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500 NE 95 StPermit No STATE OF FLORIDA. t COUNTY OF DADE. I "' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Street and Number where work is to be performed —No D Amount of Permit $ —' (Signed) 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. / Owner's Name and Address �` (.4, Registered Architect and /or Engine r Employing Electrician's Name..../ -' °e—ei0 5 i = No 97 Street.. /1.. ' 49 . ; Location and Legal Description Lot Block Subdivision v Street No d c �' Street (ill— State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories S ervice Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Typ of InstQallation —C uit Tubing B.X.L Metal Moulding Master Electrician. Electrical l:nspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of rida Permanent Supplement, and has complied with the provisions thereof, and will require similar com pliance 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 subcontractors, on work to be performed under this 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, and 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. SWITCH OUTLETS LIGHT O UTLETS PLUG RECE'P'T'S FIXTURES N O. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER H EATER W. HEAT. CONN. ACE HATER STRIP H EATER TOTAL CONTR. IS1 LIST L 3 3 f ® ....- �j ' 3 ''i-- CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1•3 HP N EON TRANS. RADIO TOTAL TR. 1ST Permit No STATE OF FLORIDA. t COUNTY OF DADE. I "' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Street and Number where work is to be performed —No D Amount of Permit $ —' (Signed) 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. / Owner's Name and Address �` (.4, Registered Architect and /or Engine r Employing Electrician's Name..../ -' °e—ei0 5 i = No 97 Street.. /1.. ' 49 . ; Location and Legal Description Lot Block Subdivision v Street No d c �' Street (ill— State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories S ervice Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Typ of InstQallation —C uit Tubing B.X.L Metal Moulding Master Electrician. Electrical l:nspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of rida Permanent Supplement, and has complied with the provisions thereof, and will require similar com pliance 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 subcontractors, on work to be performed under this 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, and 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. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description. Address of Building Lot 1/ MIAMI SHORES VILLAGE, FLORIDA PERMIT 11° 12258 f] Work to be performed under this Permit CONTRACTOR OR BUILDER Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of �/ Permit $ jf J IB i C7 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 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 ordinan 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 reel nsibdity for work done by his agents, servants or employees. Signed • - +*t ` s-'' BY X 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. I BY AUTHORITY BUILDING ❑ MIAMI SHORES VILLAGE FLORIDA Date_j -` 19 7 ELECTRICAL PLUMBING ❑ PERMIT N9 9150 License n trac ors f � ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with am 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 respon sibility for work done by his agents, servants or employees. } J .+C Signed • r '� . - /� �-'' C' " (INSPECTOR) BY In consideration of the issuance to me of this permit gree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, wings, 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. r CONTRACTOR or BUILDER BY AUTHORITY 1 Subdi- Bl vision Sq Ft Value of Project $ I Amount of II Permit $ Via) MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date s -,�. t -_ .r ✓ 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. Permit No y a r Owner's Name and Address No Street Registered Architect and /or Engineer Employing Electrician's Name STATE OF FLORIDA, l COUNTY OF DADE. 1? 68. Amount of Permit $ 7 (Signed) No / Street Location and Legal Description Lot Block Subdivision w Street and Number where work is to be performed —No Lt Street ./....,. State work to be erformed and building ( y Floors) • p purpose of buildin B Floors t ■ C• w l ?,, . t New Building Remodeling Addition Repairs No. of Stories Service Overheard Size Feeders.;" . Conduit..: Main Sw j Amps Main Fuses Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his bbligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supple:nent, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ,..., 'fir Master Electrician. 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, and 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 agar workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE•P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST {` f / " r l , l CHECK 1 _y . i jt V I' . . —) C � ^� ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.! HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK / j i I ; ,4. 1 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date s -,�. t -_ .r ✓ 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. Permit No y a r Owner's Name and Address No Street Registered Architect and /or Engineer Employing Electrician's Name STATE OF FLORIDA, l COUNTY OF DADE. 1? 68. Amount of Permit $ 7 (Signed) No / Street Location and Legal Description Lot Block Subdivision w Street and Number where work is to be performed —No Lt Street ./....,. State work to be erformed and building ( y Floors) • p purpose of buildin B Floors t ■ C• w l ?,, . t New Building Remodeling Addition Repairs No. of Stories Service Overheard Size Feeders.;" . Conduit..: Main Sw j Amps Main Fuses Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his bbligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supple:nent, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ,..., 'fir Master Electrician. 