444 NE 96 St (11)Contracting Co. el),k
Qualifier
State #41,69 i unicipal 1
Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle one)
WORK DESCRIPTION
DFt 4has exlsh
Square Ft. ,.f1
** *
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 4 / 4 / 1e / e / /0 4 . 14 1 Tax Folio
Legal Description
Owner Lessee / Tenant ////a 1t#i am( ./jr
Owner's Address _:57#217E7
0 . 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 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.
OWNER'S AFFIDAVIT: I certify that all the foregoing information
be done in compliance with all applicable laws regulating
authorize the above -name contractor to do the work
l �
Signatur of. owner and /or Con President
Date: Cj /y/ f
, 7 1 7.22t , mar V2
Estimated Cost(value)
SS4 ## .CPhone 2 -- J 6,4 �` 7`-
Ins .Go. 1 1, l
Notary as to Owner and /or Condo Presid
My Commission Expires:re
nr �
FEES: PERMIT V170 RADON
e Competency #
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Address
Address
Address
Master Permit #
Phone 7. SE7
Address 9‘ /V/77 2 kiti D :c;4 2-49
1
C
is accurate and that all work will
cons ction and z•-ning.J Furthermore, I
stated.
S' gnatu a of Contractor or Owner-Builder
ate:
Notary as to Con or Owner- Builder
My Commission Expire _ ,._
* * * * * * * **
C.C.F. I " NOTARY TOTAL DUE '5
Fire
Zoning Buildin j Electrical
Mechanical Plumbing Engineering
Other
•regeassiva Glees Technology
.1 .1d Wd T : T 066 'At(W
NOTICE OP ACCEPTANCE' ADDZNDVM
4 -
AccspTAttCS we,'
APPAOVSD 01 /14/9a
Nxaxwa 1 11 / 39 / 98
This addendum converts this product's present llevation Rating to the following
corresponding rating
Design Pressure Ratings 66.04 P8r in accordance with AGCY 7.84.
This product has not been subjected to the Impact Teat Procedures per ProtocolPA 701.94,
therefore, it meet be installed with an approved Hurricane Protection Devine,
--put
Oil Diamond, PA.
Supervisor
Product Control Division
96T£ 880 £i8 :131 'ld9Q DN1Zi3BNIJN3 '1'D'd : WQad
8293 294 SO2 SMOQNIM ssiia ZZ :VT NOW 176- 6T -d3S
170'd
1, . For multiple window installations, approved mullion drawings and calculations must be
fded with Product Control.
2.
3.
This Acceptance will qualif' smaller units of the same design and as the unit tested.
4. Extension of Acceptance may be considered after a new application has been flied and the
supporting data, for test reports less than four (4) years old, has been re-evaluated.
5. Any revision or change in materials, use or manufacture of the product shall automatically
be cause for termination, unless prior approval is granted for revision or change.
6. Any unsatisfltctory performance of this product or a change in Code provisions shall be
grounds for re- evaluation.
7.. This Acceptance shall not be used as an endorsement of any product sales or advertising
purposes,
$, Aluminum windows and sliding doors have been tasted in accordance with ANSI/AAMA
101 -88 or for wood window unit by ANSI/NW/DA 1,S, 247 and Aiding doors
ANSVNWWDA I.S. 3-8 and swing doors ANSI/NWWDA I.S, 8 -88.
9. Swinging doors shall be tested for positive and negative wind pressures as per Chapter 23
of the South Florida Building code.
10. Hardware for all windows and doors shall conform to Security and Forced Entry
Prevention, Chapter 36 of the South Florida Building Code,
11, The spacing of fasteners shall be u tested or 24" whichever is less,
a The fast Wiener shall be located a maximum of 6" from each corner and mullion or stile.
Minimum penetration of fastener shall be u tested or 3/4" whichever Is higher. No wood
or plastic shields or pins shall be used,
Unless otl rwise noted in the test report, minimum size of screws shall be No. 8 for first
and second floor installations and No. 10 for all other floors above the first and second
floors,
advis.ian
QTd Wd 0Z: t I66T 'b 'AdW
-3-
Diamond, P.E
roduct Control Division
Supervisor
96TE 8817 £t8 :131 'tdQ JNI2133NION3 '1'J : W084
8297 29L G02 SMOIIN I M sslia 93:1't NOW 1,6-6T-c133
i
r
nranrs m xf _ Lass 2,1o �nple�t /�
....3t1XL Tsai fuck&
INTERIOR WXNDLOADs 83.0 p,e.f.
