MC05-1264i nspection Number: INSP -3320 Permit Number: MC -12 -05 -1264
Inspection Date: 10/16/2006
Inspector: Grande, Claudio
Owner: DEVELOPMENT, TALISMAN
Job Address: 469 91 Street NE
Project: <NONE>
Miami Shores Village, FL 33 an
Contractor: OSCAR AIR CONDITIONING, INC
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New
Phone Number (305)310 -4673
Parcel Number PARC2004 -16
Lot:
Friday, October 13, 2006
Page 1 of 2
Passed
Inspector Comments
i l i f
,,
1
1 ►t'al
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
i nspection Number: INSP -3320 Permit Number: MC -12 -05 -1264
Inspection Date: 10/16/2006
Inspector: Grande, Claudio
Owner: DEVELOPMENT, TALISMAN
Job Address: 469 91 Street NE
Project: <NONE>
Miami Shores Village, FL 33 an
Contractor: OSCAR AIR CONDITIONING, INC
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New
Phone Number (305)310 -4673
Parcel Number PARC2004 -16
Lot:
Friday, October 13, 2006
Page 1 of 2
'"'ADDENDUM TO BUILDING PERMIT APPLICATION
AN ArPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTED, PERMIT HAS E.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM'
GAS RANEE
METER SET (GAS)
GAS PIPING
ELECTRICAL
MECHANICAL
TEM
ATH TU3
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
LIGHT OUTLETS
CENTRAL HEATING
IDET
RECEPTACLES
A/C (WIND)
ISHWASHER
ISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) I ,/
RINKIhG FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK I r/
LOCK DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION I '
REASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
NTERCEPTOR
RANGE TOP
UNDERGROUND TANKS I • 1
OVEN
ABOVE (MOUND TANKS
.AVATORY
TRAY
WATER HEATER
U.F. PRESSURE VESSELS
.AUNORY
:LOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTCRS OVER 1- 3 I•P
HOT WATER BOILERS I I
1
SINK, POT /3 COMP.
MOTORS OVER 3- 5 If
MECHANICAL VENTILATION I L.---r
SINK, RESIDENCE
MOTCRS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 H'
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
I
A/C WINDOW
I REINSP,ECT)ON I 1
WATER SUPPLY TO:
I
AIR CONDITIONERS
I .
I .. " -, •
A/C UNIT
FIRE SPRINKLER
I
STRIP HEATER
GENERATORS TRANSFORMERS
- '
I
1
j
I
HEATER -NEW INST.
1
I
I GENERATORS •TRANSFORMERS
I
I
HEATER - REPLACE
I
I
I GENERATORS TRANSFORMERS
(
1 1
LAWN SPRINKLER -WELL
I
I
SPECIAL PURPOSE
SWIM ING POOL
1
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECT IONS
.1• S I GN TRANSFORMERS
( I
UTILITY -SEWER
SIGN TIME CLOCK
I
UTILITY -WATER
1 FIXTURES
1
1
I
SEPTIC TANK
ANTENNA •
RELAY
TELEVISION OUTLETS
4 TILE/RES.
DRAIN- - TEED,
VIOLATION •
PUMP & ABANDON SEPTIC TANK
REINSPECTION •
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
I
AREA DRAIN
ROOF INLET
Crt AD WATT!) WCATCD
'"'ADDENDUM TO BUILDING PERMIT APPLICATION
AN ArPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTED, PERMIT HAS E.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM'
GAS RANEE
METER SET (GAS)
GAS PIPING
ELECTRICAL
MECHANICAL
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Oncr Address 1
Cite State . " Zip
Tcnant/Lessee Name
s
Job Address (where the work is being done) ."
-------'
Qunlifier. % '
" , _
Describe Work:
Total Fee Now Due S
(Continued on opposite side)
Miami Shores Village
7
City Miami Shores Village County Miami-Dade
Is Building Historically Designated YES NO
Architect/Engirecr's Name (if applicable) Phone #
Permit No.
Master Permit No. i
Permit Type (circle): Building Electrical Plumbing 7 'Mechanical Roofing
,' 7 -- J . . i /I P ‘ 7. •
Owner's Name (Fee Simple Titleholder) , , ; -
• a- w Uplione
. , ,
Phone #
Zip
., . . , • . , . ,; .: 7
./
,,'' : ' i .. ' '; ! ' ' '" . PQM' #
Contractor's Company Name . , ‘'" ,
, , „, , , . . ..
