5798BUILDING
ELECTRICAL
PLUMBING
ROOFING
0
❑
PERMIT N°
0
MIAMI SHORES VILLAGE,
5798
Contractor's
License No.
Work to be performed under this Permit
Owner of d
Building
Architect
Contractor
or Builder
Legal Lot
Description Bi.
Subdi-
vision
Address of .�- ,. {' Value of ' ""`° 11 Amount of
Building 3 * Project $ 11 Permit $
This permit is, granted to the contractor or builder named above to construct the building or to install the equipment or
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be perf
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities.
time it the work is not done in with such ordinances or if the plans are changed without authorization. A Furth
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough owled
pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or speca . s and
done by his agents, servants or employees.
In consideration of the issuance to me
pertaining thereto and in strict conformity with
cepting this permit I assume responsibility for
CONTRACTOR OR BUILDER
Signed.
device described in the application
ed in compliance with any plans
•
it may be revoked at any
condition upon which this permit is
of th ordinances and regulations
e mes responsibility for work
INSPECTOR'
of this permit I agree to perform the work cover
the plans, drawings, statements or specifications
all work done by either, myself, my agent, se
f' p
f
ereunder in compliance with all ordinances and regulations
milted to the proper authorities of Miami Shores Village. In ac-
t or empioe.
AUTHORITY
4-A?v-
Permit No
MIAMI SHORES VILlAGE
PLUMBING INSPECTION DEPARTMEN
APPLICATION FOR PLUMBING "!1
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 �l 4, eHI . No /J �''r// // k— Street_ 77 � f
Registered Architect and /or Engineer ,'
Employing Plumber's Name 7-�— IVI Pi( No (9T -�4/� Street Z a-ze_ 49c
Location and Legal Description Lot Block
Street and Number where work is to be performed —No / 4 Y '/Y4—+ O.7t Street—
State work to be performed and purpose of building (By Floors)
New Building___ Remodeling
Subdivision_-_
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
Amount of Permit $
(Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige Fps as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors empl„> ed 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 die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this pennit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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
N TE: 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
-
-
LAVA•
TOR(ES
SINKS
SLOP
SINKS
LAUNDRY
Twits
URINALS
URINALS
CATCH
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
,1i//.
WELL
SPRKLR.
SYSTEM
$W IM'G
POOL
CoorrR.
LIST
�/
I
--.--
.—.—
CHECK
40 S 1
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
Amount of Permit $
(Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige Fps as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors empl„> ed 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 die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this pennit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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
N TE: 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.