the work to be
notice or notices as are
der this permit, as are
mber.
STATE OF FLORIDA, } as,
COUNTY OF DADE.
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.
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
TUB6
SHOWERS
LAVA.
Tort=
SINKS
SLOP
SINKS
LAUNDRY
rues
U RINAL{
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
L IST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE'
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
-
CHRCK
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING Nir.MIT
S 7 Li
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.
Owner's Name and Address__ -_ °
Registered Architect and /or Engineer
Employing Plumber's Name _ - ` tdd... _ Street---_-_ ....... _.......
Location and Legal Description Lot_-_ _.-._ ........ _- ..... ____._.____ _ Subdivision
Street and Number where work is to be performed— No._
t2
Street
State work to be performed and purpose of building (By Floors) _____
New Building _- _ -- Remodeling_------ _------ -_____ Addition
Size Septic Tank •
/
Feet of Drain Tile___ I
Nature of Water Supply: City —Well.
Amount of Permit $
1
My Commission Expires
No.________ Street
Repairs No. of Stories
e of T�' _ Capacity Gals
eet o Tank or Drain Field from Well
.Size of Soakage Pit
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga
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 employed
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public
required by the Act. The undersigned agrees to employ only such sub- contract on rk to be perfrmed
licensed by Miami Shores Village.
umbing Inspector.
s as an employer of labor
upplement, and has com-
by him in the work to be
notice or notices as are
der this permit, as are
mber.
STATE OF FLORIDA, } as,
COUNTY OF DADE.
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.
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 a
A de for the approval of the pp y ppr 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._—.- ._._ ... ____ ...... ______ Street.
Registered Architect and /or Engine r-- ----- ___
--- -� - �� - _-- _ .- -�-------- ---- -- - -• - _ - �
�. > f �= No. -- - -- - -- Street - — _
Employing Plumbei s Name___.1 - -- `�� "- - - -- , - - -• --
Location and Legal Description Lot.____— _____ —_____ Block_ - _�_._______. Subdivision
Street and Number where work is to be performed -No _- .��•-( P ®7, Street
Amount of Permit $ -_ - __
STATE OF FLORIDA, ss.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors) __________
New Building __ __ Remodeling_— __________ __ Addition
Size Septic Tank __- _- _- __ -_ -_ Type of Tank_____ Capacity Gals
Feet of Drain Tile. ____.__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - Well ._______ _ __. Size of Soakage Pit
(Signed)_
Date
Repairs
No. of Stories
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 be performed under this permit, as e
licensed by Miami Shores Village.
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.
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
TUBS
Tuns
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N6
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 a
A de for the approval of the pp y ppr 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._—.- ._._ ... ____ ...... ______ Street.
Registered Architect and /or Engine r-- ----- ___
--- -� - �� - _-- _ .- -�-------- ---- -- - -• - _ - �
�. > f �= No. -- - -- - -- Street - — _
Employing Plumbei s Name___.1 - -- `�� "- - - -- , - - -• --
Location and Legal Description Lot.____— _____ —_____ Block_ - _�_._______. Subdivision
Street and Number where work is to be performed -No _- .��•-( P ®7, Street
Amount of Permit $ -_ - __
STATE OF FLORIDA, ss.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors) __________
New Building __ __ Remodeling_— __________ __ Addition
Size Septic Tank __- _- _- __ -_ -_ Type of Tank_____ Capacity Gals
Feet of Drain Tile. ____.__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City - Well ._______ _ __. Size of Soakage Pit
(Signed)_
Date
Repairs
No. of Stories
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 be performed under this permit, as e
licensed by Miami Shores Village.
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.
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.
Amount of Permit $_
g7g
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
My Commission Expires
Block_
(Signed)
(Signed
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 mplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of wo
_. - - '
Owners Name and Address �_ _ _ - _ ___— _ _ —� No._`?`"�
Registered Architect and /or ngineer
— //----- - - -- -- —
Employing Plumber's Na'f _ + 2 ells iC No. -- _–J Street
Location and Legal Description Lot_____
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling __ Addition Repairs —___ No. of Stories
Street. /0 _ -�`
Street ______
__-- �----- _----- __— _�_-- ___ —_ --
Size Septic Type of Tank _Capacity Gals.._______
Feet of Drain Tile_______.___._______ —_ —___ Dist. Feet of Tank or Drain Field from Well____ —__ ____- _____ —___— __.. _
Nature of Water Supply: City —Well Size of Soakage Pit _____ – _____
_________�-- �_____ —_ --- -_ —___
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 under signed agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. ss'
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.