EXTERIOR WINDLOAD t 91.0 p, • . l
WATER RESISTANCE ' 8.30 p.s.f.
AIR INYILTRATIoN I 0.04 cfm /e , f .
FORCED ENTRY : wri. 14608 (FER)
ACCEPTANCE N*, s o ..iiL -. +1 c g 1
APPROVED
EXPIRES
t Nov. 29, VIA
scat a..a.
SILL t 3 #10 x 1 3/4" PH CP Sb
HEAORRM 3 #10 x 1 3/4' RH CP SD
JADWS t 3 •10 x 1 3/4' PH CP SD
ROM PasAaiLain Nat' 11 . pAaE
ARm= Fflh i.xVATTONs JiP TQ. 1111 1 t AbOieg_fi Ua a a o
This product must be re- evaluated for structural adequacy when instal
within the Coastal Construction Zone in accordance with Chapter 23
Sub - section 2309.2 (b) of the South Florida Building Code.
This. revision eupere*des Notice of Acceptance $92 1113.8 and
changes the name from Vinyl Tech to Progressive Glade Technology /Vint'
Tech.
6 d Wd 02 : I 0661 17 'J,HW
D amen
Product Coat -1 Division
Supervisor
96tC 880 £T8 n31 'Ida! JNI83311I ONB 'i'0 ; woad
£0'd 8£9Z £9L S0£ SMOQNIM SSIl3 9Z:tT NOW b6- 6T -d3S
D c tP.=ia a 1=
A4344LARSIAHATIOn
Series 400 Aluminum
Awning Window A -055
e , ny�. AtLt tZ .
3' is 1" by 5' - 3" high
ib e>u y>iTm, pour, each 36" by 15 3/4" high.
twailuanumailt Double vinyl bulb in frame head, jambs and in bott
rail of the top five vents. Single vinyl bulb in frame sill and botta
rail of bottom vent.
C ARP n a 4 !A!Prnal. Roto operator. Automatic metallic hook lock
pin at each aide of each vent.
aualaugaisiuma Double strength annealed glass.
afmljUgHdn ; Exterior glared using Oilicone 'edheeive and rolled
aluminum glaring tape.
matim M ,' None
MULTTNR4 None
ax Nmeg RNT None
Yne. Flange type frame
8 d Wd 61:1 066117 •.Jew
ZO'd 829Z £9L SO2
APPROVED o M�e rc>1, ,1,4.
EXPIRES AQY 2
s •V
• , . q
aleAlatiBiLICCMAMLAUlaras
AAMA 101 -88 A -055
Dade County Approval 992.1113.5 (91)
Expiree I November 29, 1994
Approved for installation up to 100,
above grade.
nag. Elevation must be reduced
the coastal construction 2
a mon•, .S
roduct Control
Supervisor
on
-2r
9612 88P Ct8 :ial '1d3Q DN1833413 '1'0'd : W0d4
SMOQNIM SSIla SZ :i'T NOW b6- 6T -d3S
t
.
METROPOLITAN DAN COUNTY, FLOAIOA
cwdnn.M
Danwrr , M1wAIw
Wocedimal
MO Lwow
A mil Aor
Amu AO*
Co lds Min
Mow M. Slack
LaMrwnca A. 9w*iA
44 8404
Oscar 8nMa4+1
AIM CaIp al
&Wang CaMar
lore Ji la Arnow
K. Carlton Docker
AmoM Oafdn m
Wiwi M. Mary
. °mg, Lo,
/o& s Wotan
Sim laws
*MO MAIN, tr.
Iowa 11,wr
MAN Mary
• Arnrnfir M, Nts
MON Owidd
044 Mmomm
m. ;maw
Job Pin *
Sagl
Pork: Dow
Se* 04 *we
al Oloso44
L d Wd 8T :1 1766T 'ti 'AaW
t0'd 829Z 29L S02
PAMUCT.. C AST o NOm* R 2 f RDTONCJ
Progressive, Glass Technology/
Vinyl Tech, Inc.
155 Center Court
Venice, P1. 34292.
