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740 NE 96 St (8)Permit No _ Date 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 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 , 19 Owner's Name and Address ` 1 _.. No Street Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block .._. Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) and for no other purpose. New Building Remodeling Addition Repairs No of Stories 1 To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ z Amount of Permit $ 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 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. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. J ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Disapproved / , 4' Date .. ._ "a _. .., i (Signed) �V L� Building Inspect to me well known, Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires LANNING BOARD DATE Chainnan 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. riuu1 lv• *21 . WW1 a LEG ALLOtS v -2'/ e , .0.1.1. °ti, r4Si33r.3 RECORD GARBAGE TAX AID BY etF_nc .11 /2I >/ ��te YEAR ANNUAL TAX PERIOD USED AMOUNT N PAID DATE PAID RECEIPT NUMBER -ereerge rieseetwarger (o) i ce `' HIV 796 AZ << /.2.- j�� / /' - -/ - S . « /J• r / '1 -' `r 3 -s o / a yyS - 4S-4174 /." 6-C _ - A, _, _ 1 /, 1/ / le---1 , 1 r - / - , - / / :> -, ?t I -):5 _ �, i f ,,,, ., ,___/- /d - 1 - .' r C • ,. /7( y STATE OF FLORIDA, COUNTY OF DADE. ss. 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 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. Owner's Name and Address Registered Architect and /or Engineer _1 :_1 Name and address of licensed contractor Location and legal description of lot to be built on: Lot__ ___ Block Subdivision Street and Number where work is to be done __ — 2 1 ? C. er (� — State work to be done and purpose of building (by floors) . 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 $ Amount of Permit $ 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 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, o9 work to be performed under this permit, as are licensed by Miami Shores Village. —_ Street -' . Remarks ( Signed ) S C Notary Public, State of Florida Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. Date Read, Sworn to and Subscribed before me. Disapproved Date ( Signed) Building Inspector My Commission Expires PLANNING BOARD ______ _ DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 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 Florida, all ordinances of Miami Shores Village and all rules and regula- tions 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 Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot ( y ; t Block__./ — Z —__—_ Subdivision Street and Number where work is to be done___— __! ____ ___ State work to be done and purpose of building (by floors) Distance to next nearest building STATE OF FLORIDA, u . COUNTY OF DADE. Building Inspector Date Date----- -;- - - -• -- � - - - -- - -- Nor ----------- ___— ___and for no other purpose. New Building__________!__ — Remodeling___— __ Addition_— ___ - -__ Repairs No. of Stogies____ —V • To be constructed of______— Kind of foundation — __ —___ _— Roof Covering_ —_ —. _ __ ' ____5 _ —_ .. —.— Estimated Total cost of improvements $ t G Amount of Permit $ / �! " 3 7 Zone cubage required__ Plan Cubage Size of Building Lot 1 X 4 1 ::. Maximum live load to be borne by each floor I hereby submit all the plans ;nd i T e c ifications for said building. All notices with reference to the building and its construction may • be sent to ( ' (' ' The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit: and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on A wo - to to performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) i� ( 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 be 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 thez.. n by him stated are true. Permit No .:V 7/ >/ Date Disapproved (Signed) Read, Sworn to and Subscribed before me. Notary Public, State of Florida G My Commission Expires_ —__� PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved— Date Disapproved —Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. 6r7.3 9" e'9 rkr /6 ;:(45- ify 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 regula- tions 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. - 1 / / Date__.______. -------- , 1 r / / > Owner's Name and Address N _L_ •Street �� - _ ( (. - Registered Architect and /or Engineer Name and address of licensed cofitractof Location and leg7I description of lot to be built on: r Lot _l. ! �`,w Block_ L_ Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) — _____________________ ____________ •--- - - - - -- -and for no other pu New Building_____ —___. + ___ __ Remodeling__________ —___ Addition_ Repairs No. pf . Sto,riea____ ✓ _______ To be constructed of_._1 _ _ Kind of foundation Roof Covering__ _ t Estimated Total cost of improvements $ !c t`t m Amount of Permit $_ 1 C y . 