Loading...
MECHANICALBUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building 0 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA PERMIT NI? 3823 Work to be performed under this Permit B1 DATF Contractor's License No. 195 Subdi- vision Value of Project $ Amount of 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, 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 thorough knowledge of the ordinances and regulations pertaining 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 done by his agents, servants or employees. Signed. BY 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 6 ms s. ,; ... ... .. ....... . .. . ....... .... ....... .... ..... ... . . . .., , ; „:.,: ;,.: ..i :.:,n , l.:4;,. .,,,v ,,i,„„.„,,,,..,,,, , ,, , . 7,,,:.:„ if:tfe . *PP • '80.*IFE.RiOr tki!.:p15 ' ':`" ' . . . • . " "" ' (4:ffltto4' : . cf-.7•, -:.,, „ .. ' •'‘' .-- 1" . 3 . 0.(... : ' IllriagliM . .04" t All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications ri submitted for above work, an °p' ed in a substantial workm trer for tne sum of Cvt- vff- lANciu rev. t i v-e- ,71-4-01 2..,.., (2.-.. 1 ...4 Dollars ($ 1 5 1 5 F with payments to be made a follows: ...,-,-- 1 . Respectfully submitted lig* My alteration or deviation troll above speceications involving extra costs will be executed only upon written order, and will become an crxtra merge Per az. 1. 1, ti PO 'Z .042.. Qv 1 M over and a b o v e the estimate. A I I agreement% cont.ngent upon strikes. ac- eidetic, or delays beyond our control. Note • This proposaf by us if not accepted within 1 days. FROP : RI OLF I ELECTP C PROPOSAL ADDRESS •; • , rE e ..„, 08118 atm; MADE USA • . vA ' u- PHONE NO. / ( 1 c l 50 VA r-)00‘) Date FAX W. : .305 740 9029 08 2004 7:3F1 Pl A 5c 4" LU , 1 C -_ 4 ,„cL ooco 54-11 3'119.5 5J ift+ia ■044.-A ft_ I 45 1 PROPOSAL SUBMITTED TO: 443-8E506 PROPOSAL WORK TO BE PERFORMED AT: PROPOSAL NO. SHEET NO: GATE o 3/64 ADDflSS DATE OF PLANS ARCHITECT 04/45.4 T1 &LA 04 — 0 55 11 r r AdOEfffANCE:OF,PROPO.SAL The;atiove PiiCeSSPeCificiiitiOri.landlodnditionS are :Satisfactory and are hereby adcepted. You are authorized tOdb the Work as SPecified::PayMents will be made as outlined 'above. Signature qprt4 Signature Bonding Company's Name (if applicable) Bonding Company's Address - ' • City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I tmderstaand 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. 1 the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 _ , by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Chc 05/13/03 egoing instrument was acknowledged before me this day of /2.6-1 ,, 200 , by 4A AJ. oVrrn o is persona y kno n to m= or who has produced Sign: Print: My Commission Expires: Engineer Zoning 0 as identification pp c who $ r i y 4 1 Y P''' NOTARY PUBLIC ' =2 '•`e= Commission #DD198168 / ,� _1*;. `� QQ Expires: Mar 30, 2007 O Bonded Thru 1 C,t � '" o Atla;tic Bonding Co., Inc. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * ** ******* * * * * ** * * * *** ** * * ** k * * * * *** **** **** * * * * * * ** ******** ***** **** ******** *** ** * *** ** * ** ** *** APPLICATION APPROVED BY: Plans Examiner BUILDING Owner's Address i 2) 5 ME q u City I' ► ABM . 3 110, e. State FL— Job Address (where the work is being done) City Miami Shores Village is Building Historically Designated YES $ Value of Work For this Permit Type of Work: ,®Addition Describe Work: Total Fee Now Due $ Notary $ Training/Education Fee $ Scanning $ Radon $ Code Enforcement $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd venue : S res, Florida 33138 Tel; (3'6) 795.2204E4: (33 5) 756.8972 1. PERMIT APPLICATION° Master Permit No. FBC 2001 Permit Type (circle): Building Electrical Plumbing (Mechanical cal � Roofing Owner's Name (Fee Simple Titleholder) v@ e \ e cio it Phone # O5 7 S 0 RI Zip 33 i ° '� Tenant/Lessee Name Phone # fns vie '1 Ft- 5 County Miami -Dade Zip 3 1 y � - NO Contractor's Name 14.1 file44,614 L/l)(i Phone # 3a`J S2 Z., 5 5 Contractor's Address /706 b NI t1.) City ON iirk State / Zip 3 30 5 Qualifier tr- 47Z -- State Certificate or Registration No. eia- e6225) is-,34t Certificate of Competency No. Architect/Engineer's Name (if applicable) J (5 _ .o li I la Phone # ❑Alteration New ❑ Repair/Replace ❑ Demolition ****.