543 NE 102 St (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 complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during the progress of work.
, 4i 11 � A & i 53 A �3 Street iv/if / 0 r
Owner's Name and Address + No. i
Registered Architect and /or Engineer / 1 f /� / / /
Employing Plumber's Name (2 ( 9 anti? /F1 '' PTi(- No. lag 01 13 Street f l/ A I ( 7H/4 0 30 6 ,
Location and Legal Description Lot / Block_ Subdivision
Street and Number where work is to be performed — No. 5 /V' r / / 0 3 / p
Street e
State work to be performed and purpose of building (By Floors) /� 141 0 /� f 9' / /V fl L b
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile pQ 0 O
Nature of Water Supply: City - Well L= Ir
Amount of Permit $ s/' , t6
v
Type of Tank a19
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)
(Signed) l �`
Date 3/ / 3 g I
Capacity Gals. 6 0 ® -/Q
,0y4
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 complied 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 S ores Villa
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 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 $25.00 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
FOUNTAINS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN SOAKAGE
FIELD PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G.
POOL
CONTR.
LIST
Z7
CHECK
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 complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during the progress of work.
, 4i 11 � A & i 53 A �3 Street iv/if / 0 r
Owner's Name and Address + No. i
Registered Architect and /or Engineer / 1 f /� / / /
Employing Plumber's Name (2 ( 9 anti? /F1 '' PTi(- No. lag 01 13 Street f l/ A I ( 7H/4 0 30 6 ,
Location and Legal Description Lot / Block_ Subdivision
Street and Number where work is to be performed — No. 5 /V' r / / 0 3 / p
Street e
State work to be performed and purpose of building (By Floors) /� 141 0 /� f 9' / /V fl L b
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile pQ 0 O
Nature of Water Supply: City - Well L= Ir
Amount of Permit $ s/' , t6
v
Type of Tank a19
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)
(Signed) l �`
Date 3/ / 3 g I
Capacity Gals. 6 0 ® -/Q
,0y4
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 complied 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 S ores Villa
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 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 $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials
and/or workmanship.
- JNf {UTJ'+ui � .
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
.APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Date of Application 3// /q
Name of Owner Telephone
Mailing Address of ('wner 5 '/ 3 fz , / D S / ,
Owner's Agent ( ' %1 SA T if,i uilder
Agent's Mailing Address / 39 3 Le) fo 7 / LJj ? 1b • e - Telephone No.
Property Street Address -5 3 A, /.r. , / Q 3 T
Lot No. Block No Subdivision
NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BOUNDS DESCRIPTION
v 106 9
This Application is for: New System Repair R c /1 / Existing System
/5
Type of Sewage Flow
Establishment (Gallons per day)
TOTAL FLOW =
Type of No. Bedrooms Heated or Cooled Area
Residential (each dwelling unit) (each dwelling unit)
AUDIT CONTROL NON9 245000 Applicant's Signature
HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used)
(Stock Number. 5744.001. 4015.1)
Authority: Chapter 381, FS
Chapter 10D -6, FAC
Permit Application Number /- 61
PART 1 - APPLICATION
ft
ft
Number
Date Subdivided
No. Dwelling
Units
Sewage Flow
Based On
S age Flow
(G Ions per day)
Exact Directions to Property
Page 1 of 3
Permit No ___ (__��
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th' 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.
Mrs. D. Aly
Owner's Name and Address. ..........
- -___ -- - -_ -_ - _ -- _ --
Registered Architect and /or Engineer _ .
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
ABC SEPT TANK SERVICE 3123 N ,W, 54th St.
Employing Plumber's Name _ -- . AC — — _ No._ - --- __ -- - _ -- - 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_
STATE OF FLORIDA, I
COUNTY OF DADE.
Remodeling -__ -- Addition._._
Size Septic Tank__ _ . -- -- -- - -- - . -- Type of Tank __ -- -. _ -- _ ._ -- _ --- -- _ - • - _ - •
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. _ _ .... - -- _ - _ . - _- - . Size of Soakage Pit
es.