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 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 subcor>tractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the uncle ned aut ity, altar) appeared 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 be did sign the same. and that all facts therein by him stated true. l Permit No Y / Date Disapproved (Signed) Chairman Member Member Council Approved MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT i5 c, d9 authorized to administer oaths and take acknowledgments, personally • Date Disapproved Building Ins • -ctor My Commission Expires_________ _ PLANNING BOARD DATE • Member Member Member to me well known, R §wprn to and Subscribe: re me. t-t--e LA. -r• Notary blic, State of Florida 4 -4-Date NOTE: A charge of $1.00 will be made for making cot •ns or changes to this application after approval has been optained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re tion is made necessary by improper notice for inspection or faulty materials and/or workmanship. BUILDING ELECTRICAL PLUMBING Owner of * ' ! r 4■<1s. Building Lz Architect / / , / Contractor % or Builde et Description Address of 0'71'7 Legal 3 Building j , ' J IAMI SHORES VILLAGE, FLORIDA DATE' 1942 P ER M IT l r ? 6 7 8 U Contractor's l,nse No. this Permit C Wor to be perfor ed under fori This pe it is granted to the contractor or .wilder named above to construct the .uilding or to install the equipment or device described in the appli- cation 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 abo e ass es th r sponsibility for a thorough knowle the ordinances and regulations pertaining to the work covered hereby whether shown on the plans it . : wings/ the statem��}�'►pr specification . assumes respon- sibility for work done by his agents, servants or employees. // Signe& In consideration of the issuance to me of this permit I agree to perfprin the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in s • t conformity with the plans, drawings, statements or specifications submitted to the proper authoritiet of Miami 31joiS V, e. In acgeptipg this p mit I esp for all work done by either myself, my agent, servant or employee. RACTOR BUILDER BY B AUTHORITY MIAMI S H O RPtiS VILLAGE BUILDING INSPECTIOIFbDEPARTMENT APPLICATION FOR BUILD,I FiER 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 Shotes Village and all rules and regula- tions 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_ Owner's Name and Address_.:. C AL (' Registered Architect and /or Engineer 1 Name and address of licensed contractor STATE OF FLORIDA, u. COUNTY OF DADE. Location an legal escription of lot to be built on: Lot_ 'y p 1 Block 6 �_ —_ JJS``uu�di ision ti 2_1._ ' el ,,ee'''' "t Isr Street and Number w}iere work is to be done _____ ___.___ ___ Z ___7_SQ__ T � __ State work to be done and purpose of building (by floors) Ll C �; r 0,1 �L E --------- - - - - -�� – �// -- ��_`_and for no other purpose. New Building____________ Remodeling________________ Addition__._________ Repairs No. of Stories___/ ____ To be constructed of 0-...__J:1'__ Kind o foundation _ __Q___. _ —__— Roof _ �__ Covering- '� � _� : : _� _ r Estimated Total cost of improvements $ %„� — - mount of Permit $� Zone cubage required 7L...1 c ( _Plan Cubage /_ ,a Distance to next nearest building _Z Size of Building of ) . ,.. / 4 4 – 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 L... ri 1 r 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 Law; 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. r; `X Remarks (Signed) 12 � � __'___ Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared .4 Street____ - --- -- 19—__ -6-* 3, ,r to me well known, and who, being by me t duly sworn, upon oath deposes and says that be is th of the above escribed nstruction, that be has carefull read th foreS9jpgilication, and that he did sign the same, and that all facts therein by hii stated a true. / "..--1 4* Permit No. L. ; __ Date Read, Sworn to and Subscribed before me. Disapproved __�____ // _ Date Notary Public, State of Florida (Signed) { " ^ Building Inspector My Ccmmission expires sq._ y 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. 1 t 1 0,0'5• 4 /3 ' 3 " 13'x" )>> 30,42 2 �'7 ,z7. z s 11 ' 2 1 0 .t12-94 S 4- o 60 3g° G o g 4 .9 38'01 1 ' � .3 2. .3 3 .Z 3 2Z 9 91 Zt c c s os s -2 0 67 0 3 . 3 . 7 5 I - 2'o 0' 8" 15'3" 8 _ 2."3 O' Co I Q' 0 O a �� 92 Z - 5' 4 ��� r S � .? / s ,9 ) � 3 �' 4 ii - is 13.5 Ag %?.5 �a4 ot7o s r o 2 62 .