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PLUMBING
n is 1IR "e .,tC� , ifl: X �: ,rSa llL MU D CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ X ]Repair [ ]Abandonment APPLICANT: Friedberg, Richard S. LOT: 15 BLOCK: 9 SYSTEM DESIGN AND SPECIFICATIONS PROPERTY ID #: 11- 3206 -013 -1270 T [ A [ N [ K [ OTHER REMARKS: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT OM THE SEPTIC TANK SHALL 13 bcU " O:l T' II9 C ci YDi DEFLECTIOR DEVICE III3TAI. SPECIFICATIONS BY: Icaza, Carlos APPROVED BY: Icaza, Carlos DATE ISSUED: 6/7/02 REPAI PROPERTY STREET ADDRESS: 25 NE 99 St Miami FL 33138 AGENT: WALLACE P, Ponder Wallace SUBDIVISION: Miami Shores Sec N 1 (Section /Township /Range /Parcel No.] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. 900 ]Gallons SEPTIC TANK MULTI- CHAMBERED /IN SERIES: (Y ] 0 ]Gallons MULTICHAMBERED /IN SERIES: [Y ] 0 ]GALLONS GREASE INTERCEPTOR CAPACITY 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS Q [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] D [ 200 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R ( 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [V' 1STANDARD 1 N ]FILLED I CONFIGURATION: [/ N ]TRENCH ( ji: ]BED N / F LOCATION TO BENCHMARK: Highest Floor Elevation of E /R, I ELEVATION OF PROPOSED SYSTEM SITE [ 3.1 ] [ FEET E BOTTOM OF DRAINFIELD TO BE [ 6.1 ] [ FEET L D FILL REQUIRED:[ 0.0 ]INCHES EXCAVATION REQUIRED: THIS PERMIT IS NOT FOR ADDITION(S). *Existing 900 gl. septic tank to remain. *Install 200 sq.ft. of drainfield or available but *Invert elevation to be no less than 8.60' NGVD. *Bottom elevation to be no less than 8.10' NGVD. [ ]Holding Tank [ ] Innovative Other [ ] Temporary [ NA ] TITLE: DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) [ostda cone 4oi6 -1] CENTRAX #: 13 -SG -13118 DATE PAID: FEE PAID : RECEIPT . OSTDSNBR : 02 -1727- -R [ N ]MOUND [ N ] [ N ] 14.20' NGVD. ] [ BELOW BENCHMARK /REFERENCE POINT ] [ BELOW BENCHMARK /REFERENCE POINT [ 36.0 ] INCHES no less than 100 sq.ft. f - -. THIS PERMIT IS NOT FO &A®pITI N(S INVERT ELEVATION BOTTOM QF DRAINFIELD ELEVATION 1-)c- TITLE: Engineer I Dade EXPIRATION DATE: 9/5/02 CHD Page 1 of 2 APPLICANT: PROPERTY ID #:11 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS • LOT: 1c' BLOCK:' c2J TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUS: PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. r PROPERTY SIZE CONFORMS TO SITE„ ALAN : [ ] YES [ 1,,r1N0 NET USABLE AREA AVAILABLE : ; 1 3 i L Fc ACRE: TOTAL ESTIMATED SEWAGE FLOW: /DO GALLONS PER DAY [RESIDENCES -TABLE 1 , _OTHER -TABLE 2] AUTHORIZED SEWAGE FLOW: �C.) GALLONS PER DAY [1500 GPD /ACRE OR'250 GPACRE] . UNOBSTRUCTED AREA AVAILABLE: ?_0%, SQFT UNOBSTRUCTED AREA REQUIRED: 13O SQF1 BENCHMARK /REFERENCE POINT LOCATION: f L • /2, o 6 _ ELEVATION OF PROPOSED SYSTEM SITE 1St' s , [INCHES/01 (ABOVE /r LO31 BENCHMARKtREFERENCE - "POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: FT DITCHES /SWALES: W4 FT NORMALLY WET? [ ] YES 4. 1 NC WELLS: PUBLIC: /i/4 FT LIMITED USE: A(/,4 FT PRIVATE: ,i fd FT NON- POTABLE: "V, BUILDING FOUNDATIONS: FT PROPERTY LINES: FT POTABLE WATER LINES: F1 SITE SUBJECT TO FREQUENT FLOODING: [ ] YES ( 10 YEAR FLOODING? [ ] YES (44 -ANC 10 YEAR FLOOD ELEVATION FOR SITE : FT MSL /NGVD SITE ELEVATION: /.l } FT MSL /NGVI / tAe SOIL PROFILE INFORMATION SITE 1 Munsell # /Color Texture Depth !0 V/ "1/ 5o v ,i '' 0 to ' r ,) +..! A, :J« ,; to i 1 r '/ . ' • r Il tO i�: t ;' / / f to if 5i, ow r‘ i • i 1 to / ' ` to r 1 + j + to y (+ \ ± / i` . , to . f _`141 v% ,1 t6 7? " USDA SOIL SERIES ; ., ,,717(,1;ii+„ I�l��i,:'� - SITE EVALUATED BY: DH 4015, 10/96 (Replaces HRS -H Form 4015 (Pape 3] which may be used) (Stock Number: 5744 -003 - 4015 -1) AGENT: SUBDIVISIONi 4¢ 1i.