500 NE 102 St (7)Permit No.
Size Septic Tank
op
Feet of Drain Tile_ __EA
Nature of Water Supply: City —Well
Amount of Permit $ '
STATE OF FLORIDA,
COUNTY OF DADE.
— ( Signed
)- - --
(Signed)
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING ' MIT
— — o�
Date `t is•
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 .l�Z
work k.�. . i
Owner's Name and Address " _ CA" Ly ic No._ j"."9 O
Registered Architect and /or Engineer — :___ -
Employing Plumber's Name__. - �' / __.— Y /
P Y�g ' � ' � �,r- -- � :'_��- ��No._ �_L_� Street._.f.� 4 Y
Location and Legal Description Lot_____ _________________ Block
Street and Number where work is to be performed —No -C-® 0
State work to be performed and purpose of building (By Floors) _-_______________________
New Building Remodeling _---- __--------- __.____ -- Addition Repairs No. of Stories ... .......................
Street 0 e ;
SSu bdivision_____,____
Street it/t. e 6
Type of Tank_ Capacity Gals
Feet of Tank or Drain Field from Well
_Size of Soakage Pit
)lumbing .....
nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation: 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.
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____ w
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 hint, 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
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
11
SOAKA
77 I 1 P1T
EASE
RAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•0
POOL
CONTR.,
LIST
1
!
t
_ - --
_.
CHECK
Permit No.
Size Septic Tank
op
Feet of Drain Tile_ __EA
Nature of Water Supply: City —Well
Amount of Permit $ '
STATE OF FLORIDA,
COUNTY OF DADE.
— ( Signed
)- - --
(Signed)
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING ' MIT
— — o�
Date `t is•
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 .l�Z
work k.�. . i
Owner's Name and Address " _ CA" Ly ic No._ j"."9 O
Registered Architect and /or Engineer — :___ -
Employing Plumber's Name__. - �' / __.— Y /
P Y�g ' � ' � �,r- -- � :'_��- ��No._ �_L_� Street._.f.� 4 Y
Location and Legal Description Lot_____ _________________ Block
Street and Number where work is to be performed —No -C-® 0
State work to be performed and purpose of building (By Floors) _-_______________________
New Building Remodeling _---- __--------- __.____ -- Addition Repairs No. of Stories ... .......................
Street 0 e ;
SSu bdivision_____,____
Street it/t. e 6
Type of Tank_ Capacity Gals
Feet of Tank or Drain Field from Well
_Size of Soakage Pit
)lumbing .....
nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation: 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.
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____ w
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 hint, 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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No.. ..... .'� _ Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or mho
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. •A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address . ..... .__._.�:_... No. _ Street
Registered Architect and /or Engineer
Employing Plumber's Name - il-- ..... -. =- -.. " No . Street..
...,...__.__- Blacti Subdivision
z -
� : v � -- .0 r ___.._ Street.. / ' es D°
State work to be performed and purpose of building (By Floors)_ .._ _ _
New Banding Remodeling !/ ditioa ..._......�/
//
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 ell.
Amount of Permit '1),
0
-.Type of `` T �nk
Dist. Feet,bf Tank or Drain Field from Well. ..._��
_.. Size of SoalktieltP
(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 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
Beamed by Miami Shores Village.
(Signed).
Repairs
No. of Stories
Master Plumber.
STATE OF FLORIDA, ( ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all f:a•
therein by him stated are true.
My Commission Expires .. __.. — Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or foul
materials and /or workmanship.
""
TUBS
TUII
&NOW LRi
LAVA.
TORIES
/I
&I/iKf
•LOP
SINKS;
LAUNDRY
TUBS
tJ RINALI
//
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURE,
CONTR.
LIST
/
)
CHECK
&EWIR
CONN.
DRAIN
FIELD
SOAKAIIE
PIT
sR/
ORIASI
TRAP
SOLAR
HEATER
/ DRIP
WILL
SPRKLR.
SYSTEM
SWIM'G
POOL
.,
&LPTIC
TANK
CONTR.
LIST
CHECK
U
d
/
p
— I*
/
%
/
w
l
2
/
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No.. ..... .'� _ Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or mho
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. •A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address . ..... .__._.�:_... No. _ Street
Registered Architect and /or Engineer
Employing Plumber's Name - il-- ..... -. =- -.. " No . Street..
...,...__.__- Blacti Subdivision
z -
� : v � -- .0 r ___.._ Street.. / ' es D°
State work to be performed and purpose of building (By Floors)_ .._ _ _
New Banding Remodeling !/ ditioa ..._......�/
//
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 ell.
Amount of Permit '1),
0
-.Type of `` T �nk
Dist. Feet,bf Tank or Drain Field from Well. ..._��
_.. Size of SoalktieltP
(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 5988, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
Beamed by Miami Shores Village.
