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1026 NE 97 St (10)• BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name Contractor's Address 11'1 ?4) o Cit '``∎AAA:: Qualifier �p Architect/Engineer's Name (if applicable) $ Value of Work For this Permit Type of Work: ❑ d ition D scribe Work: t. ,j0r id,ge 5 Submittal Fee $ uilding� Scanning $ 3 Radon $ Code Enforcement $ // °. Total Fee Now Due $ (Continued on opposite side) M4141 Shoes Village 1005 N.E.4ti &e2ni S el: (305) 795.2204 Fax: ( Owner's Name (Fee Simple Titleholder) IRobef7 1 Nona Mb(Grn i1 Phone # 30 5 757. -6 772 Owner's Address /6 c3 (o jig 97 01 5 r City I G vh 1 5tior:• s state IBC, zip 33 (3 ff Tenant/Lessee Name Job Address (where the work is being done) Aod ( u/ 97 57 �►k 6..00 oft Permit Fee $ Electrical Plumbing County Miami- ade NO State -Pt— Zip . b1`61 f Zoning Structural Plan Review. $ ..__ ent 3138 756 c„, 7 —o-0 Mas Permit $To. Phone # bQS 1 15E - x- n Phone # Phone # Mechanical Zip `,l Square Footage Of Work: 00 ❑Alteeration ❑Ne [Repair /Repl e r 1 %W vvt iii b 1\1 \4 ► o\e k+ le) ' ASS 0-mr- * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** . V07 — L ibyt o Roofing ['Demolition CCF $ 3, coicc Notary $ Training/Education Fee $ ? / — Technology Fee $ 3 75 Bond $ 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 N \ N' 1} Owner or Agent The forgoing instrument vas as acknowledged before me this J/ � day of 4 , 200), by -11 40 L ' f' biei f)11 1'(� n who is ersonally known me or who has produced ft & 'i,�, * /�� / 7 s datification and who di tike an oath. NOT ffB, IC: Sign: t o>1 Print: NOTARY PUBLIC: Sign: Print: C9MMISSI My Conunission Expires:_ My (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 12/15/03 •A- Signature FEB o 7 1L%)- Contractor The foregoing instrument was acknowledged before me this day of '-,QUO , 20 , f , by t o Co l♦ c who i erso - ay kno ome or who has produced cation and whorid take an oath. �� �ph1M e ,5,' 005 1RFS.. ) °n �,... r 8a� S: t rtt oft\` c -�'' y µ0 ************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning :?• " ` �•,• a. t.. Lot 10, Block 18I, REVISED PLAT OF TRACT 1808, Sig OF TRACT I80C, TRACT - 181A • AND . TRACT 181B OF' THE REVISED 16.; FLAT OF MIAMI SHORES 8 accord — o _ing to the plat as recorded. . • in Plat Book 43, ' Page 51,' of the ' to Public Records of Dade County, W . Florida. ' Certified.to: Lawyers Title Insurance Corporation, Central Mortgage Company, Donna Wolf and W. Robert Abrainitis 14 ztt Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 2/9/2005 Applicant: DONNA Owner: ABRAMITIS JOB ADDRESS: 1026 NE 97 Contractor ALL FLORIDA POOLS Local Phone: 305 - 893 - 4036 Parcel # 1132050170220 Building Permit Permit Number: BP2005 -120 ABRAMITIS DONNA ST Contractor's Address: 11720 BISCAYNE BLVD Legal Description: REV PL MIAMI SHORES SEC 8 Page 1 of 1 PB 43 -51 LOT 10 Fees: Description Amount FEE2005 -1729 Building Fee $150.00 FEE2005 -1730 CCF $3.00 FEE2005 -1731 Training and Education Fee $1.00 FEE2005 -1732 Technology Fee $3.75 FEE2005 -1733 Scanning Fee $3.00 FEE2005 -1734 Submittal Fee ($50.00) Total Fees: $110.75 Total Fees: $110.75 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 7/25/2005 Construction Value: $5,000.00 Work: RESURFACE POOL AND DECK Signed: (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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BLK 181 LOT Y� NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA COUNTY OF 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. t Legal description of property and street address: M . s '4,6■0/...4 S8 t eAmr,g,ct ° C-><w4 � ;, ) o k, Zfe Awls NCA. 2. Description of improvement: 3. t o t Owner (s) name and addresi L'oer}" AbtAMt tiS koace Interest in property: Name and address of fee simple titleholder: 4. Cpnnactor's name and address: 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 ___ orida provided by Section 713.13 (1) (a) 7., Fl Statutes: I; 8. In addition to himself, Owner designates the following person (s) to receive a copy of the Lienor's Notice as' provided in Section 713. 