***********************, Submittal Fee $ Permit Fee $ ` CCF $ CO /CC Permit No. Square Footage Of Work: ICON (j oq,-12.2.4 Technology Fee $ Zoning Bond $ Structural Plan Review. $ Attn: Chet Cordinal Gordon 135 N. E. 94` St. Miami Shores, Fl 33138 COOLING METHODS, INC 17060 NW 56 Court Miami, FL 33055 (305) 622 -9454. Toll Free 1- 888 - 272 -5697. Fax# (305) 622 -6924 CAC 054234 PROPOSAL January 14, 2005 We hereby propose to furnish the materials and perform the labor necessary for the installation of 2 supply vents in addition. Included will be: 1. Permit fees 2. All duct work necessary 3. Installation of 2 new supply vents 4. Installation of exhaust vent 5. All trash removal All work will be done in a workman -like manner and in accordance with South Florida Mechanical and Building codes. Cooling Methods Inc. proposes to perform these services for the sum of $495.00. At signing of contract a 50% deposit is required, with 50% due at completion. Warranty: 1 year parts and labor. This offer is valid for thirty days from proposal date. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Customer's signature Date 63 C Coolin.f e . ods, Inc. Representative Date 1 l is 1 OS Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/28/2005 Applicant: FLORENCE BLACK - GORDON Owner: BLACK - GORDON FLORENCE JOB ADDRESS: 135 NE 94 ST Contractor COOLING METHODS Local Phone: 305 - 622 -9434 Parcel # 1132060132881 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2005 -20 Contractor's Address: Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $1,000.00 Work: A/C Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: Description Amount FEE2005 -3869 Building Fee $150.00 FEE2005 -3870 CCF $0.60 FEE2005 -3871 Training and Education Fee $0.20 FEE2005 -3872 Technology Fee $3.75 FEE2005 -3873 Scanning Fee $3.00 Total Fees: $157.55 Total Fees: $157.55 Total Receipts: $0.00 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 responisibility for all work done by either myself, my agent, servants or employes. 'Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: MC2005 -20 Printed: 3/28/2005 Applicant: FLORENCE BLACK - GORDON Owner: BLACK - GORDON FLORENCE JOB ADDRESS: 135 NE 94 ST Fees: Description Amount FEE2005 -3869 Building Fee $150.00 FEE2005 -3870 CCF $0.60 FEE2005 -3871 Training and Education Fee $0.20 FEE2005 -3872 Technology Fee $3.75 FEE2005 -3873 Scanning Fee $3.00 Total Fees: $157.55 Total Fees: $157.55 Total Receipts: $0.00 Contractor COOLING METHODS Local Phone: 305 - 622 -9434 Parcel # 1132060132881 Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $1,000.00 Work: NC Signed: (INSPECTOR) Mechanical Permit Contractor's Address: Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK 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 responisibility for all work done by either myself, my agent, servants or employes. tigned: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/28/2005 Contractor COOLING METHODS Local Phone: 305 - 622 - 9434 Parcel # 1132060132881 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2005 -20 Applicant: FLORENCE BLACK - GORDON Owner: BLACK - GORDON FLORENCE JOB ADDRESS: 135 NE 94 ST Contractor's Address: Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $1,000.00 Work: A/C Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: Description Amount FEE2005 -3869 Building Fee $150.00 FEE2005 -3870 CCF $0.60 FEE2005 -3871 Training and Education Fee $0.20 FEE2005 -3872 Technology Fee $3.75 FEE2005 -3873 Scanning Fee $3.00 Total Fees: $157.55 Total Fees: $157.55 Total Receipts: $0.00 In consideration of the issuance to me of this permit, 1 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/28/2005 Applicant: FLORENCE BLACK - GORDON Owner: BLACK - GORDON FLORENCE JOB ADDRESS: 135 NE 94 ST Contractor COOLING METHODS Local Phone: 305 - 622 -9434 Parcel # 1132060132881 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2005 -20 Contractor's Address: Permit Status: APPROVED Permit Expiration: 8/1/2005 Construction Value: $1,000.00 Work: A/C Page 1 of 1 Legal Description: 1 53 41 & 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 19 & E3OFT LOT 18 BLK Fees: Description Amount FEE2005 -3869 Building Fee $150.00 FEE2005 -3870 CCF $0.60 FEE2005 -3871 Training and Education Fee $0.20 FEE2005 -3872 Technology Fee $3.75 FEE2005 -3873 Scanning Fee $3.00 Total Fees: $157.55 Total Fees: $157.55 Total Receipts: $0.00 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 responisibility for all work done py either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 4 Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR. PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature l'ortrl ^-, 1 c0 oaf l'"" Signature Owner or Agent A jl ntractor The foreg ing instruments was acknowle e dged before me this c . T Y The foregoing instrument was acknowledged before me thus 2 I day of 20 V%%by (...41 ,L,(o .x) / '> &' Y? day of Co e", , 20 04, by c'' Tal / who is personally known to me or who has produced rt- b C.