Bloch
( . _._. •C
Date
Subdivision_
Street
Capacity Gals..
February 20, 1969
No 543 N.E Street 102nd St
No. of Stories _ ..
My Commission Expires Notary Public, State of Florida
mblag In;pecto.
The undersigned applicant for this building permit does hereby ccrtlfy that he understands and accepts his obligations an employer of labor
under the Florida Workmen's Compensation Act, being Section 5g66, Compiled General Laws of Florida Permanent Supplement, and 1 as ;mm-
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 no' ices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on wor rr to be perfo. _ ed under this per nit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly,authorized to administer oaths and take acknowledgu:ents, personall 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 ..acts
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-
Toms
SINKS
SLOP
LAUNDRY
TUBS
URINALS
URL
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU MT' NS
TOTAL
F'XTURE6
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
CONTR.
LIST
CHICK
Permit No ___ (__��
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th' 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.
Mrs. D. Aly
Owner's Name and Address. ..........
- -___ -- - -_ -_ - _ -- _ --
Registered Architect and /or Engineer _ .
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
ABC SEPT TANK SERVICE 3123 N ,W, 54th St.
Employing Plumber's Name _ -- . AC — — _ No._ - --- __ -- - _ -- - 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_
STATE OF FLORIDA, I
COUNTY OF DADE.
Remodeling -__ -- Addition._._
Size Septic Tank__ _ . -- -- -- - -- - . -- Type of Tank __ -- -. _ -- _ ._ -- _ --- -- _ - • - _ - •
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. _ _ .... - -- _ - _ . - _- - . Size of Soakage Pit
es.
Bloch
( . _._. •C
Date
Subdivision_
Street
Capacity Gals..
February 20, 1969
No 543 N.E Street 102nd St
No. of Stories _ ..
My Commission Expires Notary Public, State of Florida
mblag In;pecto.
The undersigned applicant for this building permit does hereby ccrtlfy that he understands and accepts his obligations an employer of labor
under the Florida Workmen's Compensation Act, being Section 5g66, Compiled General Laws of Florida Permanent Supplement, and 1 as ;mm-
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 no' ices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on wor rr to be perfo. _ ed under this per nit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly,authorized to administer oaths and take acknowledgu:ents, personall 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 ..acts
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 673 _CD
Size Septic Tank_
Feet of Drain Tile
STATE OF FLORIDA, l
COUNTY OF DADE.
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, 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. No._ .5 1/, ✓/4- ---- __ -_ -- Street __ 16.: - _.`S
Registered Architect and /or Engineer ___ �� ��C. 1? S r �L✓c L L �n /
Employing Plumber's Name 1"/ /( /f 5 • /? t ; ___ -_ -- -_ No.___ /11ki_3.L _ _ Street___4 L
Location and Legal Description Lot ____________________________. Block Subdivision
Street and Number where work is to be performed —No .55 LVt- Street j o 2 f 1.
State work to be performed and purpose of building (By Floors) _
New Building __ Remodeling
Addition
Repairs
Date - i ___3
__-___Type of Tank__ Capacity Gals.
_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.____.— ....... _Si _____ze of Soakage Pit
Amount of Permit $ -_ _____�v -_ -_ -- — (Signed)___ -_ Q
lumbing 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 corn -
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.
( Signed) _ 1// c /(6' S �. /,t L[ �. 2 ✓e
�9 ? Q �L / � 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
No. of Stories.... ............
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
B ATH
TUBS
SHOWER!
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LI
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 673 _CD
Size Septic Tank_
Feet of Drain Tile
STATE OF FLORIDA, l
COUNTY OF DADE.
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, 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. No._ .5 1/, ✓/4- ---- __ -_ -- Street __ 16.: - _.`S
Registered Architect and /or Engineer ___ �� ��C. 1? S r �L✓c L L �n /
Employing Plumber's Name 1"/ /( /f 5 • /? t ; ___ -_ -- -_ No.___ /11ki_3.L _ _ Street___4 L
Location and Legal Description Lot ____________________________. Block Subdivision
Street and Number where work is to be performed —No .55 LVt- Street j o 2 f 1.