C011112CtOr Address ,,
State
Zip ,
,
S Value of Work For this Permit Square Footage Of Work:
Scanning S Radon S Zoning Bond S
Code Enforcement S Structural Plan Review. 5
,
St o Certificate or Registration No. Certificate of Competency No. '
Submittal Fee S Permit Fee $ CCF $ CO/CC
Notary S Training/Education Fee 5 Technology Fee $ ,77
y •
Type of Work: ['Addition El Alteration E New 0 Repair/Replace 0 Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
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 pennit 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 Ike 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 will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to me or who has produced
As identification and who did take an oath.
Print:
Chc 05/13/03
Signature
Contactor
The f /jo instrument was acknowledged before me this
day of t ! st o d V, by l :.
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLI
Sign: Sign:
Print: i 7. < tt d "di
My Commission Expires: My Commission Expires: ` rs ,ii ://
Carta M Parker
* �
i:i:r:f: *ici::t9::F is st *:t7c *ic �t *ici; * * *:tiF *:F �c 9: *�:9: *:y9;9: * * * * *:t:t �c ah is is i:ic * *9: i; 9::k * *9; :k l; Y: r': >: * * n *'t :Y *iF 9 ; * *9tki:'.Y S§iY *: *iC �t
t ksr o Expires August 27 2005
.. -.
.� rc• ** . ** * * * ** x *�k# # * * ** k k :,: i r Y * *x ** *�k : * * * * * * * ** *�k Yak k�k t ; ::,::,: *:;:
APPLICATION APPROVED BY: `� t) Plans Examiner
Engineer
Zoning
Issue Date: 12/20/2005
Owner's Name: MARTIN PALMER
Permit Type: Mechanical - Residential
Work Classification: New
Job Address: 469 91 Street NE
Comments:
INSTALLATION OF DUCTWORK AND EQUIPMENT
Additional Information
Miami Shores Village, FL 33138
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 12/19/2006
Contractor(s)
OSCAR AIR CONDITIONING, INC
Phone Primary Contractor
Yes
Tons:
Additional Info:
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 responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due
CCF
Education Surcharge
Miscellaneous Fee
Permit Fee - Additions /Alterations
Scanning Fee
Technology Fee
Total:
Amount
$3.60
$1.20
$35.00
$140.00
$3.00
$4.40
$187.20
Building Department File Copy
Applicant Signature
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: MC -12 -05 -1264
Phone: 305- 310 -4673
PARC2004 -16
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 4,000.00
Required Inspections
Rough
Rough Duct
Ventilation
Smoke Test
Hood
Smoke Det Test
Final
Invoice Number
MC - 12 - 05 - 23192
Total:
Amt Due
$187.20
DEC 21 ND
e_re_#- ® 4 06
Amt Paid
` �z
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
Inspection Number: INSP -3314
Inspection Date: 03/08/2006
Inspector: Perez, JanPierre
Owner: PALMER, MARTIN
Job Address: 469 91 Street NE
Project: <NONE>
Tuesday, March 7, 2006
Miami Shores Village, FL 33138
Contractor: OSCAR AIR CONDITIONING, INC
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Php : (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Number: MC -12-05 -1264
Permit Type: Mechanical - Residential
Inspection Type: Rough
Work Classification: New
Phone Number
Parcel Number
Lot:
305 - 310 -4673
PARC2004 -16
Page 2 of 2
Passed
.. ,
Inspector Comments
!
14
3\
\'•
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP -3314
Inspection Date: 03/08/2006
Inspector: Perez, JanPierre
Owner: PALMER, MARTIN
Job Address: 469 91 Street NE
Project: <NONE>
Tuesday, March 7, 2006
Miami Shores Village, FL 33138
Contractor: OSCAR AIR CONDITIONING, INC
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Php : (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Number: MC -12-05 -1264
Permit Type: Mechanical - Residential
Inspection Type: Rough
Work Classification: New
Phone Number
Parcel Number
Lot:
305 - 310 -4673
PARC2004 -16
Page 2 of 2
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing L' Mechanical; Roofing
Owner's Name (Fee Simple Titleholder) ,e_//..(/46 /a/ �/ ' /;� Phone #
Owner's Address c i //I 2 //://".'
