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1196 NE 97 St (11)Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1°' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. OF FLORI A, COUNTY OF MIAMI -DADE nt Name Sworn to and subscribed before me this 1 day of `W , Signature o N O blic - 6Aae1$SVFi @ ` My Commission # CC 818228 SEAL: G Q g or tty Expires: 03 /16/2003 1.800 -3- NOTARY 7:1 rotary `_ :rvioe & Bonding Co. Personally known OR, Produced Identification Type of identification Produced: STATE OF FLO Signature o ontractor / Qualifier 1. L cc alin Print Name q� Sworn to and subscribed before me this '- ` day of Signature of Notary Public - State of Flori PERMIT APPLICATION SEAL: s , e0, LAu - . — v o G� Z � n My Commission .< <.- - Expires: 03 /16/2003 �0- INS'''' ;Th. Notary a Service & Bonding Co. j; Personally known l t 80 d N0 ARV - -, -u erit c ion Type of Identification Produced: CONTRACTOR Name A . �-• u> a iU License No. Address ,...., �� S� �l /� � �iteA�.il�,� � .� R �., Telephone 3ost eciS Qjnq{Fax _ i fax Qualifier Name, iu V.� , I'� t 4 PROPERTY OWNER Na rig .me\ gj(G 1'le`l kJ. (5') (5 ')/". Address �� � ch,he, � e ^ L ^ / ` � 12.04 ( Y � ) • Home Telephone Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair 're' Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Step 1. Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other (0476 r46 ?7 Address Apt. Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Mi‘ovit S'(LaJ City Description of Work Zoning Square Feet Value of Work Sri e Ct%.a ,e_ � .etot.(s' Units 1000 ctIcH NoRtts �pC. If) 0 • INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: PERMIT APPLICATION S ) ?, t+Lp Master Permit No. Subsidiary Permit No. IO Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A PPLICATION State Zip (sc,A) eikkite S Pc-4. Linear Feet Floors I Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) ENGINEER Name License No. Address Telephone Fax SECTION BY C DA Zoning Electrical %%'' �� '� c �C Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST ® OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review ® PROOF OF OWNERSHIP (Attach) ▪ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ /m - (sq.ft. = x/1000 x ¢.60) (¢.005 / sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. t/ A/C Central 1 -3 Ton Fan Outlet, Wall q Service, Temporary A/C Central 4 -7 Ton A/C Wall/Win. Tons Fire Pump Dryer Vents, Number of Outlet, Switch 1 Signs Ventilation, Cost A/C Central 8 -15 Ton Air Handler, Tons Fixture - Fluorescent Ductwork, Cost of Oven • 1 Space Heater (kw) Periodic Inspections A/C Central 16-20 Ton Barbecue Fixture Light Fire Sprinkler System Parking Lot Lights Process/Pressure Piping Spas/Hot Tubs Supply, AC Well A/C Central 20+ Ton Bath Fan - Vented, # Flood Lights Fireplaces, Number of Plugmold/Strip Pressure Vessel Subfeeds, No. of Amps Temporary Toilet A/C Window Catch Basin FPL - Load Central Gas - Propane Posts Pump, Re- circulate Swim Pool, Commercial Temporary Water Closet Air Conditioners Clothes Washer Garbage Disposal Gas Piping Range/Range Top Pump, Replace - Pool Swim Pool, Residential Urinal Chiller Mental Chair Generators, etc. Grease Trap Receptacles Pump, Sprinkler Switchboards Utility - Sewer Clear Violations Discharge Well Heat Recovery IIce Maker Refrigerator, Comm. (p/PH) Pump, Sump Temp Serv., Construction Utility - Water Compactor Dishwasher Low -volt, Burglar Indirect Wastes Refrigerator, Domestic s' elay Repair Temp for Test - 30 days Vacuum Pump Deep Freezer Disposal Low -volt, Fire Interceptor Renew - Temp Service r oof Inlet Water Closet Demolition Domestic Well Low -volt, Intercom/Teleph. Laundry Tray Repair Circuits Septic Connection Water Heater Dishwasher Drainfield, 4" Tile/Res. Low -volt, Television Lavatory Service, Number of Amps Septic Tank Water 'Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Mental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well IIce Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes s' elay Repair Vacuum Pump Disposal Interceptor r oof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water 'Heater New Drains, Area - IY[i eter.S`et (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, 'French . Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Permit No C3wners'Name and Address Amount of Permit $ 3 6 STATE OF FLORIDA, } COUNTY OF DADE. $s. My Commission Expires �B�►f�JB SH' ■!RES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT n 1 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oz other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu: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. ..No fl % % - Street Registered Architect and /or Engineer Employing Electrician's Name k L\ - c ... R q C.. No )%,10 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No of Stories Service Overhead Conduit Main Sw Am Size Feeders C Amps Main Fuses .Amps Underground P Type of Installation — Conduit Tubing B.X.L Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo -da Permanent Supplement, 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) Master Electrician. 1) Street S 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. 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 TOTAL CONTR. LIOT CHECK ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS MOTORS 0.1 HP 1.8 HP NEON TRANS. RADIO TOTAL CONTR. Lim' ?7 ' 3 A-94 /e. , (e) c) CHECK Permit No C3wners'Name and Address Amount of Permit $ 3 6 STATE OF FLORIDA, } COUNTY OF DADE. $s. My Commission Expires �B�►f�JB SH' ■!RES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT n 1 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oz other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu: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. ..No fl % % - Street Registered Architect and /or Engineer Employing Electrician's Name k L\ - c ... R q C.. No )%,10 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No of Stories Service Overhead Conduit Main Sw Am Size Feeders C Amps Main Fuses .Amps Underground P Type of Installation — Conduit Tubing B.X.L Metal Moulding (Signed) Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo -da Permanent Supplement, 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) Master Electrician. 