„ SOIL PROFILE INFORMATION SITE 2 PERMIT # [Section /Township /Range /Parcel No. ot(bx ID__Musibex] Munsell /Color /;)1(1/. / Texture `i \ Depth - 0 to to (1 "4 to to to to to 1 ) to to ' 1. USDA SOIL SERIES: OBSERVED WATER TABLE: r J•: INCHES [ABOVE / BLOW] EXISTING GRADE. TYPE: [PERCHED / ] ESTIMATED WET SEASON WATER TABLE ELEVATION)" t! INCHES [ ABOVE / ' EXIST ,IN4 GRADE. HIGH WATER, VEGETATION: [ ] YES [�4'NO MOTTLING: [ ] YES [ t y l k0 DEPTH: /'f_ INCHES f 1 SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: i,..196-,0,1,A4 DEPTH OF EXCAVATION: ' INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH ( L'3 BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: DATE: Page 3 of 3 S: : Each block represents 10 feet and 1 inch = 40 feet. PART II - SITEPLAN J ! . Lai* Plan submitted Approve STATE OF FLORIDA DEPARTMENT OF HEALTH 1' • APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMFT0 )- t om; �` Permit Application Number - . r5•6 J � 11 L 1 015, 10/96 (Replaces HRS -H Form 4015 which may be used) ac Number. 5744 -002 - 4015 -6) I k i ,,,1 _►1i 44 IP_ . A .1 I wlr ,/ emilmmomow Y'i 1 Not Approved • ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DatK 6-7c) 2 County Health Department Page 2 of 4 cCO Miami Shores Village 10050 NE 2nd Avenue o Phone: 305-795-2204 ry 3 0 re Contractor WALLACE PONDER SEPTIC Local Phone: 305- 620 -8320 QO (� Parcel # 1132060131270 sT PAY TO THE ORDER OF Printed: 6/10/2002 NationsBank, N.A. ACH R/r 063100277 FOR Applicant: CAROL ANN Owner: FRIEDBERG JOB ADDRESS: 25 Fees: FEE2002 -3283 FEE2002 -3284 FEE2002 -3285 Permit Status: Work: 200 SQUARE FT DRAINFIELD NationsBank NE 99 Approved Permit Expiration: WALLACE PONDER 12 -99 D /B /A WP SEPTIC TANK CO. 305-620 -8320 17235 N.W. 12 CT. MIAMI, Fl. 33169 Legal Description: Description Buildier's Bond CCF Building Fee Total Fees: tf $hor. • —__ g = ___, ; r,..._, Look for: blue background on the flout of this check, and the image Plumbing Permit Permit Number: PL2002 -144 12/7/2002 FRIEDBERG CAROL ANN ST Contractor's Address: 17235 NW 12 CT MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 15 DATE Amount $300.00 $1.20 $80.00 $381.20 Salt'CO logo on back. If not present, do trot cash. Construction Value: $1,300.00 n'00203 LH' 4063 L002? ?I: 0036656593 2031 63-27/631 FL 94 Page 1 of 1 Total Fees: $381.20 Total Receipts: $0.00 e- inspection BLK 9 LOT SIZE 50.000 X 3tion herefor in strict compliance with all cations that may have been submitted to or if the plans are changed without , nsibility for a thorough knowledge of the at he assumes responsibility for work done pertaining thereto and in strict conformity ponisibility for all work done by either P91 (1 Miami Shores Village ,-v- 10050 NE 2nd Avenue o Phone: 305-795-2204 N Printed: 6/10/2002 Applicant: CAROL ANN Owner: FRIEDBERG JOB ADDRESS: 25 f v NE 99 Permit Status: Approved Permit Expiration: 12/7/2002 Work: 200 SQUARE FT DRAINFIELD Plumbing Permit Permit Number: PL2002 -144 FRIEDBERG CAROL ANN ST 0 re Contractor WALLACE PONDER SEPTIC .. Contractor's Address: 17235 NW 12 CT Local Phone: 305 - 620 -8320 Q0 M Parcel # 1132060131270 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 15 BLK 9 LOT SIZE 50.000 X Fees: Description Amount FEE2002 -3283 Buildier's Bond $300.00 FEE2002 -3284 CCF $1.20 Total Fees: $381.20 Total Receipts: $0.00 FEE2002 -3285 Building Fee $80.00 1 Total Fees: $381.20 Construction Value: $1,300.00 Page 1 of 1 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper unicipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without Q authorization. A further co dition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulation . pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done ( by his agents, : giants ants o employees. / Sign . Ai " i ' SPECTOR) BY: f 11 In consider • o � a of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the pia , . r:wi gs, tatements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: • Look for blue hack round on the front of this check, and the imageSafnk PAY TO THE ORDER OF FOR NationsBank Nat.iottsllank, N.A. ACH R1T 063100277 G WALLACE PONDER 12 -99 D /B /A WP SEPTIC TANK CO. 305 - 620 -8320 17235 N.W. 12 CT. MIAMI, FL 33169 ttia 1/~< Gkores Vi( aoe "Lit1/47427 DATE present, ao not c .un. n'00 203 