Notary Public. State of Florida
Master Plumber.
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.
DRAT
FIE
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
/
"""t4
Permit No.
Amount of Permit $_
g7g
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
My Commission Expires
Block_
(Signed)
(Signed
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 mplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of wo
_. - - '
Owners Name and Address �_ _ _ - _ ___— _ _ —� No._`?`"�
Registered Architect and /or ngineer
— //----- - - -- -- —
Employing Plumber's Na'f _ + 2 ells iC No. -- _–J Street
Location and Legal Description Lot_____
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building Remodeling __ Addition Repairs —___ No. of Stories
Street. /0 _ -�`
Street ______
__-- �----- _----- __— _�_-- ___ —_ --
Size Septic Type of Tank _Capacity Gals.._______
Feet of Drain Tile_______.___._______ —_ —___ Dist. Feet of Tank or Drain Field from Well____ —__ ____- _____ —___— __.. _
Nature of Water Supply: City —Well Size of Soakage Pit _____ – _____
_________�-- �_____ —_ --- -_ —___
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 under signed agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. ss'
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.
Notary Public. State of Florida
Master Plumber.
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.
BUILDING
ELECTRICAL
PLUMEjNG
Owner of
Building
Architect
Contractor
or Builder
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE ,�'6 194
PERMIT N9 3579
Work to be performed under this Permit
aa f
Signed-
Subdi-
vision
Value of
Project
Contractor's
License No
WARRING: This Construction may be In Vinlo n,
War Production Board General Limitations 0 :_ .
coil arP cautioned to consutt Your War Piodiic iou
Board office before starting tiro work autha to
Mb Nnn
Legal Lot Bl.
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 ir
application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in comp/
with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Perm/
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 coy
upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowl
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specificatir
that he assumes responsibility for work done by his agents, servants or employees.
By y -. /,
Amt. of
Permit
INSPECTORR'
In consideration of the issuance to me of this permit I agree to perform the work cdvered'hereunder in compliance with atl milinances a
tions per hthg thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper au ies of Mi4
Villagef it ac�,Eptjng- this permit I assume responsibility for all work done by either myself', my agent, servant or employee.
d r y
BY AUTHORITY
t
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Owner of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 2580
Work to be performed under this Permit -
Legal Lot BI.
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 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-
INSPECTOR
In co9sideration of the issuance to me of this permit I agree to perform the work covered 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 accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
Y -
•
Subdi-
vision
Value of
Project
DATE 194
Contractor's
License No.
Amt. of
Permit
BY AUTHORITY
JOB:
BUILDING :
•
ELECTRICAL :
•
PLUMBING .
The following is ready for Inspection:
Inspector's Report :
•
•
/7„
AD:
WORK
DONE BY:,
WILL BE READY
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
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 c y ;lied with, whether ein 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 En
Employing Plumber's Name
Location and Legal Description Lot________!
Street and Number where work is to be performe
State work to be performed and purpose of building (By Floors)
New Building_
Remodeling_
Size Septic Tank________
Feet of Drain Tile___!
Nature of Water Supply: City — Well._
Amount of Permit $ /
PLUMBING'INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
____ _- � __ _Block______
d —No
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. ss'
My Commission Expires
MIAMI SHORES VILLAGE
Addition__
Date__
o Street
No. Street_____.
tee- -- Subdivision_
S _ Type of Tank _-_ __>,,_L, _ Capacity Gals.___-__--____
—__ Dist. Feet of Tank or Drain Field from Well_____________ _______________________________
.Size of Soakage Pit _____ _______________ ___— ___ ____— _______________,.___
.ems ier,
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws f - Plorida Permanent Supplement, and has com-
from all contractors sub - contractors employed by him in the work to be
inspection on the rte of t)ae work such public notice or notices as are
sub - contractors, n wore' to be performed under this permit, as are
(Signed)
Repairs No. of Stories__
authorized to administer oaths and take acknowledgments, personally
Before me, the undersigned authority, a notary public, duly
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.
Notary Public. State of Florida
Master Plumber.
or other
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
T I/
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
�.
