Loading...
PLUMBINGMIAMI SHORES VILLAGE, FLORIDA BUILUU+iG ELECTIUCAL ❑ ERMIT T? 12061 PLUMING ROOFING Owner of Building •r :IA },,+,th.A►.1 Architect Contractor �' i or Builder '.' "�► Legal Lot r II BL Description Address of •► , r /''� r Building �i vision vision Value of Project $ DATE ❑ Work to be performed under this Permit NOW* , +�a.yC,. .. s! — BY INSPECTOR Contractor's Liens. No. 1 A. of Perm1t. : /( This permit is granted tp the contractor or builder named above to eons the building or to install the equipment or,desice deo:rend agg canon herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with pi�ml. drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be rs�wload Mi as time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition whidr granted is the understanding that the contractor or budder named above assumes the responsibility for a tho ough knowledge of the pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes done by his agents, servants or employees. In consideration of the issuance to me of this permit I agree to perYdsm the work covered hereunder in compliance with all ordinances sad rsrolatioas pertaining thereto • d in strict conformity with the plane, drawings, statements or specifications submitted to the proper authorities of Miami Shone Viltage. In accepting I e responsibility for all work done by either m �:. my agent, servant or employee. .0 BY AUTHORITY Date �� I 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 tlie 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 N � Street__ ___1_______ Permit No. ) d\O "' I New Building L� Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Engirer_ Employing Plumber's Name ___/ Location and Legal Description Lot Street and Number where work is to be performed— No.___IS_ 7____42.1. Street_ State work to be performed and purpose of building (By Floors) 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 Suppl V City W ell. 1 ' 0 Size of Soakage Pit My Commission Expires C C No 7 Z 1 Sheet / 2' Block Subdivision r y The undersigned applicant or 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 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. (Signed) (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 de es 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. Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee o 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 BAS IN FLOOR DRAIN DRINKING FOUNT •NS W M 11 TOTAL FIXTURES CONTR. LIST CHICK ���rrr/// t / ` r ` �/ 1�� ` �� ,, . i SEPTIC TANK SEWER DRAIN CONN. FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL I— SPRKLR. SYSTEM SWIM'G POOL .id 4)%' Pils , / , oro CONTR. LIST ' I t / 60 CHECK 1, 00 Date �� I 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 tlie 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 N � Street__ ___1_______ Permit No. ) d\O "' I New Building L� Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Engirer_ Employing Plumber's Name ___/ Location and Legal Description Lot Street and Number where work is to be performed— No.___IS_ 7____42.1. Street_ State work to be performed and purpose of building (By Floors) 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 Suppl V City W ell. 1 ' 0 Size of Soakage Pit My Commission Expires C C No 7 Z 1 Sheet / 2' Block Subdivision r y The undersigned applicant or 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 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. (Signed) (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 de es 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. Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee o 1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. • '..} !* / 1 L i ,/ Th ---"" I C r) , , ' I °_).,■,''''' .rii i --- - 2. Permit No Owners Name and Address MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and /or gin Employing Plumber's Name I Location and Legal Description Lot. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)_.-.___ New Building_-__ ___ - - _ Remodeling----__.._ -_-..__ Addition__-_._ _ Repairs ..- - - - - -- -- Date ...-- •-------- ._..._..__......_ ._..__._ 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. L N o...�. Street______._ ..... Street._. Subdivision ........__.......____ Street - _ - - -_. _--- __ -_ -- No. of Stories. .. - - Size Septic Tank_ Feet of Drain Tile Nature of Water Supply: City—Well Amount of Permit $ _Type of Tank Capacity Feet of Tank or Drain Field from Well.,._._.---_ ____ Size of Soakage Pit. (Signed)_ Pluf . ing Incpeci y 'N , The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as :' employer of labor under the Florida Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppl ment, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by im in the work to be perfonned 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 pesfernrgd under this permit, as are licensed by Miami Shores Village. / � ' I (Signed) t / �,� i r, f ,,t r : Muter Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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 Expires Notary Public, State of Florida NOTE: A re inspection fee of $1.00 will be made when much re- inspection is made•neoessary by improper notice for inspection, or faulty materials and/or worlananship. CLOSETS BATH TUBS SHOWER{ LAVA. TOgI[{ SINK{ SLOP SINKS LAUNDRY Tuna U RINAL{ CATCH BA {IN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE' TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'0 POOL CoNTR. LIST CHICK Permit No Owners Name and Address MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and /or gin Employing Plumber's Name I Location and Legal Description Lot. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)_.-.___ New Building_-__ ___ - - _ Remodeling----__.._ -_-..__ Addition__-_._ _ Repairs ..- - - - - -- -- Date ...-- •-------- ._..._..__......_ ._..__._ 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. L N o...�. Street______._ ..... Street._. Subdivision ........__.......____ Street - _ - - -_. _--- __ -_ -- No. of Stories. .. - - Size Septic Tank_ Feet of Drain Tile Nature of Water Supply: City—Well Amount of Permit $ _Type of Tank Capacity Feet of Tank or Drain Field from Well.,._._.---_ ____ Size of Soakage Pit. (Signed)_ Pluf . ing Incpeci y 'N , The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as :' employer of labor under the Florida Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Suppl ment, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by im in the work to be perfonned 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 pesfernrgd under this permit, as are licensed by Miami Shores Village. / � ' I (Signed) t / �,� i r, f ,,t r : Muter Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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 Expires Notary Public, State of Florida NOTE: A re inspection fee of $1.00 will be made when much re- inspection is made•neoessary by improper notice for inspection, or faulty materials and/or worlananship. D2 Permit No. J Application is hereby made for the approval of the detailed statement of the plans and specification s 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, whe :• herein specified or not. A copy of approved plans and specifications must be kept at building during progress of Owners Name and Address}, _ No. -- /— -s - - - Street- Registered Architect and /or — Employing Plumber's Name Location and Legal Description Lot______ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors New Building Remodeling— _-- - -__ -- --- _- __ -__ -- Addition Size Septic Tank Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, 1 as. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. -- — Block Feet of Drain Tile —Dist. Feet of Tank or Drain Field from Well (Signed)* (Sign Date Street___ Subdivision Street Repairs No. of Stories .............._._. Type of Tank Capacity Gals 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 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-con tractors 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 perform t: nder thi permit, as are licensed by Miami Shores Village. 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 E SHOWERS LAVA. TORIES S INKS SLOP SINKS LAUNDRY TUBS RINALS 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 SW IM•G POOL CONTR. LIST )( — - -.— CHECK D2 Permit No. J Application is hereby made for the approval of the detailed statement of the plans and specification s 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, whe :• herein specified or not. A copy of approved plans and specifications must be kept at building during progress of Owners Name and Address}, _ No. -- /— -s - - - Street- Registered Architect and /or — Employing Plumber's Name Location and Legal Description Lot______ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors New Building Remodeling— _-- - -__ -- --- _- __ -__ -- Addition Size Septic Tank Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, 1 as. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. -- — Block Feet of Drain Tile —Dist. Feet of Tank or Drain Field from Well (Signed)* (Sign Date Street___ Subdivision Street Repairs No. of Stories .............._._. Type of Tank Capacity Gals 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 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-con tractors 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 perform t: nder thi permit, as are licensed by Miami Shores Village. 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. MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ PERMIT N? DA Contractor's 195 7 ,L PLUMBING 0 9387 License No '`" 5 7 ROOFING ❑ Architect Contractor or Builder Legal Description. Lot Owner of Building Address of Building i 5' RRACTOR OR BQILDER BI. Work to be performed under this Permit Subdi- vision BY Sq. Ft Value of Project $ Amt. of Permit $ This permit is granted to the contractor or builder named above to construct 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 furthe ondition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorcugh knowl ge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statients or specifications and, he assumes responsibility for work done by his agents, servants or employees. Signed: t t,' 9Y '•• INSPECTOR 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, servant or employee. AUTHORITY 11 Permit No. - -- 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 othel structure herein described. This application is made in compliance and confo. 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 Divisior of Miami Shores Village shall be complied with, whether herein specified et not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address `t r J ' 1) *If No. _ Street_ Registered Architect and /or Engineer / Employing Plumber's Name _ -J / t t `5i %!__� ✓) ( � - 1 _ E hA' ._— O/='' - -_ - -- Location and Legal Description Lot_____________ _ _ _ /, ____ / Block__ Street and Number where work is to be performed— No._ _ !___ __ _N L State work to be performed and purpose of building (By Floors) Size Septic Tank._ Nature of Water Supply: City —Well Amount of Permit $ No. ___/_1._111 ) New Building Remodeling Addition Repairs__. 6 <, Feet of Drain Tile ;� -,` __Dist. Feet of Tank or Drain Field from Well f/ Date __ 1 1 c/ Street J L Subdivisten__Z31.1 1 1,1 A ki Street r i ' _31 No. of Stories ____ _• L 7" Type of Tank_ _ .01/5 - -- Capacity Gals. - .. - - -L - -- _Size of Soakage Pit (Signed) .4— 1 '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 perforned 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 #o be performed under this permit, as are licensed by Miami Shores Village. / (Si L:J;;-1±1 L MA-r) 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 appeare 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 toe therein by him stated are true. ---------------------------------- My Conunission Expires Notary Public, State of Florida t. OTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper erials and /or workmanship. notice for inspection, or faul CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS INALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTUREI CONTR. LIST _ CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST CHECK - Permit No. - -- 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 othel structure herein described. This application is made in compliance and confo. 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 Divisior of Miami Shores Village shall be complied with, whether herein specified et not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address `t r J ' 1) *If No. _ Street_ Registered Architect and /or Engineer / Employing Plumber's Name _ -J / t t `5i %!__� ✓) ( � - 1 _ E hA' ._— O/='' - -_ - -- Location and Legal Description Lot_____________ _ _ _ /, ____ / Block__ Street and Number where work is to be performed— No._ _ !___ __ _N L State work to be performed and purpose of building (By Floors) Size Septic Tank._ Nature of Water Supply: City —Well Amount of Permit $ No. ___/_1._111 ) New Building Remodeling Addition Repairs__. 6 <, Feet of Drain Tile ;� -,` __Dist. Feet of Tank or Drain Field from Well f/ Date __ 1 1 c/ Street J L Subdivisten__Z31.1 1 1,1 A ki Street r i ' _31 No. of Stories ____ _• L 7" Type of Tank_ _ .01/5 - -- Capacity Gals. - .. - - -L - -- _Size of Soakage Pit (Signed) .4— 1 '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 perforned 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 #o be performed under this permit, as are licensed by Miami Shores Village. / (Si L:J;;-1±1 L MA-r) 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 appeare 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 toe therein by him stated are true. ---------------------------------- My Conunission Expires Notary Public, State of Florida t. OTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper erials and /or workmanship. notice for inspection, or faul