City � .: 'yo °:?ye,A ( 146 State Zip - > +
Tenant/Lessee Name
Job Address (where the work is being done) 4/ , 4/ e 9
City Miami Shores Village
Is Building Historically Designated YES NO
Contractor's Company Name % <Kv -7/L' // // ' ��..4)f 4',€,Al oe Phone #
A' �� e'7 -- ,� /�� "'if/ Cit � .//d17/ State / Zip
Qualifier- -- /% °: ✓ 7/ ( 4 f, (i e
Contractor's Address
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
County Miami -Dade
Permit No. /1c
12 -o ~ (z 4
Master Permit No ` ✓ 4 l ZO
Phone #
Phone #
Zip
Square Footage Of Work:
Type of Work: ❑Addition /
yp ['Alteration ew ❑ Repair/RepIace
Describe Work: r.' i �t� c o": ;1 . f`: �is��st_ / _�f� zf t f► t�.� f ! t � / ,�
*** * ** * * *** * * * * * * *** * * **** *F * ** * ** * * * * * *** * * * * * ** **** * **
Structural Plan Review. $
State Certificate or Registration No. '> ? Certificate of Competency No. et;e : -,,
Submittal Fee $ Permit Fee $ CCF $ CO /CC
Notary $ Training/Education Fee $
g Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $
❑ Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
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 will be charged.
Signature Signature
Owner or Agent Cintracto
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this /,
day of , 20 by , day ofZt‘efi:i' // -.i , 20 'L, by & ✓c », „/�•[r e , •
who is personally known to me or who has produced ,ho is personally known to mC or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC: /
i
Sign: Si n: •., ! ! -
Sign: _ - r ,. .e-r ' .e—� ,mot �-,
_
Print:
Print: / j ji�;.,0,4 —, :
A tdALD ;f;'.S OIL.
My Commission Expires: My dmmission,Okpw ;::�I'::'.;iss o ! 4 ' Di) 0
: ) Ii F.S: Fc ua 4, 2CC
*, * * * * * *** * * * ** * *** ** ** * ** *, tit ** * * **** *** ** * * **** * * * ** ** ** * * * * * * * * *** ******i4 *•r * .91e r * *'* * pit #.ft* 'm***** ****
APPLICATION APPROVED BY:
chc 05/13/03
fl"
* * * * * * * * * * * * * * * * * * * * *
Plans Examiner
Engineer
Zoning
*
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN A6PS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
MOTCRS OVER 100 FP
VIOLATION
INDIRECT WASTES -
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4' TILE/RES.
VIOLATION
_
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL CM-ECHANICA
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 the work.
Owner's lame and Address ( FirpAce44 k
stredArcc� Engineer i,L L A't4 %EOM t �' eke .
Name and address of licensed contractor
Location and legal description of lot to be built on: // f./C.DG // &/// �p ck
Lot - 2- 1 Block L i Subdivision 14.. 5 Itio l2 . PB W r . , y
Street and Number where work is to be done L. £ c , ii 6. 1 57
State work t o be done and purpose of building (by floors). state exterior colors (submit samples) . . 2 - 4 / C 7 ; 4 4 - 4 — 2. C- -
A- le 5 y5 C & plf purr t{ . 0 -to u J 7
New Building Remodeling
Remarks (Signed)
Permit No.
Disapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date
Addition
r
Repairs
To be constructed of Kind of foundation
Estimated Total cost of improvements S 517 C • o® . Amount of Permit S
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all plans and specifications for said building. All notices with
Date
No. 'Q' eo g
Roof Covering
reference to the building and its construction may be sent to
STATE OF FLORIDA
COUNTY OF DADE. } ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared
/0 /24 19 43
Street_, C 1
and for no other purpose.
No. of Stories
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen'.-
Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement. and has complied with the provisions thereof. and will require similar
compliance from all contractors or sub - contractors employed by him in the work to be performed r 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 undersign agrees to employ onl such subcontractors, on work to be performed
under this permit, as are licensed by Miami Shores Village.
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 :.plication. and that he did sign the same, and that all facts therein by him stated are true.
Read. Sworn to and Subscribed before me.
Date
Notary Public. State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of 525.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
A re- inspection fee of 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and workmanship.