485 NE 92 St (13)Issue Date: 9/20/2006
Owner's Name: KRISTINE BARBIERI
Permit Type: Driveways /Sidewalks /Slabs
Work Classification: New
Job Address: 485 92 Street NE
Contractor(s)
HOME OWNER
Phone Primary Contractor
Yes
Additional Information
Miami Shores Village, FL
Expires: 03/19/2007
Type of Work:
Bond Return :
Additional Info:
Classification: Residential
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 Amount
CCF $2.40
Education Surcharge $0.80
Notary Fee $5.00
Permit Fee $125.00
Scanning Fee $6.00
Technology Fee $3.12
Total: $142.32
Building Department File Copy
Applicant Signature
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Permit Status: APPROVED
Permit Number: DS - - - 2351
Phone: 305 - 759 -3380
Parcel #: 1132060140280
Block: Lot:
Section: PB:
Total Square Feet: 535
Total Valuation: $ 3,450.00
Re . uired Ins . ections
Foundation
Sidewalk
Landscaping
Final
Invoice Number
DS - 9 - 06 - 26162
Total:
10€1,4/
Amt Due
$142.32
Amt Paid
2
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 -26975
Permit Number: DS -9 -06 -2351
Inspection Date: 10/10/2006
Inspector: Grande, Claudio
Owner: BARBIERI, KRISTINE
Job Address: 485 92 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: HOME OWNER
Building Department Comments
Thursday, October 5, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
1 1.
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number 305 - 759 -3380
Parcel Number 1132060140280
Lot:
Page 2 of 2
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP -26975
Permit Number: DS -9 -06 -2351
Inspection Date: 10/10/2006
Inspector: Grande, Claudio
Owner: BARBIERI, KRISTINE
Job Address: 485 92 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: HOME OWNER
Building Department Comments
Thursday, October 5, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
1 1.
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number 305 - 759 -3380
Parcel Number 1132060140280
Lot:
Page 2 of 2
C9 [2,\
BUILDING
PERMIT APPLICATIO
FBC 2004
i
Permit Type (circle):
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
SEP 5 d
Master Permit No.
Electrical Plumbing Mechanical Ro th'
Owner's Name (Fee Simple Titleholder) I( V.(, sn iU of Z. ( 1 ( Phone # 305 �J � ' S 3 go
Owner's Address t f � /vim' 5 2 ,31
City /4 if li' 1( �`' LM &cstate
Zip 53`7u
Tenant/Lessee Name Phone #
Job Address (where the work is being done) T S /t/E-
' 52
City Miami Shores Village County Miami -Dade Zip 3313
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name ciJ4 Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate egistration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 3 `tS 4 Square / Linear Footage Of Work: 5
Type of Work: ❑Addition oeration
Describe Work: // Pd'
Permit No. 0 S a 6 235/
❑ Repair/Replace [�_ I )ern
*************************************** FP e ************ * * * * * * * * * * * * * * * * * * * * * * * * *** * * **
Submittal Fee $ Permit Fee $ / ......./ ' CCF $ 2 KJ CO /CC
Notary $ 0'(0 Training/Education Fee $ 0'10 Technology Fee $ ' • 12.
Scanning $ ). Op Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 142 Uo
See Reverse side -+
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
'I ;'1gortgage 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 Ag
. Ow. Contractor
The foregoing instrument was acknowledged ��f 4 ra (f before me this 1 - 5 The foregoing instrument was acknowledged before me this
day of_T, 200L , by '1115►n ,{Tj 1ii?WN1 , day of , 20 , by
who iss (
identification and who did take an oath. as identification and who did t an oath.