13 (1) (b) 7., Flo kda Statutes. Name and address: NAAr Name and address: 9. Expiration date of this Notice of Commencement (the expiration date different date in specified) � 411/144 /' Signature of Owner r4- /( - 1 7 - 5 - 6 -52 3 Print Owner's Name 717/16 A 11 i (ij Sworn to and subscribed before me this 1 day of - 5/K ) , 20 e6 Notary Print N My Co LJ`d- Q e) tnauhtt- •._ CFN 2005R0141857 OR Bk; 2307E Ps 4775; (1as) RECORDED 02/11/2005 10:51:45 HARVEY R:UVIFI, CLERK OF COURT MIAMI -DADE COUNTY? FLORIDA LAST PAGE . Prepared by: -.S �t�ssi is 1 year from the date of recording unless a UC STATE OF FLORIDA COMMISSION NO. COON ) MY COMMISSION IXP. FEB. 15 111111111111111111111111111111111111111111111 i 'REcEll rs) Miami Shores Village c o 2003 Building Department C K. a- /(o0 . BUILDING PERMIT APPLICATION FBC 2001 $ Value of Work For this Permit 11 3..O(), (7n Scanning $ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): (Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 110 Yl Ca 146 m i rl 5 Phone # 305 71 6 771 Owner's Address I as(o Ai E 9 7th f yT feel' Al City tam( 5V10 State Ft Zip 33138 Tenant/Lessee Name Phone # Job Address (where the work is being done) /Ooa(o 7 City Miami Shores Village County Miami -Dade Zip 33138 Is Building Historically Designated YES NO X Permit No. 5 P2003 - 1660. Master Permit No. Contractor's Company Name Q WY) Phone # Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) Phone # Radon $ Square Footage Of Work: Type of Work: DAddition ❑Alteration ['New , Repair/Replace Describe Work: RP) lace, --Pact Ct hoa(ci 1 ( Otle, d par Y1c c(ncl * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ c30 . 00 Permit Fee $ /(2 CCF CCF $ Notary $ Training/Education Fee $ t� /L �/ o ` Technology Fee $ , J r c7 Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) ❑ Demolition 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 obt in 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. NOTARY Sign: Print: Chc 10/14/03 Signature y �^ /7-7:444_ ) Owner or Agent who is personally known to me or who has produced 1W Vargas • . Ex s ires: 13, 2007 'rlantic Bonding Co., Inc. My Commission Expires: Signature Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of �`' , 20 UJ, byb5nfe %t fte),(07)11I ay of , 20 by who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: 4 Sign: Print: My Conunission Expires: * * * * * * * * * * * * * * * * * * * * * * ** *********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner Engineer Zoning 441 t I 17 r1Gk o yv u' l S being the legal property owner, for the property Located at: / Ong (o / )E 97Th Sitreet Legally described as , Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7)And I have read and understand the following disclosure Statement, which entitles me td slrork as my own contractor, I further understand that I as the owner must appear in person to complete all applications. VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that 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 or a farm out - building. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that 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 means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument Was acknowledged before me this 0 day of 20 V -> B y l� l f'€ ' 44ho is personally known to me or who has L � , Produce as identification and who did take an oath. No Com Ex � bei Vargas fission #DD23198 res: Jul 13, 2007 Bonded Thu tlantic Bonding Co., Ino Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2003 -1862 Printed: 12 /1/2003 Applicant: DONNA ABRAMITIS Owner: ABRAMITIS DONNA JOB ADDRESS: 1026 NE 97 ST Contractor Local Phone: Parcel # 1132050170220 Signed: Building Permit Contractor's Address: Legal Description: REV PL MIAMI SHORES SEC 8 Fees: Description Amount FEE2003 -7590 CCF $1.20 FEE2003 -7592 Building Fee $100.00 FEE2003 -7593 Notary Fee $5.00 FEE2003 -7594 Training and Education Fee $0.40 FEE2003 -7595 Technology Fee $2.50 Total Fees: $109.10 Total Fees: $109.10 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 5/29/2004 Construction Value: $1,200.00 Work: REPLACE FASIA AND DRYWALL (INSPECTOR) DEC 0 5 PAID Page 1 of 1 PB 43 -51 LOT 10 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: BLK 181 LOT MIAMI SHORES VILLAGE - 75'8 - 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 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 FlO a. 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 specnN 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: Lot • � Block e/ Street and Number where work is to be done New Building Remodeling ,e a Subdivision /41/,57•47 u /OoZ 41. e. S 1 Date L5 �/ 19 ( /^ No. / C Street 2 / V . /I [ $ 7Pit 11,4. 833) State work to be done and purpose of building (by floors), state exterior colors (submit samples) 6( c°Zn o„.4: and for no other purpose. Addition Repairs No. of Stories / Roof Co ering To be constructed of Kind of foundation Estimated Total cost of improvements S � � 8 C9 O Amount of Permit S 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 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 obligatons 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 employ only such subcontractors, on work to be performed under this permit. as are licensed by Miami Shores Village. Remarks (Signed) Date Date STATE OF FLORIDA COUNTY OF DADE. } ss. 