Your application for Product Approval of JUWALAQILAthmi,
Awninn W4 nrinu r,_r under Sections 203 and 204 of the Sout
Florida Su ng Code governing the use of Alternate Mater
and Types of Construction, and completely described in the
plans, specifica and celcula as submitted by
(305) 375 -2f
accepted by Product Control under the Specific Condition
forth on pages 2 - 24 and the Standard Conditions on Page 3
ACCEPTANCE No.! 92 fl m , s
APPROVED =
EXPIRES
a
swum **
a;; -
;I •�:
$WN*11A cONp7T/r»4
•
METAO•OAOH CENTEF
BOARD OP Ru1.0 ANO APPIA
WIT, 101G
111 N.W, 10 erRiln
MIAMI, FLORIDA 30126.1071
RO1) 3064111
a awn • •
Product Control Divil
Supervisor
ES POR SPECI EI
This application for Product Approval has been accepted by
Metropolitan Dade County Soard of Rules and Appeals to be u
in the Incorporated ond Unincorporated areas of D .e County
under the conditions set forth above.
APPROVED!
.1.
96TE 880 Eta :'13.l
ar 04 anger, ,.
Deputy Secretary
Metropolitan Dade Count
Hoard At ROAN and App.,
'ld3a ON 1833N 19N3 '1 'rJ 'd : WOdJ
SMOQNIM SSI13 t.Z:bt NOW 176- 61—d3S
Date
4,
Legal Description
Own Lessee / Tenant 44..■/ / / /4l41
Owner's Address
Contracting Co.
Qualifier
State # G°/ 0 ?0%D
Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle one
WORK DESCRIPTION
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 4 104 . 14 &.-ZL Tax Folio
4 )9 F - /ZS 7 ,
&v,e ss# '? - /
CPhone
Address
Ins .Co . 1 J'�-C/ s/
y
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
is accurate and that all work will
•
gnature of Contr
ate:
and z
tor or Owner- Builder
i... J /c °/1 •11:
ction
** * * * * * * * * * * * * * *
Furthermore, I
Notary as to Cont actor or Owner- Builder
My Commission Expire / 7 , 7
r �.�u.t�.:,,,; '. �� 2S"."i$
D'ITidaLa u m dl .. ,::: _ � ..
* **
FEES: PERMIT 0;6 RADON C.C.F. 1L " NOTARY TOTAL DUE � '
Fire 1 n _ _ Other
Electrical
Mechanical Plumbing Engineering
progressive liar• Teohnalogy
TTd Wd TZ:T 0661'0 'AIN
S0'd 829Z £9L GO2
NOTICE OF ACCEPTANCE' ApDZNDV)(
AQOsPTAtles woo 34` 11.00 $11
APPROVSD 01/16/P9
SUMS 11
This addendum oonverte this produotis pr,u.nt Rlevstion Rating to the following
corresponding rating'
Design Pressure Ratings 6840 PPP, in accordance with AgCR 741.
This product has not been subjected to the impact 'feet Procedures per ProtocolPA 201 -94,
therefore, it inu t be installed with an approved Hurricane Protection Device.
Oil Diamond, P,R,
Supervisor
Product Control Division
96T£ 880 £T8 :191 '1d9Q DNId -33NION3 '9'd WQ84
SMOQNIM SSIl a LZ:bT NOW b6- 6T -d3S
*0'd
1. For multiple window installations, approved mullion drawings and calculations must be
filed with Product Control.
2.
3.
This Acceptance will qualify smaller units of the same design and u the unit tested.
4, Extension of Acceptance may be considered otter a new application has been flied and the
supporting data, for test reports lees that four (4) years old, has been re-evaluated.
S. Any revision or change in materials, use or manufacture of the product shall automatically
be cause for termination, unless prior approval is granted for revision er change.
6. My unsatisfactory performance of this product or a change in Code provisions shall be
grounds for re-evaluation.
7, This Acceptance shalt not be used as an endorsement of any product sales or advertising
purposes.
8, Aluminum windows end sliding doors have been tested in accordance with A■SI/AAMA
101 -88 or for wood window unit by ANSI/NWWDA I.S. 247 and sliding doors
ANSI/NWWDA L.S. 3-8 and swing doors ANSI/NWWDA I.S. 8 -88,
9. Swinging doors shall be tested for positive and negative wind pressures as per Chapter 23
of the South Florida Building code.
10, Hardware for all windows and doors shall conform to Security and Forced Entry
Prevention, Chapter 36 of the South Florida Building Code.
