43 NW 91 St (4)- -'
CLOSETS
BATH
Tuff
SHOWERS
LAVA-
TORIES
a1NK•
SLOP
$INKS
LAUNDRY
Tuff
URINALS
CATCH
!DAWN
FLOOR
DRAIN
Daum ma
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
mar
WELL.
a
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
1'
,--
Permit No . •c21/ / Date. 4 iq° S3 ._
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subi!>♦fted for the building or other
stricture 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 st
building during progress of work.
Owner's Name and Address 6 A ati i A4O r" ,i' d
Registered Architect and /or En
Nor D ..�, ) o ,4 eitin.eLe ......�A f .....,.,./6'
Location and Legal Description Lot /'✓�,�� /Wil L' Ba S 1- 1 Subdivat 1/ 3Loy ea oef //-
Street and Number where work is to be performed —No '/ 3 .// / Gf) Street. ._. " 1724
State work to be performed and purpose of building (By Floors)4 2/2.0_e __4 4_ 3;72.i.r:14. /gc . t2' r �/.�Z4'
New Building____ .... Remodeling____ _____ Addition_- ______ Repairs No. of Stories
Employing Plumber's Name
Size Septic Tank__ -Type of Tank
Feet of Drain Tile Dist- Feet of Tank or Drain Field from .....
Nature of Water Supply: City —Well. Size of Soakage Pit.
Amount of Permit
Do
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 I111T com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the wort; to he
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 err
required by the Act. The undersigned agrees to employ only such sub- emtractors, . k to be under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, /s.
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 be did sign the same, and that all facts
therein by him stated are true.
My Commission F�rpina
NOTE: A re- inspection fee of *1.00 will be made wham auce mialipaet1Vaa Is soade.neoseeery by improper notion for b scare ion, or fad
materials and /or worlomanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed
No if 3 / • Street_ 9 / 5 _..�
M73-'
Notary Public, State of Florida
Master Plum
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building f-` 4 .1,!
Architect
Contractor
or Builder
Legal
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA /!
DATE ` / 1954_
PERMIT
4/1 a! & . of
N9 3769
Contractor's
License No
Work to be performed wider this Permit
i f c` rI %.
Value of Amount of
Project $ Permit $
Lot I Bl Subdi-
vision
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorou knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or spe ifica�ons and that he assumes responsibility for work
done by his agents, servants or employees.
Signed. i&J (. 2
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered reunder 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 ac-
cepting this perm t I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDI BY AUTHORITY a 4191/0-
i_Ltige of Miami Shores
JOB -' 2
ADDRESS
43 n9.
INSPECTION Pet . - 4 -
TIME READY `� 1
«j .
5 / Si(
REMARKS
INSPECTOR
N° 4459
DATE — 2 `.�
dil of Miami Shores
JOB DeolAi
ADDRESS #- R / / , /
INSPECTION ?a �5 7. �• ' �'� „'`
TIME READY -
N° 4346
REMARKS
INSPECTOR DATE ` ` ' r '
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
building D'c
❑
II.rchitect
ontractor
Dr Builder t 1'4 `)
i.egal Lot })
Description
Address of r s'
luilding ' �' • ! a +
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE SP' z a
PERMIT N? 4201 Contractor's
License No S t v
B1
195_
Work to be performed under this Permit
BY
11 )
Subdi-
vision
Value of Amount of
Project $ Permit $
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
lrawings, statements or specifications that may have bee submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ime if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
;ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
one by his agents, servants or employees. f y w
Signed CO
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered ereunder in compliance with all ordinances and regulations
,ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
:opting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY 641110°
Permit No
267
\4702 f2
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 °h?a. C- i. No._____.__________ Street
Registered Architect and /or Engineer - - - -_ -- - - - - -- - - - - - -_ _ -- -- __-------- ______
B r
Employing Plumber's Name No._______— ___ —____ _ Street.
Location and Legal Descriptia} /Lot Blork
Street and Number where work is to be performed —No 4 / 3 /1/ [J Street
State work to be performed and purpose of building (By Floors) _._ —_
New Building !-"` ___ Remodeling —___ __ -- Addition_
Size Septic Tank ....... -- _-- ..... ----------------- - - - - -- -Type of Tank
Nature of Water Supply Well
Amount of Permit $ 1 3
STATE OF FLORIDA, 1 85,
COUNTY OF DADE. j
(Signed) _ 1A -
(Signed).
Date — 3 / — S
Subdivision .....
-- ----- ------ - -_ ----
Repairs No. of Stories.
Capacity Gals
Feet of Drain Tile. _Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, 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.
Master Plumber.
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of 81.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or worllmanship.
CLOSETS
TUBS
TUBS
SHOWER!
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
UR
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
ISieL
TOTAL
FIXTURES
CONTR.
LI ST
9'
Ol
/
/
01.
--1-:-
--1----1
CHECK
•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
P IT
GREASE
TRAP
t9irR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW I
POOL
CONTR.
LI ST
CHECK
' '
/ _
---I-----I---,-
Permit No
267
\4702 f2
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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 °h?a. C- i. No._____.__________ Street
Registered Architect and /or Engineer - - - -_ -- - - - - -- - - - - - -_ _ -- -- __-------- ______
B r
Employing Plumber's Name No._______— ___ —____ _ Street.