-x` S- ) o s � 7 GORGE ROSENBERGER JOB LOCATION (ST. OR AVE.) OWNER'S NAME 740 N. E. 96th Street GENERAL CONTRACTOR Clifford J. Mueller L.UILDING PERMIT NO. 6780 ZONE X NEW CONSTRUCTION PEQUIREMENTS 17,500 CBS DATE 7/7/48 1_ Building Inspector APPROVED REJECTED SUBMITTED TO VU / ANN /MO / 19I/XR'D� / 7/7/48 RESUBMITTED TO PLANNING BOARD l_i KNITTED TO VILLAGE COUNCIL PRESENT ADDRESS 7345 Byron Ave M. Beach LOT BLOCK .- 81 W _7 68 A r fl, ESS 540 NW 102nd St PERMIT FEES 1 5• 00 CU. FT PLAN CUBE 17,626 CU FT DRS ?WINGS S PEECIFICATIONS. RESTRICTIONS AND CUEE CHECKED BY. JDH TYPE STORI EE.. ROOF CONSTRUCTION REFERRED TO COUNCIL REMARKS LICENSE NO. MS Section #3 PHONE NO. ES"". COST S Frame: Built-Alp Gravel Oak Floors - Porch - tile_ le_ DESCRIPTION REPAIRS Liv Din Rm combined- Enc _porch & Bath -2 BedRms...& Bath ... DESK.,. 'ON ALTERATION ADDITION 1 -car garage Ldy tubs SUBDIVISION _6054 215? BUILDER'S BOND NO 722 DATE 7/7/48 INTERIOR CONSTRUCTION REASONS PHONE NO. LICENSE NO. 11,000.00 DATE 7/7/48 C ERTIF!CATE OF OCCUPANCY NO. 632 ISSUED 1 1 /26/48 BY JDH To George Rosenberger 740 NE 96th St BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION ��}} 7 /9j /` 8 L� Bolen TEMPORARY SERVICE 7/12/48 $ 1.00 $ BEAMS & LINTELS 7/29/48 TDH $ 1.00 $ SEWER SOLAR HEATER $ FRAMING 9 GAS $ FIXTURES $ $ /tiX $ INSPECTIONS DATE BY RE- INSPECT FINAL - i ,- > , ROUGHING 7/16/48 JDH TO 8/18/48 GLEAN -U Byrd 11/22/4 K � GAS ROUGHING 8/24/48 CONTRACTOR McGuire Plumbg Co PHONE d PERMIT NO. 6819 I DATE 7/15/48 FEE $ 8 •75 NEW BLDG. X I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE 7/12/48 $ 1.00 $ SEPTIC TANK No Dade 7030 9 -1-48 $ 1.00 $ SEWER SOLAR HEATER $ MOTORS $ GAS $ FIXTURES $ $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING 7/16/48 JDH TO 8/18/48 JDH 411W GAS ROUGHING 8/24/48 JDH SEWER H. W. HEATER CONN SEPTIC TANK 9/2/4.8 H SOLAR HEATER FIXTURES 1Y8/ a.. PERMIT NO. 6974 DATE 8/23/48 FEE $ 8040 NEW BLDG. X I ALTERATION I ADDITION X REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE Gates 6800 7/12/48 $ 1.00 H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY ■ RE- Ijya 1 B.Y i l'EMP: $EI3VICE Ij14 / 475 J 411W ROUGHING 8/24/48 JDH H. W. HEATER CONN RANGE CONN. FIXTURES &•FINAL 24941446ii i a.. BUILDING INSPECTIONS PLUMBING PERM ITS& INSPECTIONS 1 CONTRACTOR ELECT PERMITS & INSPECTIONS Gates Elcc Co lac PHONE APPROVAL TO POWER CO N° 632 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Owner Lot � Y Bloc Subd' Street Address f r / A roved use by occ anc ti - PP Y P Y Remarks • This Certificate of Occupancy is issued for building at above named location only abide by and comply with all conditions of Zoning, Electrical, Plumbing and Buildin the erection, construction, alteration o the a pon rdin 1 mea ss provision that the applicai 92, ' , 94 and 97, known hores Village pertain str ctures. BUILD DIVISIO BUILDING ELECTRICAL PLUMBING Owner of Building Architect )4 Contract or Build N IA1411 SHORES VILLAGE, FLORIDA DATE '14 PERMIT N? 6780 be pemo d trader ibis Perndt issuance to me of this permit I agree to the &wins, 1� ' work dice by either UD Legal Description Address of Building This pefait is granted to the contractor or builder named above to constract the, b ante- cation � strict compliance or all ordinances hat may have be an to and • that may v at any time it et work is not in compliance with such redinances or permit is granted is the and that the contractor or budder naaS pertaining to the covered hereby whether shown on the si ty for work done by his agenta servants or employees. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3:- Job Address 7 Li D ) C. •,, 9C 5t' Tax Folio /f J 2. G- 6- • -� e/ v-- -?-1 C p Legal Description Historically Designated: Yes No /tom c, r Owner/Lessee / Tenant _�f �l f�/ ` ��C / . lf Cer‘,e_le- Y Master Permit # Owner's Address '7c( 61 )4 ( 9 t 1 (t� <", Lf s J' Phone 7 4 — 7 : ) {j Contracting Co. 0 co, 4 �✓� Address 7 W' Xr: 96 Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address WORK DESCRIP'T'ION .M a 1 e Signature of owner and/or Condo resident Date Notary as to Owner and/or Condo President Date FEES: PERMIT 4 /0.0 0 RADON Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN X1%1 G `'`' " i Square Ft. Estimated Cost (value) LSO v C' 0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this urisdiction. 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 is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor t • : oThe work stated. My Commission Expires: My Commission Expires: tee, / Aa....i , :51i,t i , ature of ontractor or Ow Date — )-) j Not as to Contractor or Owner - Builder Date C.C.F. , �i O NOTARY 1/4.5�00 TOTAL DUI: y r c5 b APPROVED: (9 Zoning Building )1q7/6 7j6 Electrical Mechanical Plumbing Engineering 1S' k. LL.e. r( T. SKETCH OF SURVEY scale 1 " =20'