550 NE 102 St (8)Permit No.__ 19
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Location and Legal Description Lot Blow'
Street and Number where work is to be performed -No 550 N.
State work to be performe8 and purpose of building (By Floors) - ..__
Date__ 1 - -
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 Miajni 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 Dean Clause No. 550 N.E. _ Street. 102nd Street
Registered Architect and /or Engineer....__._____ __ .
Employing Plumber's Name O'Neal Septic Tank C o. No. _ $ _ N. W. street.. 56th Street
Subdivision
Street 102nd Street
New Building__ Remodeling_____ Addition..______ R
ding -- -- .----------- ....____. g�_ -..._. ___._._..___ Repairs No. of Stories
Size Septic Tan1c_ - - - - -- -50 __-- _�____ -_- -Type of Tank- 8.Q12tic
300 sq _ ft.__ Dist Feet of Ta or Drain Field from Well
Feet of Drain Tlle___— .
Nature of Water Supply: City - Well.__— _______.___ »___— ___Size of Soakage Pit
Amount of Permit $ ► 0 "
STATE OF FLORIDA, } es.
COUNTY OF DADE.
Capacity Gab. 900
( sign ed )__1_` - i w oi &
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
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclrnowledgments, 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
Plumbing Inspector.
NOTE: A re- inspection fee of $1.00 will be made when such re inspection is uncle . necessary by improper notice for inspection, or faulty
materials and/or workmanship.
CLOfETf
BATH
TUBE
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tin's
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No.__ 19
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Location and Legal Description Lot Blow'
Street and Number where work is to be performed -No 550 N.
State work to be performe8 and purpose of building (By Floors) - ..__
Date__ 1 - -
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 Miajni 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 Dean Clause No. 550 N.E. _ Street. 102nd Street
Registered Architect and /or Engineer....__._____ __ .
Employing Plumber's Name O'Neal Septic Tank C o. No. _ $ _ N. W. street.. 56th Street
Subdivision
Street 102nd Street
New Building__ Remodeling_____ Addition..______ R
ding -- -- .----------- ....____. g�_ -..._. ___._._..___ Repairs No. of Stories
Size Septic Tan1c_ - - - - -- -50 __-- _�____ -_- -Type of Tank- 8.Q12tic
300 sq _ ft.__ Dist Feet of Ta or Drain Field from Well
Feet of Drain Tlle___— .
Nature of Water Supply: City - Well.__— _______.___ »___— ___Size of Soakage Pit
Amount of Permit $ ► 0 "
STATE OF FLORIDA, } es.
COUNTY OF DADE.
Capacity Gab. 900
( sign ed )__1_` - i w oi &
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
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclrnowledgments, 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
Plumbing Inspector.
NOTE: A re- inspection fee of $1.00 will be made when such re inspection is uncle . necessary by improper notice for inspection, or faulty
materials and/or workmanship.