__ who is personally known to me or who has produced y , O? - / - 7 - yt As identification and who did take an oath. I"" b 41 7- as ideptifacationaad wrliQ,djd,tlake an oath. • NOTAR Sign: Print: My Commission Expires: *************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: 9 ����' , 'e' VV Plans Examiner Engineer Zoning Chc 05/13/03 LIC: r ", NOTARY PUBLIC: C . y` :J j am / —�' , Ginn �S ,..... �� Comnussion coa2387o \. Expires: May 26,008 -, 7 1 ;z4 Fl. edl ' " "" Atlantic BondiBond u n g Co., o Inc. mission Expires: * PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date , Job Address /36 N, / : 9. Tax Folio Legal Description Historically Designated: Yes No ( • 1 d �CL iC �} 3 9'D Owner/Lessee / Tenant � S `"' /Jl ©r'D � Master Permit # Owner's Address ) 35 Ai . E. 945t, Phone Contracting Co. C— PC) -- (' 1 e_) �C -`)'Yl ,_ .. C , Address ) 13 e' J V . e. ) S i Qualifier 7 0t to I i. Y I I & -e n SS# // -_' hone q -lp 3 7 3 State# C ) ©0 105-2 Municipal# Competency # Ins. Co. MAD) a Ind CbSuat Architect/Engineer Bonding Company Mortgagor Address WORK DESCRIPTION co lvke til e_r Signature 9f owner an •r Condo President Dat otary as to Owner and/or Condo President_ Date My ara t.Sa� a ti t � � Ot\N 2A L : "� TT -�: • FEES: PERMIT . ' " RADON Address Address Permit Type (circle one): BUILD EL ECTRICAL JPLUMBING MECHANICAL ROOFING PAVING FENCE SIGN �W 1 CO S V\" C.1 t Y1 Y1-e vo Square Ft. Estimated Cost (value) .�/O a 0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 0 " AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable ating cons . • t' on :. d zoning. Furthermore, I authorize the above- rarrfed c ntractor to do the work stated. Signature o Contractor or Owner- Builder Notary as to Contractor or Owner- Builder My Commission Expires: �pR 1 f'tj tIPEICIAL NOTARY SEAL 0152 SCOTT CJ 'DAVIS ); CO I BSI 0%I NUMBER CC255237 (I F MY COPT ISSION EXP. Or = > :.. 1997 / C.C.F. NOTARY .5 ' TOTAL DUE APPROVED: Zoning Building Mechanical Plumbing Engineering Electrical 6 if ( (A - 6 Date Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 13S Al E 9 4 31- Tax Folio /( 32 o c,- 0 / 3— e_6 f leers - nt K --( Legal Description II II Historically Designated: Yes Owner/Lessee / Tenant M l` CI r t° d d l Q j Oros Owner's Address l 3 S NEE 9 Li s r Date 6.' (y - IC Contracting Co. Ct k /T d' CO vt £o. Address Qualifier RbrT T. CT State # CAC 0 26`-fici Municipal # 0 ' 3 Competency # Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING 00 C ouutti, ,tn, Ce-JAA/L4) iuk;1/41 WORK DESCRIPTION Square Ft. Signature of owner and/or Co o President Notary as to Owner and/or Condo President Date My m ts$idly xp F23IAL NG o ANV ad ‘ r.) OAN.113A C7 C . ©1`iui CPCa' %! 10 FEES: PERMIT ,,1 67G Dae Master Permit # Phone 7 S1» 134r /.. Phone . 6 O .Cb 3q No a! Estimated Cost (value) ) 7 A0 0 0 FRIA Signature .. ., • . L ,C c c,„.„ -> ;l lder :' ' MY COWS= 0 8W 1 WADED MU Tn5PAIN I URANCe, KC, ECHANICA ►. ROOFING PAVING FENCE SIGN Not My Co s '.n xpires: Ins. Co. Moir 4 / 4-1 C,1 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMI3ING,-SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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 oning. Furthermore, I authorize the above -named contractor to do e work stated. 6 /9 .96 Date Date C.C.F. /. ® e NOTARY (5 O TOTAL DUE 4 7. 0 a APPROVED: Zoning Building Electrical Mechanical I-- / ‚ \ (/ /1 //% 7 Plumbing Engineering 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 Mianii 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 Mianii Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor_ Location and legal description of lot to be built on: Disapproved Date ( Signed) Building Ins motor MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT A. No Date , 19 b "-S Street ado a8 0 -��� G/oSo Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) i and for no other purpose. New Building Remodeling. Addition Repairs No. of Stories To be constructed of Kind of foundation v • Roof Covering Estimated Total cost of improvements $ <� Amount of Permit $ �� —Z Zone cubage required Flan 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 the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ onl --snbc ontractgr,s.: onwvork p armed under this permit, as are licensed by Miami Shores Village. i 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 � � Date « — TS Read, Sworn to and Subscribed before me. Notary Public, State of Florida 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. P-