L11' 1:063 L00 2 7711: 00366565935611' 2031 63- 27/631 FL 994 I$ 2 Y DOLLARS s KUILDING ELECTRICAL PLUMBING HOOFING Owner of Building Legal Lot Description Address of g Building (r' CONTRACTOR OR BUILDER MIAMI SHOES VILLAGE. FLORIDA DATF PERMIT N° 6553 Architect Contractor or Builder V' t- $C ' it" S ( Au ) Work to be performed under this Peru' it Signed: Value of Project $ BY Contractor's License No It AUTHORITY r 1952- 5 00/00 tr.. &Jett r+J t t Subdi- vision Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A furth condition upon wlicb this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough know dg of the or'din•ss =s aed regulations pertaining to the work covered hereby whether shown on the plans or drawings or fn the state ents or specifica s • that he assume nsibflily for work done by his agents, servants or employees. considerati• of the issuance to me of this permit I agree to perform the work covered here In compliance with all ordinances and regulations per i g thereto • f stri conformity, with the plans, drawings, statements or specifications submitt o the proper authorities of Miami Shores Village. In ac• ceptin • is perm spont'ib' for all work done by either, myself, my agent, servant or - mployee. KUILDING ELECTRICAL PLUMBING 110 . G 4r Owner of wilding n rchi teat _,ontractor 3r Builder MIAMI SHORES VILLAGE, FLORIDA DAT © PERMIT N° 6067 Contractor's License No. Work to he performed under this Permi egal Lot 1 ')escription +1 Bl. 4ddress of 4" 7r ,�7' wilding '/ ' This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device desoWet} ikt the c p15 tion ierefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance wi 'any plans awings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit mak be revoked at any .ime if the work is not done in compliance with such ordinances or 0 the plans are changed without authorization. A further condition upo>dr vargh this permit is ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordfltances and regulations ,ertaining to the work covered hereby whether shown on the plans or drawings r in a statements or cificat and that he assumes responsibility for work lone by his agents, servants or employees. Value of Project $ BY. AP 5. Subdi- vision w.,.. Amount of Permit $— �., 1 PEC In consideration of the issuance to me of this permit 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac. =epting this permit I ass e responsibility for all work done by either, myself, my / ervant or employee. ��,_, 1 , PalilleA 4l ' �,, r ..1' ,. .,... / -x•43 CONTRACTO OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time tigt# �_ Type In .' `i . ! _ � •_ -- Approved Correction Re- Insp'n Fee Permit No. NamtA .0 Address as C°InPa6.241j Phone # • • For Inspector/ C� o a 1 •Yl 4a c ame & D o iq--)1/41vA v KiIIAMI , SHORES VILLAGE, FLA. Na 6702 JOB -/ 05 tL o EIS ADDRESS Z 1 --- A/- L� 17 2'' 9' INSPECTION :/' / L 7 TIME READY 424 -1 - 5 - 3 v - 7 REMARKS. INSPECTOR 1l` r DATE 9 / MIAMI SHORES VILLAGE 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 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. 1 J Owner's Name and Address . _!J .... Street Street Registered Architect and /or Engineer .. ---- -__ - -- — _ - _------ _ - - -- Employing Plumber's Name X ` A S _- - - = v L D1C / — / S{fel .4 /2.2w. .. Location and Legal Description ..... Block Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Size Septic Tank Feet of Drain Tile_ Nature of Water Supply' City —Well of Soakage Pit -- - ---------------------------------- Amount of Permit $ STATE OF FLORIDA, } u. COUNTY OF DADE. Remodeling — - My Commission Expires PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ' ;kMIT ___._ Addition._____._.______ __.___ Repairs No. of Stories - Type of Tank._ Capacity Gals. Dist. Feet of Tank or Drain Field from Well ( Signed) _ (Signed)_ -- Date / L ' ( — J J I Subb vision . v, _ - — Street 711 Notary Public, State of Florida P1 b g Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations :.: employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Su .. ment, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be . erformed under this permit, as are licensed by Miami Shores Village. ( l Master Plumber. 