Location and Legal Descriptia} /Lot Blork
Street and Number where work is to be performed —No 4 / 3 /1/ [J Street
State work to be performed and purpose of building (By Floors) _._ —_
New Building !-"` ___ Remodeling —___ __ -- Addition_
Size Septic Tank ....... -- _-- ..... ----------------- - - - - -- -Type of Tank
Nature of Water Supply Well
Amount of Permit $ 1 3
STATE OF FLORIDA, 1 85,
COUNTY OF DADE. j
(Signed) _ 1A -
(Signed).
Date — 3 / — S
Subdivision .....
-- ----- ------ - -_ ----
Repairs No. of Stories.
Capacity Gals
Feet of Drain Tile. _Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, 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.
Master Plumber.
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of 81.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or worllmanship.
WC..
Permit No 3 7
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 confnr lit'y with the &hiding 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 o- p.m:. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address ______
Registered Architect and /or Engineer____—
Employing Plumber's Name.
Amount of Permit $------- 3 -- - - - - --
MIAMI SHORES VILLA
PLUMBING INSPECTION DEPARTMEi
APPLICATION FOR PLUMBING
Date
YI D
No.._.--- _-- _- -_-- _---- _____ -- Street
Street_
Location and Legal Description Lot__ - -___" .____.___ _ ___ Block_ ___ _ ____._______________. Subdivision. __.._______._._
Street and Number where work is to be performed —No # ,/ - 2a • .9/ Street
State work to be gLined and purpose of building (By Floors)
New Building _._ Remodeling_____ ____ Addition._______._._.__ .____. Repairs No of Stories.
Size Septic Tank LPG o _ Type of Tank___ Capacity Gals
Feet of Drain TilearZ_-_.- — *-`- = -- /- 4- • -Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. ______________._.__ Size of Soakage Pit
(Signed)_ -- tA)
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 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 the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on k to be performed nder this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to rue 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 worlananship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
URINALS
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
I_—
CoNTR.
LIST
CHECK
Permit No 3 7
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 confnr lit'y with the &hiding 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 o- p.m:. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address ______
Registered Architect and /or Engineer____—
Employing Plumber's Name.
Amount of Permit $------- 3 -- - - - - --
MIAMI SHORES VILLA
PLUMBING INSPECTION DEPARTMEi
APPLICATION FOR PLUMBING
Date
YI D
No.._.--- _-- _- -_-- _---- _____ -- Street
Street_
Location and Legal Description Lot__ - -___" .____.___ _ ___ Block_ ___ _ ____._______________. Subdivision. __.._______._._
Street and Number where work is to be performed —No # ,/ - 2a • .9/ Street
State work to be gLined and purpose of building (By Floors)
New Building _._ Remodeling_____ ____ Addition._______._._.__ .____. Repairs No of Stories.
Size Septic Tank LPG o _ Type of Tank___ Capacity Gals
Feet of Drain TilearZ_-_.- — *-`- = -- /- 4- • -Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. ______________._.__ Size of Soakage Pit
(Signed)_ -- tA)
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 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 the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on k to be performed nder this permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to rue 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 worlananship.
Permit No
Owner's Name and Address.-- .- --• - _ / � / `e
MIAMI •SHORES VIL ":AGE
PLUMBING INSPECTION DEPARTMEI <`
APPLICATION FOR PLUMBING: '
Amount of Permit $-------- - - - -J= `'- —__ -__ _. ------ __ -_ -- - _^ (Signed) /�' i • // • %.
Date - - / I
Application is hereby made for the approval of the detailed statement of thy plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conforr:ty 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.
No.____ _- Street
Registered Architect and /or Engi- -- ------- ----- -- _ - __ - _ - - -__r __
Employing Plumber's Name °� � . No. ___ L'.S e-c 44 '"?
Location and Legal Description ____ .____. _..______ ___ _ Block__ Subdivision
Street and Number where work is to be performed -No N,kl • 9 1 ' ^ Street —
i
State work to be performed and purpose of building (By Floors)__ -___
New Building ____ -- _.. Remodeling _ 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 4•._(.tl-et-C.-- Size of Soakage Pit
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 5986, 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.
My Commission Expires Notary Public, State of Florida
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
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 worlomanship.
CLOSETS
BATH
TUBS
SHOWER!
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tuns
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'S
POOL
CONTR.
LIST
CHECK
Permit No
Owner's Name and Address.-- .- --• - _ / � / `e
MIAMI •SHORES VIL ":AGE
PLUMBING INSPECTION DEPARTMEI <`
APPLICATION FOR PLUMBING: '
Amount of Permit $-------- - - - -J= `'- —__ -__ _. ------ __ -_ -- - _^ (Signed) /�' i • // • %.
Date - - / I
Application is hereby made for the approval of the detailed statement of thy plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conforr:ty 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.
No.____ _- Street
Registered Architect and /or Engi- -- ------- ----- -- _ - __ - _ - - -__r __
Employing Plumber's Name °� � . No. ___ L'.S e-c 44 '"?
Location and Legal Description ____ .____. _..______ ___ _ Block__ Subdivision
Street and Number where work is to be performed -No N,kl • 9 1 ' ^ Street —
i
State work to be performed and purpose of building (By Floors)__ -___
New Building ____ -- _.. Remodeling _ 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 4•._(.tl-et-C.-- Size of Soakage Pit
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 5986, 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.
My Commission Expires Notary Public, State of Florida
STATE OF FLORIDA, 1
COUNTY OF DADE. 1
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 worlomanship.