NOTARY PUBLI
Sign: ` �
Print:
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
(X eV° c
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
NAME:
ADDRESS:
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
511
DATE: /
0 010
Do hereby petition. the 'Village of Miami. Shores.to actas my own contractor pursuant to the laws
of the State of Florida, F.S 4$9.103(7). And Ihave read and understood the following disclosure
statement, which entitles' Me to work as my own contractor; I further understand that I as the
owner must appear in person to complete: all ap
State Law requires construction to be done by a licensed contractor. You have applied for a
permit under an exception to the law. The exemption allows you, as the owner of your property,
to act as your own contractor even though you do not have a license. You must supervise the
construction yourself. You may build or improve a one - family or two - family residence. You may
also build or improve a corm I building at a cost of.$25,000.00 or less. The building must be
for.yftr own use and.occupancy. It may' not be built for sale or lease,.[f you sell or lease a
building you have built yourself within one year after the.construction is coinplefe, the law will
presume that you built for sale or lease, which is a violation of this exemption. You may not hire
an unlicensed person as a contractor. It is your responsibility to make sure the people employed
by you have licenses required by state law and by county or municipal licensing ordinances. Any
.person working on your building who is not licensed must work under:your supervision and must
be employed by you, Which rneans.thatyou must deduct F.I.C.A and withholdings tax and •
provide workers' compensation for that employee,,all as prescribed by law. Your construction
must comply with all applicable laws, ordinances, buildings codes and zoning regulations.
Please read and - initial each paragraph.
1. I hold title to the above property and I am planning on doing this construct
Initial
I understand that as an owner- builder I must abide by all zoning ordinances and
building regulations in effect at the time of permit application
Initial
4. I‘ understand that the building official and inspectors are not there to design,
alter or give advice on how to meet code —. only if the structure meets the
minimum code.
Initial
a. . I have an understanding of the 2004 FBC & FRC and understand that
department and its inspectors are there to help enforce and interpret the code.
There is a copy of the code in this office for review.
Initial
5. I understand that as an owner - builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of an
attorney. The department will not mitigate contract disputes.
Was acknowledged before me this 15
Initial
Initial
day of S 20 64
6. I understand that if I compensate any person or company for work performed
they are required to have a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company-or person.
7. I'understand that if any person gets injured on my construction project —they are
entitled to workmen's compensation. And if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
loss of wages during recovery from injury:
I. understand that under state and local laws I' can not do ariy Electrical,
Plumbing, Heating, Air & Roof work on thy property with out first obtaining
the proper permits by licensed contractors.
By kINS1-114 k vy \i 6ti who was' personally known to me or who has
Produced there License or � 9111/111 -
as identification.
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST � INSPECTION
PERMIT NO.V 1 t��� (O ?2J ` TAX FOLIO NO. ` \ ( L `O 'L?
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street/address: St nun tat Mll.y y o M 6
2. Description of improvement: SG - SVt -F"iNCE TIATi b '12004 Co AIC -4EYE 'r7) 1
3. Owner(s) name and address: KR ‘s-r) N (3A(Lf31 4 &'s NE 92 N1_ STe. - cs'"
N1 tscnn∎ Sl+oa.r� , PL 33►3K
Interest in property: 10
Name and address of fee simple titleholder:
4. Contractor's name and address: 4 ME O 1JN �'�2_.
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration
different date is specified)
>
Signature of Owner
Print Owner's Name X
Sworn to and subscribed before me this
Notary Public
Print Notary's Nam
My commission expires:
123.01 -52 PAGE 4 8/02
485 N `12 J.P snwarr- M IAMt S -t55 1 a 33)38
Y
•• • /, � C,
NANUY•'RIN
* MY COMMISSION # DD 383060
EXPIRES: February 15, 2009
° Bonded Thru Budget Notary Services
date is 1 year from the date of recording unless a
111111111111111111111111111111111111111111111
CFN 2006R1019631
OR Blt 24935 P9 2280; (i. u s )
RECORDED 09 /22/2006 10:07:27
HARVEY RUVIN► CLERK OF COURT
MIAMI —DADE COUNTY? FLORIDA
LAST F'AGE
Prepared by IG si n! $4-126l eYU
Address: L i kS M % ' 2 ' Sr
Mt Am( St- ble.e4 Fz
33138'
✓�l Wti T i i.',i.
�I`liil /7. ..
e
1 SW. C.B.S. RESIDENCE
No. 485
F.F. Bev. 11.59
- ' 5' sidewalk.- • 90.42'(M0tR) *�; ••
SKETCH OF SURVEY
SCALE: 1" 20' I
igl
8
Nal .