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 hin-. stated are true. 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. CLOSETS BATH TUBE SHOWERS LAVA- TORIES SINK6 SLOP SINK[ LAUNDRY Tints URINALS URINALS CATCH FLOOR DRAIN DRINKING FOUNT' N6 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST -- CHECK / MIAMI SHORES VILLAGE 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 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. 1 J Owner's Name and Address . _!J .... Street Street Registered Architect and /or Engineer .. ---- -__ - -- — _ - _------ _ - - -- Employing Plumber's Name X ` A S _- - - = v L D1C / — / S{fel .4 /2.2w. .. Location and Legal Description ..... Block Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Size Septic Tank Feet of Drain Tile_ Nature of Water Supply' City —Well of Soakage Pit -- - ---------------------------------- Amount of Permit $ STATE OF FLORIDA, } u. COUNTY OF DADE. Remodeling — - My Commission Expires PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ' ;kMIT ___._ Addition._____._.______ __.___ Repairs No. of Stories - Type of Tank._ Capacity Gals. Dist. Feet of Tank or Drain Field from Well ( Signed) _ (Signed)_ -- Date / L ' ( — J J I Subb vision . v, _ - — Street 711 Notary Public, State of Florida P1 b g Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations :.: employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Su .. ment, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be . erformed under this permit, as are licensed by Miami Shores Village. ( l Master Plumber. 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 hin-. stated are true. 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. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING t" MIT P 0 � Permit No Date___.. /.Ll Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address.___ Registered Architect and /or En Employing Plumber's Name__. Location and Legal Description Lot_____ _____.____________________N_._. B1,ock -- --_ Subdivision --- ------- --- ---_---- -- --_.__ Street and Number where work is to be performed —No S 1 9 State work to be performed and purpose of building (By Floors ) __ New Building ----- -•- -•- •__ -_ -- Remodeling —_- -- __ Addition- -- -. Size Septic Tank -_- Feet of Drain Tile_______- Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. Street. Street Repairs No. of Stories . e of Tank__ Capacity Gals et of Tank or Drain Field from Well .Size of Soakage Pit (Signed) 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 com- plied 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 sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed)- ? Master Plumber. Plumbing Inspector. 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP' SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN ORINKI NG FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DELP WELL SPRKLR. SYSTEM SW I POOL CONTR. LIST CHECK _I f/ (/ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING t" MIT P 0 � Permit No Date___.. /.Ll Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address.___ Registered Architect and /or En Employing Plumber's Name__. Location and Legal Description Lot_____ _____.____________________N_._. B1,ock -- --_ Subdivision --- ------- --- ---_---- -- --_.__ Street and Number where work is to be performed —No S 1 9 State work to be performed and purpose of building (By Floors ) __ New Building ----- -•- -•- •__ -_ -- Remodeling —_- -- __ Addition- -- -. Size Septic Tank -_- Feet of Drain Tile_______- Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. Street. Street Repairs No. of Stories . e of Tank__ Capacity Gals et of Tank or Drain Field from Well .Size of Soakage Pit (Signed) 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 com- plied 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 sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed)- ? Master Plumber. Plumbing Inspector. 