I
/
CHECK
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
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 c y ;lied with, whether ein 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 En
Employing Plumber's Name
Location and Legal Description Lot________!
Street and Number where work is to be performe
State work to be performed and purpose of building (By Floors)
New Building_
Remodeling_
Size Septic Tank________
Feet of Drain Tile___!
Nature of Water Supply: City — Well._
Amount of Permit $ /
PLUMBING'INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
____ _- � __ _Block______
d —No
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. ss'
My Commission Expires
MIAMI SHORES VILLAGE
Addition__
Date__
o Street
No. Street_____.
tee- -- Subdivision_
S _ Type of Tank _-_ __>,,_L, _ Capacity Gals.___-__--____
—__ Dist. Feet of Tank or Drain Field from Well_____________ _______________________________
.Size of Soakage Pit _____ _______________ ___— ___ ____— _______________,.___
.ems ier,
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws f - Plorida Permanent Supplement, and has com-
from all contractors sub - contractors employed by him in the work to be
inspection on the rte of t)ae work such public notice or notices as are
sub - contractors, n wore' to be performed under this permit, as are
(Signed)
Repairs No. of Stories__
authorized to administer oaths and take acknowledgments, personally
Before me, the undersigned authority, a notary public, duly
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.
Notary Public. State of Florida
Master Plumber.
or other
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.
7
Permit No,
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 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 ccplied with, whether eiein 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 En
Employing Plumber's Name , ______ ___ _ _
- -- -- - ----- __
Location and Legal Description Lot_____— '- :_______ _______''�" Block
-
Street and Number where work is to be performed —No, - 1 .." �_'_______
State work to be performed and purpose of building (By Floors)
No – —
Date_____— ___.__.
? No Street___—
– –– Street -- -- - --•l{
Street_ _ 'G
New Building — _— _________________ Remodeling Addition Repairs No. of Stories ______
___._.
Size Septic Tank_______ __ _ L,. —_ ___ Type of Tank .___ ._ ___ _ _ — _Capacity Gals.___________
Feet of Drain Dist. Feet of Tank or Drain Field from We 11 ______________— ________________ ___ —____
Nature of Water Supply: City —Well. _ Size of Soakage Pit
Amount of Permit $____
STATE OF FLORIDA,
COUNTY OF DADE. ss.
My Commission Expires
(Signed)
s
•l
(Signed) — - 1 —= -- -- ,-- '.f
Plumbing Inspecto
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 lorida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors 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 tte oft work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, wor to be performed , , r this permit, as are'
licensed by Miami Shores Village. t
04;
Notary Public. State of Florida
Master Plum l} r. / ^
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.
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.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
•
LIST
CHECK
_ 1
7
Permit No,
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 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 ccplied with, whether eiein 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 En
Employing Plumber's Name , ______ ___ _ _
- -- -- - ----- __
Location and Legal Description Lot_____— '- :_______ _______''�" Block
-
Street and Number where work is to be performed —No, - 1 .." �_'_______
State work to be performed and purpose of building (By Floors)
No – —
Date_____— ___.__.
? No Street___—
– –– Street -- -- - --•l{
Street_ _ 'G
New Building — _— _________________ Remodeling Addition Repairs No. of Stories ______
___._.
Size Septic Tank_______ __ _ L,. —_ ___ Type of Tank .___ ._ ___ _ _ — _Capacity Gals.___________
Feet of Drain Dist. Feet of Tank or Drain Field from We 11 ______________— ________________ ___ —____
Nature of Water Supply: City —Well. _ Size of Soakage Pit
Amount of Permit $____
STATE OF FLORIDA,
COUNTY OF DADE. ss.
My Commission Expires
(Signed)
s
•l
(Signed) — - 1 —= -- -- ,-- '.f
Plumbing Inspecto
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 lorida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors 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 tte oft work such public notice or notices as are
required by the Act. The under signed agrees to employ only such sub - contractors, wor to be performed , , r this permit, as are'
licensed by Miami Shores Village. t
04;
Notary Public. State of Florida
Master Plum l} r. / ^
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.