(Signed).
Repairs
No. of Stories
Master Plumber.
STATE OF FLORIDA, ( ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all f:a•
therein by him stated are true.
My Commission Expires .. __.. — Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or foul
materials and /or workmanship.
BUILDING . DATE r " `f y' 195
ELECTRICAL I PERMIT N? 13273 Contractor's
PLUMBING ( License No
ROOFING ❑ Work to be performed under this Permit
Owner of
Building ,..•••.
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
azbdi-
vision
Value of
Project $
BY
.w
1, a
t -
Amt. 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 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 • t" " a "- "' �.. BY -'t A
l INSPECTOR
In consideration of the issuance to me of this permit I agree to perfofrn 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
,.�
Work done by
Address of work
Owner
Septic Tank
Drainfeld
When read
Permit No. i 3 Or
27.2
Sewer
GO • [ '
Plumbing -'Final : . Top out
AM . PM
-EL-EC-TR
PLUMBING
Omer of Building-
Architect and/oi/Engineer
NAME /
Contractor or Builder
4 ,4
Proposed Location
$
AMOUNT
Dated
PERMIT A N9 449
NAME
•
NAME
—
/I
BLOC
SUB-DIVISION NO.
'
This permit is issued to _i" ._ ',. '"' To
...o/ 0 — P"
the building above described, as per applicatidn. Plans and Specifications heretofore filed in this office. This permit is granted upon the express condition
that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance
and compliance with the building laws of the State of ,Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and
regulations of the building department of Miami Shqefyi11. This permit may be revoked at any time upon the violation of any provisions of said
laws, ordinances or rules and regulations, or upon aty the plans and specifications unauthorized by the building inspector.
t
af.
RECD. PAYMENT ACCT. DEPT.
19_,
,./yDRESS
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMEN
, 19
ADDRESS LICENSE NO.
ADDRESS
lin11•14■=11■111.4
1 »
o.
LICENSE NO.
STREET
INSPECTOR
Ilk In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and
s and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the and
building ordinances zoning la s of Miami Shores Village d all rules and regulations of the building deparment of .fliami Shores Xille.
6 .
i (SEAL)
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.
E L PERMIT A N° 335
PLUMBING
•ner of Building
Architect and /or Engrr}Q A
Contractor or Buildef..2 ' ti` P
NAME
Proposed Location
a
NAME ADDRESS
,F
F- r' A
NAME
'k
RECD. PAYMENT ACCT. DEPT.
ADDRESS
d
•
ADDRESS
MIAMI SHORES VILLAGE
BUILDIN %IN&PECTION DE
LICENSE NO.
LOT, BLOCK SUB DIVISION STREJT
a
This ermit is issued to `�_. „� ___�__� ( Y
p Ea I a ;— = T�
the building above described, as per application, Plans and Specifications heretofore filed in this office. This permit is granted upon the express condition
that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance
and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and
regulations of the building department of Miami Shores Vigage. This permit may be revoked at any time upon the violation of any provisions of said
laws, / dinapces or rules and regulations, or upon/lily nge in the plans and specifics ' ns unauthorized by the building inspector.
� �.,,�
1
- '
INSPECTOR
41 In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and
ns and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the
building ordinances and zoning laws of vliami Shores Village 'and all rules and regulations of the bui di de r men ,.d ' Mia 'Shores Village.
1 s.
Dated
N TE: A charge of $1.00 will be made for making corrections or changes to this
,x6'-inspection fee of $1.00 will be made when such re- inspection is made necessary by
(SEAL)
application after approval has been obtained from the Planning Board.
improper notice for inspection or faulty materials and /or workmanship.
Permit No
Owner's Name and Address
Size Septic Tank
Feet of Drain Tile
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
cti Date / 45 C
Application is hereby made for the approval of the detailed statement
structure herein described. This application is made in compliance and
and all provisions of the Laws of the State of Florida, all ordinances of
of Miami Shores Village shall be complied with, whet r herein spe
building during progress of work/j
Registered Architect and /or En
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)
New Building / Remodeling Addition
Nature of Water Supply: City —Well.
OAP
required by the Act. The under signed agrees to employ only such sub -co
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority,
ss.
/1 / Block
of the plans and specifications herewith submitted for the building or other
conformity with the Building Ordinance of Miami Shores Village, Florida,
Miami Shores Village and all rules and regulations of the Building Division
cified or not. A copy of approved plans and specifications must be kept at
(Signed)
(Sign
No. .`Street
No._
Street_
Type of Tank LUX .e
__ d Capacity Gals
Dist. Feet .f Tank or rain Field from Well
Size of Soakage Pit
la
Subdivision______
Repairs No. of Stories
mbing Inspectot.