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, and 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 agar workmanship. Type Insp'n Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date So 0 Time P , Permit No_ �"' Z D � a� / `1 v v �.3 For Inspector: ( /2- b � Nam Approved ❑ Correction Re- Insp'n Fee ❑ a Date /V 2 ®P✓� 'O6 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n Permit No. Name Address ` = Company ;- s/ Phone #% i ✓' ' ✓� For Inspector: i j Name & Date Approved Correction Re-Insp'n Fee f MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPAI ,,; TMENT APPLICATION FOR ELECTRVCAL PERMIT Permit No L- 3 4D Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Flu:ida, 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. Gaza S x't 10/.7M 7._.. 1st l1vee Owners Name and Address No Street Registered Architect and /or Engineer g TT ^ t� ryp� {� L a L� ' •7i C rXCIUS CC. lie Employing Electrician's Name No ��© Street Location and Legal Description Lot Block Street and Number where work is to be performed —No 550 Street ".2. 05th State work to be performed and purpose of building (By Floors) New Building Remodeling Addition 1 Repairs No. of Stories STATE OF FLORIDA, COUNTY OF DADE. I �' Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground p P Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (Signed) >,. ,:y a 12-- �, Electric 41 Inspector. '...'"--, The undersigned applicant for this building permit does hereby certify that he understands and accepts hi obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo0 a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub•colitractors 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. Date Play 3, 107P Subdivision Y. 05th E17. (Signed) ;J > � f/ �� a vic. Master Electrician. 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, and 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. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE•P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER �7 1 a " + ei TOTAL CONTR. LIST 1 �i 1 5 ■f �. •'S. f ��. .: :r• .d : - o f , •cJ �R N .�n� e t26J CHECK F ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPAI ,,; TMENT APPLICATION FOR ELECTRVCAL PERMIT Permit No L- 3 4D Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Flu:ida, 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. Gaza S x't 10/.7M 7._.. 1st l1vee Owners Name and Address No Street Registered Architect and /or Engineer g TT ^ t� ryp� {� L a L� ' •7i C rXCIUS CC. lie Employing Electrician's Name No ��© Street Location and Legal Description Lot Block Street and Number where work is to be performed —No 550 Street ".2. 05th State work to be performed and purpose of building (By Floors) New Building Remodeling Addition 1 Repairs No. of Stories STATE OF FLORIDA, COUNTY OF DADE. I �' Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground p P Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (Signed) >,. ,:y a 12-- �, Electric 41 Inspector. '...'"--, The undersigned applicant for this building permit does hereby certify that he understands and accepts hi obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo0 a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub•colitractors 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. Date Play 3, 107P Subdivision Y. 05th E17. (Signed) ;J > � f/ �� a vic. Master Electrician. 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, and 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. Permit No ,7 4/ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date September 8, 1967 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address 500 N.E. 95th Street', Street Registered Architect and /or Engineer ._ Br. Oth�PS �P .SitrjSi i.... .,3339...,N.t! e....7th ... AQP Employing Electrician's Name No Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed— No._50.Q...N..E... 95th...Str.e. t Street State work to be performed and purpose of building (By Floors) wire dishwasher Amount of Permit $ 1 •5 STATE OF FLORIDA, COUNTY OF DADE IT ss. (Signed) (Signed) New Building Remodeling Addition g g Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground p Type of Installation — Conduit Tubing B.X.L Metal Moulding o' 27 Master Electrician. $1 Electrical 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 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 subcontractors, on work to be performed under this 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, and 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/ SWITCH OUTLETS LIGHT OUTLETS PLUG RECE•P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER 'TOTAL CONTR. LIST Wi re , 41 CHECK 1 shwa sher ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS O.1 HP MOTORS 1•B HP NEON TRANS. RADIO , TOTAL CONTR. LIST CHECK Permit No ,7 4/ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date September 8, 1967 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address 500 N.E. 95th Street', Street Registered Architect and /or Engineer ._ Br. Oth�PS �P .SitrjSi i.... .,3339...,N.t! e....7th ... AQP Employing Electrician's Name No Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed— No._50.Q...N..E... 95th...Str.e. t Street State work to be performed and purpose of building (By Floors) wire dishwasher Amount of Permit $ 1 •5 STATE OF FLORIDA, COUNTY OF DADE IT ss. (Signed) (Signed) New Building Remodeling Addition g g Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground p Type of Installation — Conduit Tubing B.X.L Metal Moulding o' 27 Master Electrician. $1 Electrical 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 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 subcontractors, on work to be performed under this 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, and 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/