6
5
4
3
air
2
Arai
LEGAL DESCRIPTION:
LOT 23 LESS THE WEST 15 FEET AND ALL OF LOT 24 BLK 50 OF MIAMI SHORES
SECTION 2 SUBDIVISION ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK
10 AT PAGE 37 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY FLORIDA.
LOCATION MAP
NTS
ABREVIATIONS (IF ANY)
OLACENTER
UNE
FDH40UND DRILL HOLE
A/C -ARt NDI?IOMNOmar
FNAPROPF3(TY LINE
R/W -RIcRIT OF WAY
C.L.F. - [MAIN LINK FENCE
W.F..WOODEN FENCE
RES.RESIDENCE
D.LP.nFOUND nom PIPS
Mi
17
18
t
19
N.E. 92nd STREET
CERTIFIED TO: Vladimir Barbeiri and Kristen Barbeiri.
WE HEREBY CERTIFY THAT THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND
CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY SUPERVISION AND MEETS THE MINIMUM TECHNICAL STANDARDS,
AS SET BY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS AND MAPPERS, IN CHAPTER 61G 17.6 OF THE FLORIDA
ADMINISTRATIVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES.
ADDRESS:485 N.E. 92' Street. Miami. Florida
JOB NUMBER: 02963108452
DATE OF FIELD SURVEY: September 30"'. 2002
REVISION DATE: May 16, 2006 (update)
REVISION DATE:
SURVEYOR'S NOTES:
- EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE ANY RECORDED INSTRUMENTS, OTHER THAN THE
ONES SHOWN ON THE RECORDED PLAT, ARE AFFECTING THE SURVEYED PROPERTY
-SHOWN ELEVATIONS AID BASED ON N.G.V.D. (NATIONAL VERTICAL DATUM OF 1929)
-LEGAL DESCRIPTION WAS PROVIDED BY THE CLIENT (ANY ADDITIONAL DEDICATIONS OTHER THAN THE ONES DESCRIBED ON THE
RECORDED DEED ARE NOT SHOWN ON THIS SURVEY)
-NO UNDERGROUND L TIUTtES OR IMPROVE 4 H4VE BEEN II0CA7ED, EXCEPT AS NOTED.
-THERE ARE NO VISIBLE ENCROACHMENT. � R•) AI= Te1OS14SIZOWN.
• •• • • • • ••• •
•
•
20
21
RECA)41.ECORDED RAD -RADTA .
P.O.C. POLYTOFCURVATURE• ••r•
•
CL.CLEAR ENC 41 0 • • FM r •
C.BS. STE tuocKsnUCC F I FF �HYD N? •
U=D KEnte • • • • SD.E
D.N.E.- DRAU4AQB MAWn. EASfMr. CALC.(C )-CALCU L4TED
S.LP,S131'MONMIS
P 0.B.■POINT OP BEGDI9ENG
•
• • • • ••• •
• • •
•••
• •••
• ••••• •
• • •••
• • •
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ay
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Z
American Services Of Miami, Corp.
Engineers -- Planners — Surveyors
LB # 6683
2450 S.W. 137 Ave., Suite 217, Miami, Florida 33175
Phone: (305) 554 -6963 Fax: (305) 554 -7516
Email: JENNY@ASOMIAMI.COM
-ALBERID .VARAS =
PROFESSIONAL tAND _SURVIVOR
ANTI PSi 3105 =
SI I LORIDa ;moss ED _ s ' iii :: viy08
NOT VALID t�TESS SOF EALED r
$
AL
Customer Name:
Customer Address: 485 NE 92 Street
Brick Paver Selections
Color Size Shape Area To Be Used Manufacturer
OLD CHICAGO 1" 4' X 8" PATIO ENTRY WALKWAY PAVER SYSTEMS
STEPS FIELD AND
I hereby acknowlege that I have been shown and accept samples of the above selected colors.