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
unde , is permit, as are
sub-contractors, on o erforme
40 461fj ,:. s
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
therein by him stated are true.
My Commission Expires Notary Public. State of Florida
ster Plumber.
a notary public, duly authorized to administer oaths and take acknowledgments, personally
the same, and that all facts
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
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
/
CHECK
1
Permit No
Owner's Name and Address
Size Septic Tank
Feet of Drain Tile
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
cti Date / 45 C
Application is hereby made for the approval of the detailed statement
structure herein described. This application is made in compliance and
and all provisions of the Laws of the State of Florida, all ordinances of
of Miami Shores Village shall be complied with, whet r herein spe
building during progress of work/j
Registered Architect and /or En
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)
New Building / Remodeling Addition
Nature of Water Supply: City —Well.
OAP
required by the Act. The under signed agrees to employ only such sub -co
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority,
ss.
/1 / Block
of the plans and specifications herewith submitted for the building or other
conformity with the Building Ordinance of Miami Shores Village, Florida,
Miami Shores Village and all rules and regulations of the Building Division
cified or not. A copy of approved plans and specifications must be kept at
(Signed)
(Sign
No. .`Street
No._
Street_
Type of Tank LUX .e
__ d Capacity Gals
Dist. Feet .f Tank or rain Field from Well
Size of Soakage Pit
la
Subdivision______
Repairs No. of Stories
mbing Inspectot.
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
unde , is permit, as are
sub-contractors, on o erforme
40 461fj ,:. s
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
therein by him stated are true.
My Commission Expires Notary Public. State of Florida
ster Plumber.
a notary public, duly authorized to administer oaths and take acknowledgments, personally
the same, and that all facts
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty ,
materials and /or workmanship.
•
Permit No. °'
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
- ,
Owner's Name and Address r l:_
j .
✓ '
Registered Architect and /or rrngineer =' .Y ._1` ' f
Employing Plumber's Name eet _ No.� Stre x " s_
11 / Block 9' 4 Subdivision_ LL' ._g t : t�+ r !,
Location and Legal Description Lot
Street and Number where work is to be performed—No., j_ Street__
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $_____
APPLICATION FOR PLUMBING PERMIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(Signed)
7
No. s.d Street
Date__..,.
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) ( 1d
4
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.
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
^' f
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
f i t
I f
CHECK
f
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
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 or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
- ,
Owner's Name and Address r l:_
j .
✓ '
Registered Architect and /or rrngineer =' .Y ._1` ' f
Employing Plumber's Name eet _ No.� Stre x " s_
11 / Block 9' 4 Subdivision_ LL' ._g t : t�+ r !,
Location and Legal Description Lot
Street and Number where work is to be performed—No., j_ Street__
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $_____
APPLICATION FOR PLUMBING PERMIT
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(Signed)
7
No. s.d Street
Date__..,.
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) ( 1d
4
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.
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
^' f
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.
Permit No. J
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 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 )ineer .#1.: _.,ee1- ±" _______________ — / _ / _ , _ / � y
Employing Plumber's Nan�� -„� �+�' No. Stree __ `' ,�_ .�1��*- Z1el__
Location and Le �" r
g al Descri p tion Lot___ � T�- F,. ��aa Block Subdivisio r,c _ . �� _ 1
Street and Number where work is to be performed— No. LeC __ Street_,t_i_ ,._f-Gc____.�1
State work to be performed and purpose of building (By Floors) .41.....1-2._ 0 ,141 4 4.027.771,..–a
New Building Remodeling_____ Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals. / 0
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
_
Amount of Permit $- ____G..r .- (Signed)
umbing Inspectel.
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 tp be performed under this permit, as are
licensed by Miami Shores Village.
(Signed! e!__ •�'�_ :_.
s s.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
44 1Z1it- ' Street
Date_
STATE OF FLORIDA,
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
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.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No. J
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 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 )ineer .#1.: _.,ee1- ±" _______________ — / _ / _ , _ / � y
Employing Plumber's Nan�� -„� �+�' No. Stree __ `' ,�_ .�1��*- Z1el__
Location and Le �" r
g al Descri p tion Lot___ � T�- F,. ��aa Block Subdivisio r,c _ . �� _ 1
Street and Number where work is to be performed— No. LeC __ Street_,t_i_ ,._f-Gc____.�1
State work to be performed and purpose of building (By Floors) .41.....1-2._ 0 ,141 4 4.027.771,..–a
New Building Remodeling_____ Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals. / 0
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
_
Amount of Permit $- ____G..r .- (Signed)
umbing Inspectel.
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 tp be performed under this permit, as are
licensed by Miami Shores Village.
(Signed! e!__ •�'�_ :_.
s s.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
44 1Z1it- ' Street
Date_
STATE OF FLORIDA,
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
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.
