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EL-04-286Miami Shores Village Building Departme 10050 N.E.2nd Avenue, Miami Shores, Florida Tel: (305) 795.2204 F 02) BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building ECEIVED 3138 OCT 1 Master Permit No. Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder), Vkr.Jacx. Cc k Phone # - (S�t ®5Q3Cc n Owner's Address '7.1/4*S City \\\NIZbzu-7.— '\r cA,e5 State Zip -3T>\ 2 Tenant/Lessee Name Phone # Job Address (where the work is being clone) k. "® City Miami Shores Village County Miami-Dade Zip 33 \' Is Building Historically Designated YES NO h Contractor's Company Name ...kE?c Contractor's Address (s>(cJ 00:2) -.(k-..c.-esz_..7 City tV -c cam, State Qualifier Phone # — Zip ,31 SO— `c tL State Certificate or Registration No. t k t k Certificate of Competency No. Architect/Engineer's Name (if applicable) $ Value of Work For this Permit Type of Work: []Addition ['Alteration Describe Work: Phone # ['New Square Footage Of Work: ]] Repair/Replace ❑ Demolition Submi Fee $ Permit Fee $ /off �°- CCF $ ttt 1 Notary $ Training/Education Fee $ 0 • (tf, 0 Technology Fee $ Scanning $ " Zoning Bond $ -" Code Enforcement $ Structural Plan Review. $ CO /CC Total Fee Now Due $ (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Nip Mortgage Lender's Name (if applicable; Mortgage Lender's Address City State Zip (Pc Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN, YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee wi l be charged. Signature wner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of by '-sc- -6 --'. -- , day of C�'k who is persenyn to me or who has produced who is pe As identification and who did take an oath. NOTARY PUBL4C:_ r ;; Sign: if PI, OFF Print: My Commi. , 20c5q by 5 me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: � r e° , ' } COMMISSION NUMBER DD033052 P MY COMt MISS N IRES My Commiss * * * * * * * * * * * * * * * * * * * * * * * * * * ** W pV . OFFICIALNOiARY •�, do ;s: RIECOLEABER3 iT » COMMISSION d NUMBER 914NOF , MY COMMISSION EXPIRES 1 JULY 2,2005 ***********************************+ k***************************************** * * * * * * * * * * ** ** * * *** *** * ** ** * * ** APPLICATION APPROVED BY: Chc 05/13/03 Plans Examiner Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /14/2004 Electrical Permit Permit Number: EL2004 -286 Applicant: SHORES PLAZA EAST CONDO Owner: CONDO JOB ADDRESS: T. 1L,b or a tat we i6. Contractor MOODY ELECTRIC INC Contractor's Address: 669 NW 90 ST Local Phone: (305)758 -2000 SHORES PLAZA EAST Parcel # PARC2004 -23 Legal Description: Page 1 of 1 Fees: FEE2004 -10135 FEE2004 -10136 FEE2004 -10137 FEE2004 -10138 Description Building Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $100.00 $1.80 $0.60 $2.50 $104.90 Permit Status: APPROVED Permit Expiration: 4/10/2005 Construction Value: $2,400.00 Work: METER ROOM UPGRADE Signed: (INSPECTOR) Total Fees: $109 (i® Total Receipts: id.cio In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: MOODS # ELECTRIC, INC. www.moodyeiectric.com 669 N.W. 90 Street • Miami, FL 33150 -2166 Tel: (305) 758 -2000 Fax (305) 754 -1333 Shores Plaza East Condo 9120 N.E. 8 Avenue Miami Shores, Florida 33138 by) Ago u&Cb. h'ilrT 2- Per `A •P t4,0 me Q a( St ' t4 3 'alas Tirk4413 PEN., NPT *63 c bP 160 rmC. Q *-1--1 T'-% k-VW C ' a,r cl► sj%K1.v' 4-1,el �¢ asov Lo3ck C-r et COINCt t -e d.e-m ii icy' •Z,TA,f' '`[:• APPROVED t ZONING c'71t"CTUVL BY DATE t ELEf T Zgaal-r.0" BLDG. 1;1 SUCT TO • T.PdE CUU1 VI..ES AND r-N 3 • . \ • \* • , bed cL eed WVA 101, oid.fr a 55 vockiio egrh Cord 0') Concrcic ; 2 /36 97,* 1/e le,)_K /i% /'1 Sparc g(f?D,7h/ ij/( 4'/? s7; N ��S THE SHORES PLAZA EAST CONDOMINIUM ASSOCIATION, INC. 745 N.E. 91 Street Miami Shores, Florida 33138 March 8, 1995 The Village of Miami Shores Miami Shores, Florida This letter will serve as your confirmation that the Plaza East Condominium Association, Inc., has approved the installation of a Carrier central air conditioning unit at the apartment of Mr. Robert Gonzalez, located at 9120 N.E. 8th Avenue, #4G. Attentively yours, Oscar Zar..