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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
'APPLICATION FOR PLUMBING PERMIT
Permit No it v v._ 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 regulation 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. c/ 9 � 4/ /
Owner's Name and Address 2$1.I.Y2CG� __ __ _ No. SW F street. ._l a ..1
:
egistered Architect and /or Engineer ' / - ....... .. ..._
mploying Plumb . o er's Name 3 044 0 12 -7/Ye N0,•-• � Street !. Cr....k .../ 4fl
Location and Legal Description Lot All 5
// / �/Blor
Street and Number where work is to be performed —No 4' �� , E / y Street. ._. , / / � _Q__el - Al .. _......... _._
State work to be performed and purpose of building (By Floon)_11.61 <'l LL QN_ f - !_?`! �!"`��'v - . . .
New Building Remodeling Addition... Repairs No. of Stories / .... .
Size Septic Tan 1c_.,--------------- - - - - -- -- -.Type of Tank___
Feet of Drain Tile.____ — -- -Dist. Feet of Tank or Drain Field from Well.
. — •—
Nature of Water Supply: Well. of Soakage Pit
Amount of Permits 1 ( Signed) --- u1
STATE OF FLORIDA, I
COUNTY OF DADE.
(Signed )
Capacity Gals..._.. ........... ___ ___- __... . ...____...
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 Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent :upylement, and has eorT-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in P.`.e wcrk co b,
performed under this permit; and will post or cause to be posted for inspection on the site o e work such publf - notice or no'icer as am
required by the Act. The undersigned agrees to employ only such sub- contractors, on vy to beperfo this p.:nni( ar az )
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personal;; eppeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ._._- ._.._._.. ...... .. ...... .. .. ..._ _..
of the above described construction, that be has carefully read the foregoing application, and that he did slips the same, and that all Ends
therein by hire stated are true.
My Conun ssion Expires Notary Public, State of Florida
Mastss Plumber.
NOTE: A re- inspection fee of 0.00 will be made when such re`inspectlon is made by improper notice for inspection, or foully
material and /or workmanship.
CLOSETS
BATH
Tune
SHOWER•
LAVA•
To
6INK•
SLOP
SINK.
LAUNDRY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
OR INK I NO
FOU NT'N!
/LJ//S4/
,�,r,
! „ � C
/
—..-1--
A
/
TOTC.L
FIIITI'.R[S
_ - -_
CO NTR.
LIOT
`
`
T
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
M
DEEP
WELL
SPRKLR,
SYSTEM
SW IM'O
POOL
CONTR.
LIST
-
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
'APPLICATION FOR PLUMBING PERMIT
Permit No it v v._ 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 regulation 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. c/ 9 � 4/ /
Owner's Name and Address 2$1.I.Y2CG� __ __ _ No. SW F street. ._l a ..1
:
egistered Architect and /or Engineer ' / - ....... .. ..._
mploying Plumb . o er's Name 3 044 0 12 -7/Ye N0,•-• � Street !. Cr....k .../ 4fl
Location and Legal Description Lot All 5
// / �/Blor
Street and Number where work is to be performed —No 4' �� , E / y Street. ._. , / / � _Q__el - Al .. _......... _._
State work to be performed and purpose of building (By Floon)_11.61 <'l LL QN_ f - !_?`! �!"`��'v - . . .
New Building Remodeling Addition... Repairs No. of Stories / .... .
Size Septic Tan 1c_.,--------------- - - - - -- -- -.Type of Tank___
Feet of Drain Tile.____ — -- -Dist. Feet of Tank or Drain Field from Well.
. — •—
Nature of Water Supply: Well. of Soakage Pit
Amount of Permits 1 ( Signed) --- u1
STATE OF FLORIDA, I
COUNTY OF DADE.
(Signed )
Capacity Gals..._.. ........... ___ ___- __... . ...____...
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 Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent :upylement, and has eorT-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in P.`.e wcrk co b,
performed under this permit; and will post or cause to be posted for inspection on the site o e work such publf - notice or no'icer as am
required by the Act. The undersigned agrees to employ only such sub- contractors, on vy to beperfo this p.:nni( ar az )
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personal;; eppeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ._._- ._.._._.. ...... .. ...... .. .. ..._ _..
of the above described construction, that be has carefully read the foregoing application, and that he did slips the same, and that all Ends
therein by hire stated are true.
My Conun ssion Expires Notary Public, State of Florida
Mastss Plumber.
NOTE: A re- inspection fee of 0.00 will be made when such re`inspectlon is made by improper notice for inspection, or foully
material and /or workmanship.