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482 NE 93 St (12)MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 bu during progress of the work. Owner's Name and Address Date 1-(44 No. _.I. t.-.._.k Street 19 Registered Architect and /or Engineer ...... ............... Name and address of licensed contractor Location and legal d of lot to be on: r - Lot ' /d._. Block Sub i isi91 ...- i __I_L U Street and Number where work is to be done-- ...__. ? �' State work tg be done and purpose of building (by floo Cff 1 C° n..; and for no other purpose. New Building Remodeling Addition d Repairs No. of Stories To be constructed of Kind of in undation Covering Estimated Total cost of improvements $ I ®• 0o Amount of Permit $ 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 the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit 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 Su1plemient, 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 under this permit; and will post or cause to be posted for inspection o the site of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such sul ontractors work to . - performed under this pennit, as are licensed by Miami Shores Village. Remarks .. (Signed) _. STATE OF FLORIDA, i COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. • •N NAME L•EALER DATE FOR CUSTOMER ) ADDRESS .. CITY • •• • II • • • • • • • • 0 • • • 0 .v /�. TEL. n DEALERS LEAVE _BLANK FENCE VC9K ORDER TICKET NO. __ -- - . -_ -_ -- GATE ORDER N4. INSTALLER ' „ N0. OF FEET GAUGE WIRE N0. OF END & GATE TERMINALS HEIGHT No CORNER TERMINALS NO.WALK GATES No. DOUBLE S DIRECTIONS TO JOB /� MISCELLANEOUS DRIVE - - _- k( ) CODE: ' END AND GATE TERMINALS (^ 4`'JALK GATES `�G) CORNER TERMINALS L1 a" 30 DRAW DIAGRAM BELCAN • o • . . • • • m • • • • • m • m . m o O • . • _ m n � � w O0 4' m.da �.�� 'I� I • -d EET CEO I I NAL AND DUPLICATE MAIL TO V1HOLESALE FENCE & PIPE CORP. 2525 N. W. 72ND ST. MIAMI 47, FLORIDA DOUBLE DRIVE GATES • • • • • • • • • • • • • • 0 • • . . . . . . . . , . • • • • 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 regula- tions 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. STATE OF FLORIDA, COUNTY OF DADE. BUILDING INSPECTION DEPARTMENT APPLICATICIN FOR BUILDING PERMIT Owner's Name and Address Registered Architect and /or E rimer Name and address of licensed contractor Location and legal description of lot to be built on: Lot____ ______________ Block ___ ___ ___ Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) New Building __ Remodeling_____ —__ Addition__ Repairs No. of Stories_______________ To be constructed of_____ ____________ Kind of foundation Roof Covering Estimated Total cost of improvements of Permit $ 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 the plans and specifications: for said building. All notices with reference to the building and its construction may be sent to 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 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 under this permit: and will post or cause to be posted fo ' nspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such •contractors, on work t• be pe under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 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. Permit No <� Date Read, Sworn to and Subscribed before me. Disapproved _ _ _ Date (Signed) Building Inspe or MIAMI SHORES VILLAGE Date- ---- ___ — — -- — 19�-r CY , No. Stree r .. . if- 2ye6• -k Notary Public, State of Florida My Commission Expires and for no other purpose. PLANNING BOARD_— DATE Chairman Member _ Member Member Member Member Council Approved__ Date Disapproved NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. // Owner's Name and Add Registered Architect and /or Employing Plumber's N r ._ Location and Legal Description Lot New Building MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. _/ Application is hereby made for the approval of the detailed statement structure herein described. This application is made in compliance and and all provisions of the Laws of the State of Florida 411 ordii ces 6f of Miami Shores Village shall be complied with whetle / h erein spec building during progress of work. ss. /�l'.. /� -✓ No. Remodeling Block 9 ,7/ Addition Amount of Permit $______ (Signed) (Signed) / Date 1 of the plans and specifications herewith submitted for the building or other conformity with the Building Ordinance of Miami Shores Village, Florida, Miami Shores Village and all rules and regulations of the Building Division ified or not. A copy of approved plans and specifications must be kept Ch Street i Street_ Subdivision Street and Number where work is to be performed—No. Street State work to be performed and purpose of building (By Floors) 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 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 5966, Compiled General Laws of Florida Permanent Supplent, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by ht 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 pr notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to- be perfor d under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida Master Plumber. 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. • 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 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. • CLOSETS BATH TUBS SHOWERS LAVA TORIES SINKS SLOP SINKS LAUNDRY TUBS 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'G POOL CONTR. LIST �f r y . / Z` �' � ,--1 CHECK // Owner's Name and Add Registered Architect and /or Employing Plumber's N r ._ Location and Legal Description Lot New Building MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. _/ Application is hereby made for the approval of the detailed statement structure herein described. This application is made in compliance and and all provisions of the Laws of the State of Florida 411 ordii ces 6f of Miami Shores Village shall be complied with whetle / h erein spec building during progress of work. ss. /�l'.. /� -✓ No. Remodeling Block 9 ,7/ Addition Amount of Permit $______ (Signed) (Signed) / Date 1 of the plans and specifications herewith submitted for the building or other conformity with the Building Ordinance of Miami Shores Village, Florida, Miami Shores Village and all rules and regulations of the Building Division ified or not. A copy of approved plans and specifications must be kept Ch Street i Street_ Subdivision Street and Number where work is to be performed—No. Street State work to be performed and purpose of building (By Floors) 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 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 5966, Compiled General Laws of Florida Permanent Supplent, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by ht 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 pr notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to- be perfor d under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida Master Plumber. 