Custorndr Initials
WA
Color
Buflnose Information:
Pool Tile Information:
Pool Fa tsh Information:
NOTE:
NOTE:
NOTE:
Cust
0
Pattem: HERRINGBONE 90
Pattern: SOLDIER COURSE
Pattern:
Signature • •
Customer's Name • •
Kirstin Barbieri Date:
Miami Shores, Florida 33138
Type
• •••
• • •
•
Q �• (lit : •
SELECTION CONFIRMATION SHEET
Retaining Wall Selections
Face
Pool Selections
Mamufactuer. N/A Color
Type: Grout Color
Manufactuer
Area To Be Used Type:
Area To Be Used Type:
Type: Color
Product Information
Brick pavers are a cement product typified by color shading and texture variations. Therefore, It Is normal for
variations in color and texture to occur. Fu thermae. when utilizing color blends individual color blended pavers
can have wide variations from paver to paver even though the pavers are the same cola. For Example, irxlvidual
pavers can be sold, lightly blended, or completely blended.
Brtck pavers are a cement product. As a result, Individual bricks wd vary In size and finish. Imperfections such
as chipping and texture incor awl nyrmel • • • •
•
Brick pavers are irdieleuelp set In VIII agd4m 4
d 4Yd- Ai a result, sparing and brick paver placement
shall vary within and between ipstalatipns
• • ••• • • • • • • •
Customer Acknowledgement
•• •
• • •
•• • •
•
• • • • • • • • • • • •
• • • • • • • •
• • • •• • • •
• • • • • • • • • •
• •• •• • • • •• ••
••• • • • • • • • •
BORDER
Area To Be Used
USBBS
Area: PATIO ENTRY WALKWAY FIELDS
Area:
Area:
PATIO WALKWAY ENTRY BORDERS
Date
Manufacturer
P
t$i”
II
1" & 2 3/8" thick. Insltiun;3rte Patterns •
. • .... • •
1" I t/
' chi � �
r i 1.� 1*
IL1�1
1� IN
i•�,ui
■ Herringbone 45° ■ Running Bond
•• 4 4
A. Diagonal - 3 color
A
•
..
1
1 1 1
1 1
1 1 1
8
• • •••
•.
• •
•
•
•
•
Cobble Stone
•'.. I
MUM
■ Running Bond
12 "x12"
Iv Iry
■ .4
.►Running Bond ■ Diamond 45°
Crown Stone
ITO
♦Checkerboard
C
Basketweave
■
■
•
•
•
■
•
i
■
•
■ Stripe - 2 Color
Owner's Name and Address
and who, bein g
of the above
therein by him
Permit No._
Disapproved
(Signed)
Registered Architect and /or Engineer
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)
�
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, whethe specified or not. A copy of approved
plans and specifications must be ke»t' at building during progress of the work.
1_ Date i!` ! ;
Date
Remarks (Signed)
Street 71
New Building Remodeling Addition
To be constructed of Kind off ndation Roof Covering
Estimated Total cost of improvements $ -
Repairs No. of Stories
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 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 t site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, rk to be performed under this
permit, as are licensed by Miami Shores Village. ``
ell ° 4,z
STATE OF FLORIDA,
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,
by me first duly sworn, upon oath deposes and says that he is the_
described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
stated are true.
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
PLANNING BOARD DATE
1" •
and for no other purpose.
Date
Building nspector My Commission Expires
Chainnan
Member
Member
Council Approved
NOTE: A charge
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.
Member
Member
Member
Date Disapproved Date
of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
Q
o
AP
KCiAMI ViLL GE
BUILDING INSPECTION DEPARTMENT
LiCATION FOR SUBLDINS F'ERMIT
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.
Date ,19
es Name and Address Js-
Street_ 4
Registered Architect and/or Engineer
Name and address of licensed contractor kt 4
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 cf building (by floors)
and for no other purpose
New Bading Remodeling Addition Repairs No. of Stories
Te be constructed c!.: Kind of foundation Roof Covering
Estimated Total cost of improvements $
Amount of Permit $
Zone cubage required _Plan Cubage
Distance to net nearest building Size of Building Lot
Maximum live load to be borne by each floor
2 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 Supi)lement,
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 inspecti n on the site of the cork such publi notice
or notices as are required by the Act. The undersigned agrees to employ only such subc7tr tors, on wor)t- to performed u er this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
Disapproved Date
(Signed) Notary Public, State of Florida
STATE OF FLORIDA,
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, beiag 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.
BuildingInspector 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 3oard.
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.
<