Permit No
Registered Architect and /or En
Employing Ptumber's Name
Location and Legal Description Lot
Size Septic Tank.
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
A
74
4 -
4 '2
My Commission Expires
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 complied with, whethgr herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work: ' a , r 11 _ d. r
., �. /�
Owner's Name and Address* f " " g : "�++� No. A �Q ° 7/ . 'Street !
r
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
Type of Tank
Block
(Signed)
(Sign Q ()'3
No._ , 7.5 4. Street _/
Subdivision
Street h '+,Loto'
Dist. Feet ..f Tank or )drain Field from Well
4 �7
Notary Public. State of Florida
Capacity Gals
Size of Soakage Pit
aster Plumber.
/
•
AWN ,41_
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, ort wo to `be 'ierformed under . this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
ss.
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.
,,1
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
F LOOR
DRAIN
DRINKING
FOUNT
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
Registered Architect and /or En
Employing Ptumber's Name
Location and Legal Description Lot
Size Septic Tank.
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
A
74
4 -
4 '2
My Commission Expires
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 complied with, whethgr herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work: ' a , r 11 _ d. r
., �. /�
Owner's Name and Address* f " " g : "�++� No. A �Q ° 7/ . 'Street !
r
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
Type of Tank
Block
(Signed)
(Sign Q ()'3
No._ , 7.5 4. Street _/
Subdivision
Street h '+,Loto'
Dist. Feet ..f Tank or )drain Field from Well
4 �7
Notary Public. State of Florida
Capacity Gals
Size of Soakage Pit
aster Plumber.
/
•
AWN ,41_
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, ort wo to `be 'ierformed under . this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
ss.
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.
,,1
',PLUMBING - INSPECTION
,„;4 -
r, Permit No.
4
WorkYdone b ...,
eIT c,/ 1 -, 4 " - - /
,,,..._
Address
Owner
- 7‘
_ank
Drainfield
Plumbing - Fina4 Routh Top out
When ready T
■=7,1.
Received b
Dato
T
Time Ica ef
.9.■■•■
AM
PM
APPLICATION FOR PLUMBING PERMIT
Permit No 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 6
i 4
Registered Architect and /or - 'gineer
Employing Plumber's Name 4 21 L1 0
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
s s.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Amount of Permit $_
.Block
(Signed)
No. /*) "7°
9' 4 7 4
Street
Stre
Subdivision_
Street__ fi
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
F
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.
(Signed)
Plumbing Inspector.
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. I
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 catefully 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 1otsce for inspection, or faulty
materials and /or workmanship. ,
� I j ci 040 / v.-
alp
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
//
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER.
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
B
CHECK
APPLICATION FOR PLUMBING PERMIT
Permit No 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 6
i 4
Registered Architect and /or - 'gineer
Employing Plumber's Name 4 21 L1 0
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
s s.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Amount of Permit $_
.Block
(Signed)
No. /*) "7°
9' 4 7 4
Street
Stre
Subdivision_
Street__ fi
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
F
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.
(Signed)
Plumbing Inspector.
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. I
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 catefully 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 1otsce for inspection, or faulty
materials and /or workmanship. ,
� I j ci 040 / v.-
alp
L r7,1=4'
I --d • o
---- - '
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date_
// -/ • 4
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 tl� ___;
8 / F red , � � � .�' '" � ,
Employing '" � No.� Streeh°ic__yf,A�7�lriet+
C1�v_
Location and Legal Description Lot__ ,/ / 3t Block Subdivisio�nC
Street and Number where work is to be erformed —No. Street
State work to be performed and purpose of building (By Floors) fix,. -. _ w)a°!-y1'"�_
Street
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit.
-)v / Q.
IP
Plumbing Inspector.
Amount of Permit $____ �° " _ — _________ _(Signed)'
'
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.
(Signed)
Master Plumber.
STATE OF FLORIDA, f
ss.
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.
My Commission Expires Notary Public. State Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER,
DEEP
WELL .1
(,/ '
'
t \
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date_
// -/ • 4
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 tl� ___;
8 / F red , � � � .�' '" � ,
Employing '" � No.� Streeh°ic__yf,A�7�lriet+
C1�v_
Location and Legal Description Lot__ ,/ / 3t Block Subdivisio�nC
Street and Number where work is to be erformed —No. Street
State work to be performed and purpose of building (By Floors) fix,. -. _ w)a°!-y1'"�_
Street
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit.
-)v / Q.
IP
Plumbing Inspector.
Amount of Permit $____ �° " _ — _________ _(Signed)'
'
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.
(Signed)
Master Plumber.
STATE OF FLORIDA, f
ss.
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.
My Commission Expires Notary Public. State 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.