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. • 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 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. • emit No/ . 6'- -�--___ Location and Legal Description Lot MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT &pplication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other tructure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, ind all provisions of the Laws of the State of Florida, all ordi aces of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whethe4ierein specified or not. A copy of approved plans and specifications must be kept It building during progress of work s) Owner's Name and Addect, 4", Registered Architect and /or Eagiler _;_ ____.______,i? Employing Plumber's 6 - / AK _____ Street__ Date F —/__4_ — 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 No. of Stories Size Septic Tad( 'Type of Tank Capacity Gals._ Feet of Drain Ti.le______ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. .Size of Soakage Pit. Amount of Permit $- STATE OF FLORIDA, as. COUNTY OF DADE. (Signed) — — — —= _0".00 ", 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 Suppl¢ and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hitn 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 r notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be perform #1 under this permit,, as are licensed by Miami Shores Village. zl / (Signed) Master lumber. 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 $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 SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST l / CHECK /^ emit No/ . 6'- -�--___ Location and Legal Description Lot MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT &pplication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other tructure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, ind all provisions of the Laws of the State of Florida, all ordi aces of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whethe4ierein specified or not. A copy of approved plans and specifications must be kept It building during progress of work s) Owner's Name and Addect, 4", Registered Architect and /or Eagiler _;_ ____.______,i? Employing Plumber's 6 - / AK _____ Street__ Date F —/__4_ — 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 No. of Stories Size Septic Tad( 'Type of Tank Capacity Gals._ Feet of Drain Ti.le______ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. .Size of Soakage Pit. Amount of Permit $- STATE OF FLORIDA, as. COUNTY OF DADE. (Signed) — — — —= _0".00 ", 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 Suppl¢ and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hitn 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 r notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be perform #1 under this permit,, as are licensed by Miami Shores Village. zl / (Signed) Master lumber. 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. 1 Permit No Registered Architect and /or Engineer Nature of Water Supply: City —Well STATE OF FLORIDA, 1 COUNTY OF DADE. ss. 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 s niitted 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 building during progress of work. Owner's Name and Address_ /_ ,f 2 s �`/ ' � �} ��� L No _ l a .l. No. , Employing Plumber's Nam // ` �� _ '�7 '1f s ! / k - ) Street__ .7 Location and Legal Description Lot Block 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 No. of Stories ( Signed) Date Subdivision z" My Commission Expires Notary Public, State of Florida Street_." ‘/ be kept at Size Septic Tank Type of Tank Capacity Gals._.._ ? , Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well 4 �91i_�• Size of Soakage Pit __ ___ ir 1-� L < ,y ,_. F Q r i G Amount of Permit $ �� -- :-- - .7-a„,- , �: ( " i' / Plumbing Inspector. J his building permit does hereby certify that he understands and accepts his obligations as an employer he undersigned applicant fort b g p Y Y of labor P g p Y 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 of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on to be performed ,under this permit, as are licensed by Miami Shores Village. / 7 — � .. . - / ' / Master f lumber. 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 rnade when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. t • CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SINKS SINKS LAUNDRY TUBS 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 CONTR. LIST n/ 7 CHECK Permit No Registered Architect and /or Engineer Nature of Water Supply: City —Well STATE OF FLORIDA, 1 COUNTY OF DADE. ss. 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 s niitted 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 building during progress of work. Owner's Name and Address_ /_ ,f 2 s �`/ ' � �} ��� L No _ l a .l. No. , Employing Plumber's Nam // ` �� _ '�7 '1f s ! / k - ) Street__ .7 Location and Legal Description Lot Block 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 No. of Stories ( Signed) Date Subdivision z" My Commission Expires Notary Public, State of Florida Street_." ‘/ be kept at Size Septic Tank Type of Tank Capacity Gals._.._ ? , Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well 4 �91i_�• Size of Soakage Pit __ ___ ir 1-� L < ,y ,_. F Q r i G Amount of Permit $ �� -- :-- - .7-a„,- , �: ( " i' / Plumbing Inspector. J his building permit does hereby certify that he understands and accepts his obligations as an employer he undersigned applicant fort b g p Y Y of labor P g p Y 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 of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on to be performed ,under this permit, as are licensed by Miami Shores Village. / 7 — � .. . - / ' / Master f lumber. 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 rnade when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. t • MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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. rr Date Owner's Name and Address (--1) _S Registered Architect and /or Engineer n� Name and address of licensed contractor °"� "� C - (de Location and legal description of lot to be built on.: Lot Block Subdivision Street and Number where work is to be done `1 ' efr eL State work to be done and purpose of building (by floors) b�,1 cs J �`-�'t Date Building Ins ector BUILDING INSPECTION DEPARTMENT Read, Sworn to and Subscribed before me. Notary Public, State of Florida Street ___. q__S and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of___SactN^- of foundation Roof Covering i Estimated Total cost of improvements $_ Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 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 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 subcontr ctors on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. J ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No b Disapproved ' (Signed) My Commission Expires PLANNING BOARD DATE Chairman ' Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.