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Date Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Address c= "�C- 162 Q 6 Company vV 0 Phone # (,3a5 CQ ' b, = p � D For Inspector: O Approved C9 Correction Re- Insp'n Fee Time o MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date_ ( �Time Type Insp' n i J 6 ) -- e-d ) / L k--^ Permit No./ ' `�2 (6 0 ' 1 . Name c--ki Ca_CL Address .G i\). qc 3 -L, Company , ,C3 0 Phone # ( 5 ' CPO - 85 0 For Inspector: t1 ) t Approved Correction Re- Insp'n Fee ❑ Permit No a Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. /lr 1 14, -` Co 1 /v.Y Owner's Name and Address Amount of Permit $ 2 7 9 • STATE OF FLORIDA, u. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN'' APPLICATION FOR PLUMBING '" ar�illIT No — ° - eSl (Signed) _ (Signed)._ Date Street Registered Architect and /or En ' eer _.____-- _—______..______— ___. -- Employing Pietlebdr's Name ffile" clwi S /Jr/a/lic,i ( 8D! - - — — — - -- _ No. — - ..__ — — Street. Location and Legal Description Lot_--_---_..... _--- _---_ —.__. _____ Block_- _ ._- - ---_ Subdivision. Street and Number where work is to be performed— No._!?_.1 N 4 -- - Street_ -. S t. 9 State work to be performed and purpose of building (By Floors) _ y r is l ale. Sy s7w DA/ e x t s f'Av t.04 1 ' W G 1. New 1g _ -- Remodeling Addition------ ._._------- - --- -- Repairs No. of Stories ................ - _ -.... Size Septic Tank _ Type of Tank Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well & S r� 4'!1 C `L_.-._Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oGligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida Mestee ber. 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. 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. CLOSET* BATH TUBS S LAVA- TORIES SIS SINKS SLOP SINKS LAUNDRY Tuna U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•O P001. CONTR. LIST CHECK Permit No a Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. /lr 1 14, -` Co 1 /v.Y Owner's Name and Address Amount of Permit $ 2 7 9 • STATE OF FLORIDA, u. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN'' APPLICATION FOR PLUMBING '" ar�illIT No — ° - eSl (Signed) _ (Signed)._ Date Street Registered Architect and /or En ' eer _.____-- _—______..______— ___. -- Employing Pietlebdr's Name ffile" clwi S /Jr/a/lic,i ( 8D! - - — — — - -- _ No. — - ..__ — — Street. Location and Legal Description Lot_--_---_..... _--- _---_ —.__. _____ Block_- _ ._- - ---_ Subdivision. Street and Number where work is to be performed— No._!?_.1 N 4 -- - Street_ -. S t. 9 State work to be performed and purpose of building (By Floors) _ y r is l ale. Sy s7w DA/ e x t s f'Av t.04 1 ' W G 1. New 1g _ -- Remodeling Addition------ ._._------- - --- -- Repairs No. of Stories ................ - _ -.... Size Septic Tank _ Type of Tank Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well & S r� 4'!1 C `L_.-._Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oGligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida Mestee ber. 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. 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. • BIDING 0 ELECTRICAL sY? C.) Owner Owner of Building Architect Contractor or Builder Legcl Lot Description Address of Building This permit is granted to herefor in strict comp iatiee W, drawings, statements or sp time if the work is not done grimed is the understai pertaining to the work done by Ws agents, s In consideration of the issuance to me ertaining thereto and in stria eonforiaity accepting tills permit I assume responsi , S 4 tt trod Yr CONTRACTOR Cif BUILDER BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SH ®RES VILLAGE. FLORIDA PERMIT ? 6076 ❑ Work to be performed under this Permit P r VC/ a fr•tt .0* fr r.