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. Read, Sworn to and Subscribed before me. Permit No. Disapproved (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved 1 ate Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Notary Public, State of Florida 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 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 Flt a, 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 spv ifie or not. A copy of approved plans and specifications must be kept at building during progress of the work. a Owner's Name and Address .O 4'21 ALI •"r r T ( S Remarks (Signed) } SS. V Date ` 19 No. / 6 Street tiG 5 1/1k. C W c. - ` Jo-o-X S `/lo7 /t' e Registered Architect and/or Engineer Name and address of licensed contractor ✓ �/ Location and legal description of lot to be built on: // J. PS' /7 e ��'C i/ (� ,��r Lot 0 Block I& I Subdivision /1`.."1-....-/ G c. 1 4 lv.-� , / D a- G At,. e - 77 c (1( 33 ' 3 7 Street and Number where work is to be done / State work to be done and purpose of building (by floors). state exterior colors (submit samples) nom' /�7 �"t S r "f�� v o / / and for no other purpose. New Building Re modeling Addition Repairs No. of Stories To be constructed of G CIti r 7` e. Kind of foundation Roof Covering Estimated Total cost of improvements $ 51 /0 0 0 0 Amount of Permit $ l Zone cubage required Plan Cubage Size of Building Lot Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all 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 obligatons 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 �st1Ch- ontractors. p r}vork to be performed under this permit. as are licensed by Miami Shores Village. STATE OF FLORIDA COUNTY OF DADE. Before me. the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known. and who. being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same. and that all facts therein by him stated are true. Date A Read, Sworn to and Subscribed before me. Permit No. Disapproved (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Notary Public. State of Florida Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. Date atlt(t- Miami Shores Village Building and Zoning Department Attention: Building Official SWIMMING POOL OWNER S. CERTIFICATION Z certify that I am the legal owner of the property described as located at [OA, -, P" °"' )1- 3 3 1 3 In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. I further understand that this certification, however, does not eliminate the need for obtaining d permit and erecting an approved barrier prior to final inspection and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade 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. , 119.7 Owners Name and Address Mr. B o e t t i ghe im e r_. ..__ N ..10 2 6 streetrn.: e 97 St . Registered Architect and /or Engineer ,,:,.. ....a . , ,..,.. Name and address of licensed contactor An ir. tWs Roof F Imp ro . CO, 4300 E . 11 Ave . Location and legal description of lot to be built on: Lot Block Subdivision _ ..._� ._- Street and Number where work is to be done 1026 N. E. 97 St. Miami Shores ,- Fl State work to be done and purpose of building (by floors) s.e.sj.d.enc - .Re na V.�....Il� �.S.S�� �'.. �,1 e_ T om valley. - Repair felts and replace tile. and for no other purpose. New Building Remodeling Addition Repairs XX No. of Stories To be constructed of Kind of foundation Roo 0. Covering t 11 e Estimated Total cost of improvements $ 40.0... ..Q.Q Amount of Permit &.... - Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot \faxirnum 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 Andrew s ....Rao.f...... .... Impr.ou.. Co...- 43.0.0..- E.. ... ..11 Ave 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 Shp element, and has complied with the provisions thereof, and will require similar compliance • all contractors or sub - contractors employe by him in the work to be performed under this permit; and will post or cause to be po ed for inspection on the site of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only .uch s • •ntr /ors, o¢Yvork . per armed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) � I • 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, 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 e true. Permit No. ___.__� Disapproved (Signed) ui din Inspcc or Chairman \ferober Member .. ... NOTE: A charge of $1.00 will be made for the Planning Board. A re - inspcction fee of $1.00 will be materials and /or workmanship. Date - . Council Approved Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Member Member Member Date Disapproved making corrections or changes to this application after approval 30 Date has been obtained from charged when such re- inspection is made necessary by improper notice for inspection or faulty