1) Street S 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. 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. -.W -_.__ SWITCH OUTLETS LIGNY ODUTTL PLUG RECC P'9'E FISIYURCS NO. LAMPS REVRIO. OUTLET IRON OUTLET RA NGE OUTLET RANGE CONK. WATER HEATER W. HEAT. CONN. SPACE HEAVER STRIP HEATER 1 H � � i A O TOTAL C LIO? L16Y -- {J �y CHECK ENT. SW. DIST. CAD. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIRY CHECK Lr v Service Overhead Amount of Permit $ �...)...c STATE OF FLORIDA, } COUNTY O DADE. sa. M1 A Underground Size Feeders Type of Installation — Conduit Tubing w SHORES VILLAGE ELECT' OCCAL INSPECTION DEPARTME T PLIC 711 0N F ®R ELECTRICAL PERMIT f Permit (!! (Z- Application hereby made for the ai f 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, Fiu: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. Owner's Name and Address 1E a f a a vo a Q• LL No Q Q vC V1- (. Street 9 ? - �. a y - )Rd. C. f Registered Architect and /or Engineer ....�..1k�.4^.L.?e.A.�'i 11 �. � w * ! � �' �.. P� �6� I �°Q- �I "b''�4 i c"'we � Employing Electrician's Name......a.o..o.� E e. ��v'i ■ C . (v�..�...... 64 1 ' ' If Street / t a' 14 `, ' Location and Legal Description fot Block Subdivision. . Street and Number where work is to be performed--No ii 5'' VI •E0 �p Street 7 $7 State work to be performed and purpose of building (By Floors) 6� 1 4 e , Dc 0 © . New Building Remodeling Addition Repairs No. of Stories Conduit Main Sw Amps Main Fuses . Amps B.X.L Metal Moulding (Signed) Electricml nslf The undersigned applicant for this building permit does hereby celtify that he understands and accepts his o..Pg ations as an employer o labor under the Florida Workmen's Compensation Act. being Section 4966, Compiled General Laws of Florid, ermanent Supplement, 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. Date efore me, the undersigned authority, a nc:ary 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 Eupireo Notary public, State of IFloriula NOTE: A re-inspection fee of 51.00 will be made a ouch re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. 3 Master Electrician. Date. 9/–/ 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, Fits :ides, and all provisions of the. Laws of the State of Florida, all ordinance 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 progreu of work. /��J� Owner's Name and Address., 11 e'. Yit 4 4*' - //0/. Q ...... A � Street Permit No STATE OP FLORIDA, l COUNTY OF DADE. I T u. ELECTR ICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT My Commission Expires MIAMI SHORES VILLAGE ERreegpi]sttered Architect and /or Engin � r f / p ®d aCk,in�, l Crrti�rici 0s ome ./f. el S . . .. ..��r li'Yb.. >. Location and Legal Descriptic; , Lot Bloc Street and Number where work is to be performed— No.... ' f State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Ps Main Fuses Amps Type of Installation -- Conduit Tubing. B X L .Metal Moulding Amount of Permit $ 7P (Signed). The undersigned applicant for this building permit does hereby certify that he understands and accepts his labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contra work to be performed under this permit; and will post or cause to be posted for ins.•,ction n the sl a of the wo as are required by the Act. The undersigned agrees to employ only such subcontract s, work to perfor licensed by Miami Shores Village. (Signed) No" .C7 ✓may 9 7 7 Street 7 Street Subdivision as ew if" , a Electrical Inspector. obligations as an employer of Permanent Supplement, and s employed by him in the ch public notice or notices under this permit, as are � CJ Master Electrician. Before me, the undersigned authority, a notary public, duly authorised 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 sated are true. 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 OUTLET{ LICHT 0 PLUG RECE'►'TS FIXTURE{ NO. LAMP./ REPRICE OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER NEA W. NEAT. C ONN. SPACE N EATER STRI► W A HIAT :I A k ` \ 1 OTAL CONTR. LIST CHECK ENT. SW. DI {T. CA {. S TEMP. TEM ►. PERM. PERM. 77 � MOTOR{ 0.1 HP M OTOR{ 1•{ HP N[ON TRANS. RADIO TOTAL GL IST LIST CHECK Date. 9/–/ 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, Fits :ides, and all provisions of the. Laws of the State of Florida, all ordinance 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 progreu of work. /��J� Owner's Name and Address., 11 e'. Yit 4 4*' - //0/. Q ...... A � Street Permit No STATE OP FLORIDA, l COUNTY OF DADE. I T u. ELECTR ICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT My Commission Expires MIAMI SHORES VILLAGE ERreegpi]sttered Architect and /or Engin � r f / p ®d aCk,in�, l Crrti�rici 0s ome ./f. el S . . .. ..��r li'Yb.. >. Location and Legal Descriptic; , Lot Bloc Street and Number where work is to be performed— No.... ' f State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Ps Main Fuses Amps Type of Installation -- Conduit Tubing. B X L .Metal Moulding Amount of Permit $ 7P (Signed). The undersigned applicant for this building permit does hereby certify that he understands and accepts his labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contra work to be performed under this permit; and will post or cause to be posted for ins.•,ction n the sl a of the wo as are required by the Act. The undersigned agrees to employ only such subcontract s, work to perfor licensed by Miami Shores Village. (Signed) No" .C7 ✓may 9 7 7 Street 7 Street Subdivision as ew if" , a Electrical Inspector. obligations as an employer of Permanent Supplement, and s employed by him in the ch public notice or notices under this permit, as are � CJ Master Electrician. Before me, the undersigned authority, a notary public, duly authorised 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 sated are true. 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.