„..,ie dive-soul Architect "'fir Contractor or Builder 544 C. 4,./ 4, ti Description 11 $ Subdi- Legal Lot 1 vision Owner of Building x. r S TO +d t Address of Building 7.4" 59 14 V This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application ' herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications. that may have been submitted to and approved by the proper municipal authorities. This permit may be revoked at any time it the work is not done in compliance with such ordinances or if the plans are changed without authorization, A f condition upon which this peanit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough kn•.r edge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in m - statements or sp= ;:fications d ih*t he assumes responsibility for wort . done by his agents, servants or employees. CONTRACTOR OR BUILDER Signed. to DATF Contractor's License No Value of 11 Amount of Project $ Permit $ AUTHORITY -- - 1952 INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work -red 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 ac cepting this permit I assume responsibility for all work done by either, mysel agent, servant or employee, BUILDING ELECTRICAL PLUMBING ROOFJNG •' S Owner of Building k" r Contractor or Builder �H Legal Lot Description — Address of Building MIAMI SHORES VILLAGE. FLORIDA DATP ft t ? 6418 contractor's License No. " " ❑ PERMIT Architect 7r Ai C`, CONTRACTOR OR BUILDER (it irrrp. • u Bl a P Work to be performed under s Pemdt / ' FIV 40 C This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device desortt� herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the worts will be performed in drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities This P time it the work is not done in compliance with such ordinances or if the plans are changed without authorization. A f aonditi granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the pertaining to the work covered hereby whether shown on the plans or drawings or in the statements o ;r ci c,lions and tlra ;` a assn done by his agents, servants or employees. INSPEc In consideration of the issua ge to me of this permit I agree to perform the work cov pertaining thereto and in strict co r xi'ty with the plans, drawings, statements or s ecificatfo cepting this permit I assume re spp: y..#litp for all work done by either, myself, mr aggrit, se # 14 e BY 24 ;a+6� �"t ie4I lI4 f49re'y ar Value of Project Subdi- vision 0). 7 9- Amount of j ( Permit $ rip., AUTHORITY application any pans revoked at any is permit is d regulations iv for work oomplignce with all ordinances and regulations proper authorities of Miami Shores Village. In ac. MIAMI ,SHORES VILLAGE, FLA. JOB ADDRESS /,45:1 r i14 N9 6683 INSPECTION 4 /. 1 � TIME READ i9V REMARKS INSPECTOR DATE Permit No (" µ' Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEh ; APPLICATION FOR PLUMBING "°` w�MIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Occupant No.__ 25 Registered Architect and /or Engineer Employing Plumber's Name Dade Gas CorP_t _ ____ No.. 59 Location and Legal Description Lot__, — _. -.. Street and Number where work is to be performed —No 25 State work to be performed and purpose of building (By Floors) New Building Remodeling - Addition (Signed)____ -- ( Signed)._ Date 11 -26 -57 Street N.E. 99 St. Street. N! W • 7 Ave. Subdivision Street N.E. 99 St. Repairs No. of Stories Size Septic Tank - -__ -_Type of Tank Feet of Drain Tile_— _____ ................. ___________Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well ._____ _ _— _ ___._Size of Soakage Pit Capacity Gals The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli Lions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perm ent Supplement, and has com- plied 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 sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Dade Gas Corp. My Commission Expires Notary Public, State of Florida Plumbing Inspector. Master Plumber. 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 swom, 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. 