568 NE 102 St (10)MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No . 7°2
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submtfted 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 ,["' _
^ Ce19/X/P0f5/9 J 6 CN� / Owaer's Name and Address \ �5 � ( i No. � Street. a — .. .. _.._ ..
Registered Architect and /or Engineer
si
$p o ° Ph Nie /�
J ( t h ff id'L�gal / l peon Lot * Bkxe f:9 . SubdivWoayi Qi g._Cz.y
Street and Number where work is to be performed —No
..5 Wee me 4 /�L`� �_lv- /// /Aft • / 3,/e4
street. / 5 - --
State work to be performed and purpose of building (By Floers)2 /t L_ /NV J 1."149.1-4'91 /fcsf , /So �i�sf W ig/ •
New Building..--- ._— _.._....... - -._.. Remodeling —_ —.__ Addition -- _ Repairs No. of Stories . .
Size Septic Tank_... _Type of Tank_
Feet of Drain Tile DiRt- Feet of Tank or Drain Field from Well .- -- .- --------- .. _ - - .. _
Nature of Water Supply: City —WeIL Size of Soakage Pit
Amount of Permit $ • t'170 (Signed)_ C_ L� 0 ty
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and Itav com-
phed with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the woe,. to be
performed under this permit; and will post or cause to be posted' for inspectio a the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such su • •, , tr on ; k to 1performed under this permit, as are
licensed by Miami Shores Village.
(Signed
Notary
Date..._.._._ _.
/ f9
STATE OF FLORIDA, 1 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 be is the.. -_-Q '•� 2 .._ of the } abov , �e ,, described construction, that be has carefully read the foregoing application, and did sign the tame, and that all facts
therein h' cMS O Z iit,'STATE OF FLO1 I)L
TAY COMMISSION EXPIRES APRIL 28. 4990,
DONDCD THF1U NO • • i . •...I.sir.i L: tt:ti
My Comasissioo Expires
State of Florida
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when mob rwlespectios le mede•neoesesry by improper Dodos for tripoeden, or fanny
materials and /or wnrlomanship.
CLoscrs
BATH
TU••
aNOW1Ra
LAVA.
TORIES
SINKS
SLOP
sums
LAUNORY
Tuns
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
PICTURES
Comm
LIST
-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SQAKAGt
PIT
G
TRAP
SOLAR
HEATER
Diu
WELL
SYSTEM
SW,M'O
P001.
CONTR.
!
LIST
CHECK
r
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No . 7°2
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submtfted 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 ,["' _
^ Ce19/X/P0f5/9 J 6 CN� / Owaer's Name and Address \ �5 � ( i No. � Street. a — .. .. _.._ ..
Registered Architect and /or Engineer
si
$p o ° Ph Nie /�
J ( t h ff id'L�gal / l peon Lot * Bkxe f:9 . SubdivWoayi Qi g._Cz.y
Street and Number where work is to be performed —No
..5 Wee me 4 /�L`� �_lv- /// /Aft • / 3,/e4
street. / 5 - --
State work to be performed and purpose of building (By Floers)2 /t L_ /NV J 1."149.1-4'91 /fcsf , /So �i�sf W ig/ •
New Building..--- ._— _.._....... - -._.. Remodeling —_ —.__ Addition -- _ Repairs No. of Stories . .
Size Septic Tank_... _Type of Tank_
Feet of Drain Tile DiRt- Feet of Tank or Drain Field from Well .- -- .- --------- .. _ - - .. _
Nature of Water Supply: City —WeIL Size of Soakage Pit
Amount of Permit $ • t'170 (Signed)_ C_ L� 0 ty
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and Itav com-
phed with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the woe,. to be
performed under this permit; and will post or cause to be posted' for inspectio a the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such su • •, , tr on ; k to 1performed under this permit, as are
licensed by Miami Shores Village.
(Signed
Notary
Date..._.._._ _.
/ f9
STATE OF FLORIDA, 1 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 be is the.. -_-Q '•� 2 .._ of the } abov , �e ,, described construction, that be has carefully read the foregoing application, and did sign the tame, and that all facts
therein h' cMS O Z iit,'STATE OF FLO1 I)L
TAY COMMISSION EXPIRES APRIL 28. 4990,
DONDCD THF1U NO • • i . •...I.sir.i L: tt:ti
My Comasissioo Expires
State of Florida
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when mob rwlespectios le mede•neoesesry by improper Dodos for tripoeden, or fanny
materials and /or wnrlomanship.
T0: CITY OF
Factory Service Co.
8475 -N.W. 66 STREET
MIAMI, FLA. 33166
DADE 591-9922 BROWARD 467-2320
FOR: WHOM IT MAY CONCERN
I. the undersigned, hereby authorize nedd/er -D. /
an employee of Factory Service Company. Inc.. to secure Dermits
for work to be done by Factory Service Company. Inc., upon the
presentation of permits application signed by me.
permit application is for 3,4/ C / 22
Pi/W
/9
MY Contratltor Certificate of Competency Number is 13299.
)D Master Gas Fitter's limp, number ip 78C11P307.
�� , YS. 8 :. "E : f21DA.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 5098
Contractor --/
or Builder
This Legal Lot BI. ,� Subdi
Description vision
Address of L value of Amt. of � Building ?2. Project Permit
permit is granted escribed in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wi[l be p formed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authori ies. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are clanged wittIt}}out authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assunast the resper}b'ibilit ' a tl •rough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or dravfings or in t1 stat cents • s s ecifications and that he „Assumes respon-
sibility for work done by his agents, servants or employees. ,'�� ”" r ` - 1,,+'
Signed %° '° .70e • By
In consideration of the issuance to me of this permit I agree to perform the wor k cored reunder in compliance w 1� ll ordinances eggy�lations
pertaining thereto and in strict conformity with the plans, drawings, statements or specificatio submitted to the proper ail 6INties of Miami. M'illage.
In acceptirig/ this permit I assume responsibility for all work done by either myself, my agent, s rvant or employee.
CONTRACTOR O$ BUIL R
v
DATE
License No
Contractor's
a-1,e
AUTHORITY
194
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
/` APPLICATION FOR PLUMBING PERMIT
Permit No Date
Application is here 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 he kept at
building during progress of work.
Nature of Water Supply: City —Well
ss.
( Signed)
r,
Owner's Name and Address No = ` Street
Registered Architect and /or Engineer
Employing Plumber's Name. No Street
Location and Legal Description Lot jj Block Subdivision
Street and Number where work is to be performed—No .. (' '_[ Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
My Commission Expires Notary Public, State of Florida
No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile- Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Amount of Permit $ ( 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 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require simitar 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. V
Master Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
i
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
/` APPLICATION FOR PLUMBING PERMIT
Permit No Date
Application is here 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 he kept at
building during progress of work.
Nature of Water Supply: City —Well
ss.
( Signed)
r,
Owner's Name and Address No = ` Street
Registered Architect and /or Engineer
Employing Plumber's Name. No Street
Location and Legal Description Lot jj Block Subdivision
Street and Number where work is to be performed—No .. (' '_[ Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
My Commission Expires Notary Public, State of Florida
No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile- Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Amount of Permit $ ( 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 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require simitar 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. V
Master Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.