•oz Secretary to t e Board of Directors Lennox Objective Guide to Installation Comparison ************* * * * * * * * * * * * * * * * * * * * * * * * * * *** &* HEAT** INC * * * * * * * * * * * * * * * * * * * * * * * * * * ** AFFORDABLE AI R 516 N.E. 190 STREET . MIAMI, FL 33179 305-940--0777 ************************************************** * * * * * * * * * * * * *** * * * * * * * * * * * * * *x ROOM - WALL DOOR .DOOR WALL WALL LOGIC 1000 RESIDENTIAL LOADS ANALYSIS PREPARED FOR: GONZALEZ PREPARED BY: AFFORDABLE AIR & HEAT, INC. FILE TITLE: DESIGN TEMPERATURES (DEGREES F) WINTER INSIDE 72 WINTER OUTSIDE 47 SUMMER INSIDE 75 SUMMER OUTSIDE 90 DAILY TEMPERATURE RANGE INDICATOR 5L DESIGN GRAINS RELATIVE HUMIDITY 25 DEGREES NORTH LATITUDE 0.5 SUMMER AIR CHANGES PER HOUR 0.4 WINTER AIR CHANGES PER HOUR 1 WHOLE HOUSE IN ZONE 1 26 X 30 14A 8 INCH BLOCK NO INSUL UNFINISHED 10D SOLID CORE 10D SOLID CORE 14A' 8 INCH BLOCK NO INSUL UNFINISHED 14A 8 INCH BLOCK NO INSUL UNFINISHED OVERHANG = 6.0 FACING -S SNGLE PN CLR GLASS METAL FRM TINT -PLAIN SHADING - DRAPES OR BLINDS SHADING COEFFICIENT = 1 SNGLE PN CLR GLASS S�ADINGADRAPES ORF S BLINDS TINT -PLAIN SHADING COEFFICIENT = 1 WINDOW 1C WINDOW 1C • WALL 14A 8 INCH BLOCK NO INSUL UNFINISHED CEILING 16A LIGHT NO INSULATION FLOOR 22A NO EDGE INSULATION WINTER INFILTRATION 42 CFM SUMMER INFILTRATION 42 CFM PEOPLE APPLIANCES 2 TOTAL FOR ROOM 1 '6,240 CU FT SENSIBLE GAIN LATENT GAIN SENSIBLE LATENT PAGE 1 AREA BTUH GAIN SO FT LOSS 166 2,117 21 242 21 242 240 3,060 52 663 1,295 148 148 1,873 406 66 1,906 1,188 ,90 2,599 1,62C 240 780 26 3,060 11,681 527 1,146 1,87; 11,93( C 681 1,55! 60( 120( 780 27,240 22,96 2,01! LOGIC 1000 RESIDENTIAL LOADS ANALYSIS PAGE 2 AREA BTUH BTUH SO FT LOSS GAIN =========19============================161====MM=====a========IM =e: == =a=====m = = == = == STRUCTURE TOTALS 6,240 CU FT ,780 SENSIBLE 27,240 22,968 LATENT 2,019 MINIMUM Cooling Capacity needed is 24,987 btu at 90 degrees outside and 75 degrees inside Maximum desired Sensible Cooling-Capacity is 26,413 btu (115% of Sensible Load) • e======= m==== m===================================== =_____= = = = == = = = = =_____________= * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Version 92.05 * * * * * * * * * * * * * * * * * * * * * * * * * * * * **e* * This Heating and Cooling Load Computation was produced using the procedures * * and tables of the Air Conditioning Contractors of America's Manual J. * * Seventh Edition. The accuracy of the calculated loads depends upon the * * accuracy of the data used and the accuracy of the Manual J load calculation * * procedures for the given conditions. No warranty, either, expressed or * * implied, is given by Lennox Industries Inc. with respect to the accuracy * * and /or sufficiency of.the information provided by this report. ************************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 4 • eof3L,?r 0-2.0 ,p I SNP ' , faSe 3 trill rtiffm if 02- 10 /Via ficc Mar 14 , 95 9:04 N':. 