11, The spacing of futeners shall be as tested or 24" whichever is less.
$ The first Wiener shall be located a maximum of 6" liow each corner and mullion or stile.
Minimum penetration of fastener shall be Its tooted or 3/4" whichever is higher. No wood
or plastic Melds or pins shall be used.
Unless otlrwisc noted in the test report, minimum size of screws shall be No. 8 for first
and second floor installations and No. 10 for all other floors above the first and second
floors.
Revised x•90-9]
eTd Wd 0Z: t P66T 'P
-3-
Diamond, P,E
roduct Control Division
Supervisor
96TE set, its :dal •1d3C1 DNI833NION3 'I 'd : W084
8293 29L SO2 SMOQMIM SSIla 93:*T NOW *6- 6T -d3S
Mich. 1
mgt
INTERIOR WINDLOADs
EXTERIOR WINDLOADi
WATER RESISTANCE 1
AYR INFILTRA'T'ION o
FORCED ENTRY 1
6 d Wd O2 : I 17661 1 '.WW
ACCEPTANCE NO., ...2221112.4.1_441).
APPROVED t "„HAreh Lfi 199
EMPIRES t
,•
4 ,
4 %;
83.0 p. e • f , SILL t 3 #],0 x 1 3/4" Pit CP $MS
91.0 p, • , f , HUM; 3 #10 x 1 3/4" 'PH CP $M.9
8.30 p.s.f. JAMBS t 3 1)10 x 1 3/4" FH CP SMS
0.04 ofm /e,f.
)TT'L 14608 (FER) MOM ploA1e -ees Note I11. paaa
ve einq grade
This product must be re- evaluated for structural adequacy when instal]
within the Coastal Construction Zone in accordance with Chapter 33
Sub sootion 2309.2 (b) of the South Florida Building Code.
This revision supersedes Notice of Acceptance 192 1113.8 and
changes the name from Vinyl Tech to PrOgresaive Glass Technology /Viny.
Tsah.
D amon
Product Cont -1 division
Supervisor
96tC 8817 08 :131 '1d3a ON1d33NI '1'J'd : WO?Jl
£0'd 8£9Z £9L S0£ SMOQNIM SSI13 9Z:i7T NOW 176- 61-d39
8 d Wd 6;;; P603 3 ' uw
Vin ' ,P ti. tn1 ._
G,43C�Rxwr oN O 11=
MODEL_DWAHATIQU
Series 400 Aluminum
Awning Nindow A -055
e A
3' • 1" by 5' - 3" high
Uo. 6 AIld , ,Q$ V NTai rout
ACCII»TAt1C N o e s -
APPROVED 1 AC� arch 16 _ 14 4
• ,. •,
'R 9 IN K AC!(!k��x Nt'!ILIARRTNCQ
AAMA 101 -88 A -C95
bade County Approval 992- 1113.5 (91)
Expires t November 29, 1994
Approved for installation up to 100.
above grade.
QAUTTQd1 Elevation roust be reduced i
the coastal construction zo
each 36 by 15 3/4" high.
NEATHERATRTpS'THQ; Double vinyl bulb in frame head, jambs and in botto
rail of the top live vents. Single vinyl bulb in frame sill and bottom
rail of bottom vent.
fin pn a ,A jctrjaT ni Roto operator. Automatic metallic hook lock a
pin at each side of each vent,
Double strength annealed glass.
Exterior glazed using M11iconq4dhesiv and rolled
aluminum glazing tape.
NiagaaLgai None
NR ( Nona
gIEQ*CFMRNtx None
ADD TIOrt r. nErn
Flange type frame
..2-
anon • , • . Ii
roduct Control
Supervisor
on
961E B8a et() :8l '1d9Q DN1d33NIO '1 'd : W08.i
8£9Z £9L S0£ SMOQNIM SSIla SZ:VI NOW 176- 6T -d3S
M
:: METROPO1, PAGE COUNTY, FLOAIOA
' MOTR
OINIrmag
Menem & M arshrw
114 WNW
Momibm
kmld ANr
hmuM0
C,00gr 8.rlrn
Thaw 41 A/, Slack
1ann1nrcf A. bowl
Oscar 8fM4+r
MM C44(
&Iwnio Case
!aryl di to Thm,,•
H Carryon Dicky
AnTold Orkho m
Maimr AI, Norm
. pwmrd Goo
MA OW Mm
Swim LAW
'lay* Maki*, tr.
ha1u MW
*Wm Rill
Atom M. Ake
Roma Unvied
A�Ird 1116Mai
114 RINIam
Omni Cour ilaat
Job Maw *
Smff
aides Doer
• OWNS
err DS and
T0'd 829Z £9L S0£
EannLCT P NTROL NOTTCE L J WA TANK
Progressive, Glees Technology/
Vinyl Tech, 2nc.
