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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.