002 P.02 zotEs t.aza East Condominium, find. 745 N.E. 91st STREET MIAMI SHORES, FLORIDA 33138 March 13, 1995 Affordable Air & Heat, Inc. 516 Northeast 190th Street Miami, FL 33179 RE: LOCATION OF COMPRESSOR FOR 9120 NE 8TH AVE #1 To Whom It May Concern; Marie McNally who resides at the above referenced apartment has expressed her desire lo convert her condominium to a central heating and cooling system locating her compressor unit on the side of the building (NE 91st Street), on the side of her unit, next to a previously installed compressor unit. The Board of Directors hereby approves the location of this particular comp essor unit. 1� Jeri t ove dale; President ohn A. Hauter; Treasurer CA rr-1(07r eo. 373 goX g Rl ff3 YflN Fo if deer SKI/ //e4r # lair_ DrA10 �i etRaT LiNes 3l Sothot Ye Li/ Of) 6/)(11e/ Lennox Objective Guide to Installation Comparison ************* * * * * * * * * * * * * * * * * * * * * * * * * *IR ** &* HEAT** INC * * * * * * * * * * * * * * * * * * * * * * * * * * ** AFFORDABLE A 516 N.E. 190 STREET . MIAMI, FL 33179 305 - 940 -0777 ************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** LOGIC 1000 RESIDENTIAL IOADS ANALYSIS PREPARED FOR: MC NALLY PREPARED BY: AFFORDABLE AIR & HEAT, INC. FILE TITLE: DESIGN TEMPERATURES (DEGREES F) WINTER INSIDE 72 WINTER OUTSIDE SUMMER INSIDE 75 SUMMER OUTSIDE DAILY TEMPERATURE RANGE INDICATOR DESIGN GRAINS RELATIVE HUMIDITY DEGREES NORTH LATITUDE SUMMER AIR CHANGES PER HOUR WINTER AIR CHANGES PER HOUR ROOM - 1 WHOLE HOUSE IN ZONE 1 26 X 30 14A 8 INCH BLOCK NO INSUL UNFINISHED 10D SOLID CORE 10D SOLID CORE 14A 8 INCH BLOCK NO INSUL UNFINISHED 14A 8 INCH BLOCK NO INSUL UNFINISHED OVERHANG = 6.0 SNGLE PN CLR GLASS ORF S BLINDS TINT -PLAIN SHADING COEFFICIENT = 1 SNGLE PN CLR GLASS METAL FRM FACINGS TINT -PLAIN SHADING-DRAPES OR BLINDS SHADING COEFFICIENT = 1 WALL DOOR DOOR WALL WALL WINDOW 1C WINDOW 1C 47 90 55 25 0.4 0.4 WALL 14A 8 INCH BLOCK NO INSUL UNFINISHED CEILING 16A LIGHT NO INSULATION FLOOR 22A NO EDGE INSULATION WINTER INFILTRATION 42 CFM SUMMER INFILTRATION 42 CFM PEOPLE 2 APPLIANCES TOTAL FOR ROOM 1 6,240 CU FT SENSIBLE GAIN LATENT GAIN SENSIBLE LATENT PAGE 1 AREA BTUH BTUH SQ FT LOSS GAIN 166 2,117 21 242 21 242 240 3,060 52 663 1,295 148 148 1,873 406 66 1,906 1.188 90 2,599 1,620 240 780 26 3,060 11,681 527 1,146 1,873 11,930 0 688 1,559 600 1200 780 27,240 22,968 2,019 LOGIC 1000 RESIDENTIAL LOADS ANALYSIS PAGE 2 AREA BTUH BTUH SQ FT ,LOSS GAIN = mmmmma= = ===== = = = = ==== = = = === === p= R a == == = == mm=== === ====== === s===== _= = ==a= STRUCTURE TOTALS 6,240 CU FT 780 SENSIBLE 27,240 22,968 LATENT 2,019 MINIMUM Cooling Capacity needed is 24,987 btu at 90 degrees outside and 75 degrees inside Maximum desired Sensible Cooling Capacity is 26,413 btu (115% of Sensible Load) • • ______________________======___________________== = = ===== = =_ = == = == = ===== == _______ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Version 92.05 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * %* * This Heating and Cooling Load Computation was produced using the procedures * * and tables of the Air Conditioning Contractors of America's Manual J, * * Seventh Edition. The accuracy of the calculated loads depends upon the * * accuracy of the data used and the accuracy of the Manual J load calculation * * procedures for the given conditions. No warranty, either expressed or * * implied, is given by Lennox Industries Inc. with respect to the accuracy * * and /or sufficiency of the information provided by this report. ************************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 4 4)O i0b E 1ec4r,ccrl MGr�e. Mc,ma11� q l?o rv. E. � iq�.AP+) M eaw►; Shorts , P-icz.„ { av5�"&" G PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date iN /93 Job Address C11; b ni• C• W ?toe, / p4-1 Tax Folio Legal Description Owner / Lessee / Tenant f 1' () Y I e yr c1 i ljy. Owner's Address 'q b N • E f- p Contracting Co. O l©Ydob L 11C4r,CC! 1 Qualifier 4LCkU n State laYd6C Municipal # Competency # 010// 0 Ins .Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDIN r ELECTRICAL,. PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION WorC, 1r 1r 1 �lr' �� 1.-0-?; Ngt V\rt 11.