State work to be performed and purpose of building (By Floors) _
New Building __ Remodeling
Addition
Repairs
Date - i ___3
__-___Type of Tank__ Capacity Gals.
_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.____.— ....... _Si _____ze of Soakage Pit
Amount of Permit $ -_ _____�v -_ -_ -- — (Signed)___ -_ Q
lumbing 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 corn -
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.
( Signed) _ 1// c /(6' S �. /,t L[ �. 2 ✓e
�9 ? Q �L / � 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
No. of Stories.... ............
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
PLUMBING
R IA) L&
0
o PERMIT
Owner of
Building t —
Architect
Contractor
or Builder
Legal
Description
Lot
4 .
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
N9 6309
Work to be performed under this Permit
ti•- -.
B1
±.44,■ - 1!
BY
r`
DATE I ` ' 19
Contractor's
License No.
Subdi-
vision
Address of f
t: .,.., Value of I Amount of --
Building ,- •� t j 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 applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
r
Signed- i• -i - INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with irll ordinance regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
ABBOT
ING
CTRICAL
P ,UMBING
4 er of
B 'Wing
A
a
D
B
d
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE
PERMIT N° 10008
Work to bg p Q,rmed under this Permit
chitect .�► /�
tractor
! a ..,.. ,,,
Builder r... t,.44 r
gal Lot II Bl.
a scription
dress of / / e. .
idling - 7' / "
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
or in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be, performed in compliance with any plans,
wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
e 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
ted is the understanding that the contractor or builder named above assumes the responsibility f a thorough knowledge of the ordinances and regulations
mining to the work covered hereby whether shown on the plans or dr ings or 'n the statement or specifications and that he assumes responsibility for work
) :.r
ne by Ms agents, servants or employees. c
..... ,,o
! . BY r,
INSPECTOR
In consideration of the issuance to me of this permit I agree to, p form the work covered hereunder in compliance with all ordinances and regulations
ing, thereto and in strict conf mity with the plans, draw' statements or specifications submittea to the proper authorities of Miami Shores Village.
tin this permit I assume 'sp sibility fo{ 11 v rk n d ne y ei'the& myself, my agent, l e agp`or employee.
Signed:
Subdi-
vision
Value of
Project $
,, 195
Contractor's
License No
Amt. of
Permit
BY AUTHORITY
$
Permit No.. /0 O 0 /
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 Engin ----- / ----- _______.____ _____________
Employing Plumber's Name/
Location and Legal Description Lot
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
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
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No 1 Vi
A� Street
Amount of Permit $ i /' vz (Signed)
Block
(Signed)
Date
My Commission Expires Notary Public, State of Florida
Subdivision
No. of Stories
ipg I nspector.
The undersigned applicant for this building permit does hereby certify that he undirstands and accepts his obligations a 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
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
i
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
CONTR.
LIST
IST
r
CHECK
( /
Permit No.. /0 O 0 /
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 Engin ----- / ----- _______.____ _____________
Employing Plumber's Name/
Location and Legal Description Lot
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
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
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No 1 Vi
A� Street
Amount of Permit $ i /' vz (Signed)
Block
(Signed)
Date
My Commission Expires Notary Public, State of Florida
Subdivision
No. of Stories
ipg I nspector.
The undersigned applicant for this building permit does hereby certify that he undirstands and accepts his obligations a 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
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
Permission is hereby granted
SEPTIC TANK
TOTAL
1:71 1
510
V i lambing Ins .ector
MIAMI SHORES VILLAGE
Plumb -ing "Permit
Miami S res Village Fla.
• to install the following described plumbing, in accordance with the
laws, statutes and regulations of Miami Shores Village, Florida and
the State of Florida, governing plumbing and drainage work done in
Miami Shores Village, Florida.
For a At No.
Lot / u •./7 Block Subdivision
Fixtures 0
As Shown on attached approved plans.
FIXTURES ROUG HED IN
FIXTURES SET
• SEWER
Payment Rec 'ved
By
N
•
This permit issued subject to approval of County Plumbing Inspector