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. CLOSETS TUBS BATH TUBS SHOWERS LAVA. TORIES SI SLOP SINK! LAUNDRY Tuff URINAL! CATCH BASIN FLOOR DRAIN DRINKING DRINK FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK -_ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•G POOL Range -, 3p . Hr T .� H , WH CONTR. LIST -- CHECK Permit No (" µ' Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEh ; APPLICATION FOR PLUMBING "°` w�MIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Occupant No.__ 25 Registered Architect and /or Engineer Employing Plumber's Name Dade Gas CorP_t _ ____ No.. 59 Location and Legal Description Lot__, — _. -.. Street and Number where work is to be performed —No 25 State work to be performed and purpose of building (By Floors) New Building Remodeling - Addition (Signed)____ -- ( Signed)._ Date 11 -26 -57 Street N.E. 99 St. Street. N! W • 7 Ave. Subdivision Street N.E. 99 St. Repairs No. of Stories Size Septic Tank - -__ -_Type of Tank Feet of Drain Tile_— _____ ................. ___________Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well ._____ _ _— _ ___._Size of Soakage Pit Capacity Gals The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli Lions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perm ent Supplement, and has com- plied 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 sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Dade Gas Corp. My Commission Expires Notary Public, State of Florida Plumbing Inspector. Master Plumber. 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 swom, 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. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No 6 o7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING Ni,iMIT I _ 1-4) Amount of Permit $ (Signed)_ 4e) Date — ?— Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address..&K z31_1/64,A_ No. Street Registered Architect and/or Engineer ...._ _ Employing Plumber's Name \7,i; Ale5 Pi.--43 4- No._. ...— 11 tT at/ _ Location and Legal Description Lot i Block ubdivision -- * Street and Number where work is to be performed—No g ‘ 4 1 f streeF State work to be performea and purpose of building (By Floors) New Building 1.--- Remodeling Addition_ No. of Stories ---- / Size Septic Tank Type of Tank_ Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply WeZ _Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hi.. gations as an employer of labor under the Florida Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. / 3 Muter Plumber. 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. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made • necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH TUBS SHOWER. LAVA. Tome , SINKS SLOP SINKS LAUNDRY Tuss URINALS CATCH BASIN FLOOR DRAIN DRINK I NG FOUNT' NS TOTAL F I XTURES CONTR. LIST 6 %. ...-- CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE FIT GREASE TRAP .114W HEATER DEEP WELL ...■ SPRKLR. SYSTEM SW I W G POOL Coterie. LIST _Li_ CHECK Permit No 6 o7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING Ni,iMIT I _ 1-4) Amount of Permit $ (Signed)_ 4e) Date — ?— Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address..&K z31_1/64,A_ No. Street Registered Architect and/or Engineer ...._ _ Employing Plumber's Name \7,i; Ale5 Pi.--43 4- No._. ...— 11 tT at/ _ Location and Legal Description Lot i Block ubdivision -- * Street and Number where work is to be performed—No g ‘ 4 1 f streeF State work to be performea and purpose of building (By Floors) New Building 1.--- Remodeling Addition_ No. of Stories ---- / Size Septic Tank Type of Tank_ Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply WeZ _Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hi.. gations as an employer of labor under the Florida Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. / 3 Muter Plumber. 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. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made • necessary by improper notice for inspection, or faulty materials and/or workmanship. Q