155 Canter Court
Venice, Pl. 34292.
Your application for Product Approval of
under Sections 203 and 204 of the South
Florida Bu ng Code governing the use of Alternate Materil
and Types of Construction, and completely described in the
plans, specifications and calculations as Submitted by
App' ir4nt 1�,LS�,a
has bee
accepted by Product Control under the Specific Conditions 8(
forth on pages 2 -24 and the Standard Conditions on Page 3 fs
4 d Wd IIS : t 1766T17 'AUW 96TE 880 08 :131
(305) 375-261(
■•■•
ACCEPTANCE NO.t
APPRQVID =
NXPXRIS
t
APPROVED
aame�si. cexpxTieNa
MET110.0A0E CENTER
ROAM o► RAM ANO APPM
WTI 1010
111 N.W. IN OTTRUT
MIAMI, mLOP1OA 34128•1074
(001) 3►64N1
G ruaon • , •
Product Control Divis:
Supervisor
• / : ; •
' ;1f •k;
This application for Product Approval has been accepted by
Metropolitan Dade County Board of Roles and Appeals to be uw
in the Incorporated End Unincorporated areas of D e County
under the conditions set forth above.
anger,
Deputy Secretary
Metropolitan Dade Count
Board of Rules and App.,
'ld3a ON1833N1EJN3 'l'O'd : WO&
SMOQNIM SSI1a jZ :bT NOW 176- 6T -d3S
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 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.
Owner's Name and Address VP H ' (4.#' 'L K_ 4 TR.. No c( q Street.. a _
Registered Architect and /or Engineer r re .V. / A . y_,0 . . S if
Name and address of licensed contractor C. • a f. ._ 7.T. . - 4.V E - 2
Location and legal description of lot to be built on:
Lot 4 et / { - L 6 Block �i Subdivision ," L ' sk. c -
Street and Number where work is to be done
e work to be done and purpose of building by floors) Z _rA . ^ _rt5
q L -e4 5 977/11e. p 4 -reA 'E J) -o p L.r{i 4-41r Q - -P®.e rct _ - -(.u_ $42..21A)
44 A-0- dr 4 --1) rt (-try - '2.6 . and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof C yFring
o
Amount of Permit $ ,e t ....��
Zone cubage required .Plan Cubage �' t
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
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compile
Estimated Total cost of improvements $ po:�
and has complied with the provisions thereof, and will require similar compli
in the work to be performed under this permit; and will post or cause to
or notices as are required by the Act. The undersigned agrees to employ
permit, as are licensed by Miami Shores Village.
Remarks
Permit No
Disapproved
(Signed)
Date
Building Insp ctor
MIAMI SHORES VILLAGE
Date 0 c r
/0
r,
19..Sv_
4 .-ST-
and accepts his obligations as an employer
Ida, Permanent Supplement,
tractors or sub -con tors employed by him
on on t - • e w r uch public notice
s o work . erformed under t is
rom all con
posted for i �_,. • ti
only such
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 ar e. /� — //��/
Date.._- r/ / Gl (LZ 5
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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
r
Owner's Name and Address._.. ._l.._4-451
4
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdiiviissi n
Street and Number where work is to be done T
Disapproved
(Signed) ...>r
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal 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.
Date
No V Street
p urposo o!' building (by floors) t.'1 .,P.0
State work to be done and
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 6 D Amount of Permit $ Z'
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 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 pennit 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 ublic notice
or notices as are required by the Act. The undersigned agrees to employ only such sub tractors, on k to be perfo • r � t
(Signed)
permit, as are licensed by Miami Shores Village.
Remarks :
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 are true.
Permit No 47 S Date I Z - f o - Read, Sworn to and Subscribed before me.
e
Notary Public, State of Florida
Building I spector My Commission Expires
19 r
.tS.'T.
cr
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.