\\.A.) Master Permit # 3 -) Phone 17 % f_ �' ) �*4 ree Address��'C�J N. G. f���Y1 e..7 phone ( '1C% -0 -2 Square Ft. Estimated Cost(value) 30(3°0 0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and instillation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructi and zoniig. Furthermore, I authorize the above -named contractor to do the work stated. Notary a My Comma ** * * * 0 1,. FEES: PERMIT A APPROVED: Si ±!gin Da Notary a My Comma Owner- Builder J' y r * * * * RADON C.C.F. Fire Other NOTARY * ** TOTAL DUE 3a Zoning Building Electrica Mechanical Plumbing Engineering Date Legal Description ) yy Owner / Lessee / Tenant arf C AJa/ 1- Owner's Address � � a 6; PERMIT APPLICATION FOR MIAMI SHORES VILLAGE se 44/ Job Address (41;0 V Tax Folio Contracting co . rdab k /7,` TeY'i r We� Qualifier 0% ssi Phone 94/0 °' 77/7 State #POYZICA, Municipal # Competency #CYfaell I Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBI , MECHANICS ROOFING PAVING FENCE SIGN WORK DESCRIPTION a v1 s Cc �`Y,'ce� ; --ItAn 5K \-1e jvd 0u-He 6. Square Ft. Estimated Cost(value) A .° 3 71r-00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Master Permit # 3757) Phone 7,5474- f'7S7 `I Address 376 ® lea S / Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. C 4%.e%Ste.t7K 1) gnature of owner and /or do Pr Jfi Date: �� , 7 Notary esident My Co ** * * * * * * * * FEES: PERMIT "I S, RADON C.C.F. APPROVED: Zoning Signatur r 3!iLii Notary as My Commis NOTARY I' * * ** TOTAL DUE ( 3 so Fire Other Building Mechanical' ,..Aasc./ir, d1ollumbing Electrical Engineering__ PERMIT APPLICATIONwFOR MIAMI SHORES VILLAGE Date) l JqS Job Address 9 1 a O N. E. )ate Tax Folio Legal Description Owner / Lessee / Tenant Polcr..-r-t- Master Permit # 37147 / Owner's. Address glAO l 6. P104 L-1 Phone 53 Contracting Co. J)e.. Address VU E. ?q o°'t" h Qualifier BUV'4 Lcotui Y ss # ihone 9L/O - 0 '2'7'7 State # Municipal # Competency Witt° NoIns.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL1PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION k VA-VA 5 KW )404--IcK r; t y- 4 (AP) Square Ft. Estimated Cost(value) ! ()' WARNING TO OWNER: YOU MUST RECORD A NOTICE OP' COMMENCEMENT AND YOUR FAILURE TO DO SONNY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all app icable laws regulating construction and _ oning. Furthermore, I aut orize the above -named contror to do the work stated. Signatu Date: Signatur Date: . -t 1.,.. ,AIL Owner- Builder Notary as to Owner an My Commission Expires: Aa Notary as tp I y Commissi',o ** R ii if .f f11 -.• = ` ` - �.v -•-.rti c — y _ .. ' FEES: PERMIT 30,°-° 30,°-° RADON C.C.F. 1 6.70 NOTARY' APPROVED: Zoning R Fire Other * TOTAL DUE .3 F �. Building Electric =� ��7,47, ~5 Mechanical Plumbing Engineering -. Y y A PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 1 95 Job Address q ( cg0 N. e Sthe.. 14p+1i Tax Folio Legal Description Owner / Lessee / Tenant Rer* 0v12.Q le z Master Permit # 374/61 Owner's Address q lac) N. E. Ave. Ap'1' Phone63 1 "'0k-iag Contracting Co. AP-kyrribblej ale" °1- Address ,!:;-1(0 Ni C )qo -u-, &J 'e Qualifier Join r fe.�01• iel SS# !'hone 3)0 'b 7ri State # Pk)r'idi .► Municipal # Competency # 41It' Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBI' MECHANICAL PROOFING PAVING FENCE SIGN WORK DESCRIPTION S 1 1 i yin '; °" c_A v-Y'e e- Y 44 /C- v i — WI °) 5 K eq- e.y Gina' 6 Ou -e-4--s Square Ft. Estimated Cost(value) 75.°0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO X"OUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the aco tractor to do the work stated. above-named Signatu Date: ndo President Notary as to Owner an My Commission Expires: 4 atu a of '.nt. ... /or Owner- Builder Dater 311 ri V Notary as to Contractor or Owner- Builder My Commission F F 7 R err. 9`9sv: * p ®� 57° »Bizir C J :Y:il FEES: PERMIT L4r29 RADON C.C.F. / a NOTARY APPROVED: Fire Other Building Electrical Engineering