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910 NE 99 St (3)'Inspection Number: INSP -19794 Inspection Date: 06114/2006 Inspector: Perez, JanPierre Owner: LASCH, DOREEN Job Address: 910 99 Street NE Project: <NONE> Monday, June 12, 2006 Miami Shores Village, FL 33138- Contractor: PALM AIR INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 ax: (305)756 -8972 IU r 1 4 kin Block: Permit Number: MC -4-06 -1066 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New Phone Number (305)754 -1861 Parcel Number 1132060143410 Lot: Phone: 305 - 758 -7545 Page 2 of 2 Passed ICom (Q ents c4t C' f 0 (� Failed Correction Needed Re- Inspection • Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until 'Inspection Number: INSP -19794 Inspection Date: 06114/2006 Inspector: Perez, JanPierre Owner: LASCH, DOREEN Job Address: 910 99 Street NE Project: <NONE> Monday, June 12, 2006 Miami Shores Village, FL 33138- Contractor: PALM AIR INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 ax: (305)756 -8972 IU r 1 4 kin Block: Permit Number: MC -4-06 -1066 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New Phone Number (305)754 -1861 Parcel Number 1132060143410 Lot: Phone: 305 - 758 -7545 Page 2 of 2 'Inspection Number: INSP -15831 JUN 1 2 ' I Permit Number: MC -4-06 -1066 Inspection Date: 06/07/2006 Inspector: Perez, JanPierre Owner: Job Address: 910 99 Street NE Project: <NONE> Contractor: PALM AIR INC Building Department Comments Tuesday, June 6, 2006 LASCH, DOREEN Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New Phone Number (305)754 -1861 Parcel Number 1132060143410 Lot: Phone: 305 - 758 -7545 Page 2 of 2 Passed Inspector Comments 7 ?/&6 -1 /1.0 Oc, A-P vt, Failed Ea Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until 'Inspection Number: INSP -15831 JUN 1 2 ' I Permit Number: MC -4-06 -1066 Inspection Date: 06/07/2006 Inspector: Perez, JanPierre Owner: Job Address: 910 99 Street NE Project: <NONE> Contractor: PALM AIR INC Building Department Comments Tuesday, June 6, 2006 LASCH, DOREEN Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New Phone Number (305)754 -1861 Parcel Number 1132060143410 Lot: Phone: 305 - 758 -7545 Page 2 of 2 Permit Type (circle): Building Cit ,r7/ m / S6/ -e State fC- Tenant/Lessee Name Job Address (where the work is being done) Total Fee Now Due $ (Continued on opposite side) 11//4 1 3c3 Miami Shores Village Building Department • 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING macmcvmer Permit No.N I C U L t Cb PERMIT APPLICATIOW 1l(Th J1 Master Permit No. FBC 2001 Owner's Name (Fee Simple Titleholder) 'TO i?E. C4 ,�/ Owner's Address 1/ 0 A46- '$7E-7 B rical Plumbing Mechanics_, Roofing City Miami Shores Village County Miami -Dade Zip 33 / 33 Is Building Historically Designated YES NO Contractor's Company Name '44-- ► I ,q (4 /A/C, Phone # 36 J ' S 7s S Contractor's Address 6 C17 Q ,1/ "' j5 ✓ 1.412 S - 6 City /� -/� /19/1( L State � Zip -FA lZ Qualifier .-- e66 rie ' /a rh/ State Certificate or Registration No. C/ CO 36 t g3 Certificate of Competency No. Architect /Engineer's Name (if applicable) Phone # $ Value of Work For this Permit O Square Footage Of Work: Type of Work: ['Addition ['Alteration New ' Repair /Replace ❑ Demolition 'A Describe Work: '( E1 0 ct/l;6Y o2 i'2,:7 co 2 6.' -_ 49' 0 6/24-14 ilJP(•, . Phone # 365' '7 4- /8 Zip 3 � J3 Phone # * * * * * * * * * * * * * * * * ** * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ CCF $ CD • CO /CC Notary $ - OD Training /Education Fee $ CD• ' Technology Fee $ 1 C.D. Scanning $ ��j� ( )—' Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) 41// Mortgage Lender's Address City State Zip t Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. 1 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature chc 05/13/03 The foregoing instrument w s acknowledged before me this 2.C=. The foregoing instrument was acknowledged before me this Z. day of-APIL -20 2 L S(-4 dayof 2 L ,20cb 32'1 I who is personally known to me or who has produced who is personally known to me or who has produced NOTARJ' P C: Sign: Print: My Commission Expires: Owner or Agent APPLICATION APPROVED BY: As identification and who did take an oath. I' •mdec :�:. -:` <� . : - ding Co., Inc. NOTARY PUB TAPE Olt pLORIDA OTARY PUB ernandez D476455 D as identificati d who did tah. f'; Y PUBLI -S'IAi ke L dan p oat �t1_1. ` Yorle nY dez .r ;;. ,i} a ; 1'•• : 7 2•1a Sign: Print: My Comte sion Expires` * ****.**_ ******************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ***,*** * * * * ***** * ******* * **************** * ******** * * 1 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL ITEM BATH T1.8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING 1/< DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) 216 VA/ DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/ ETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTCR RANGE TOP UNDERGROUND TANKS OVEN ABOVE GROUND TANKS LAVATORY LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTCRS OVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTCRS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 If VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER 7 FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER-REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL - SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS GRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL • Issue Date: 4/27/2006 Owner's Name: DOREEN LASCH Permit Type: Mechanical - Residential Work Classification: New Job Address: 910 99 Street NE Comments: REPLACING 2 1/2 TON CONCENDER AND AIR HANDLER Additional Information Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 10/23/2006 Contractor(s) PALM AIR INC Phone 305 - 758 -7545 Primary Contractor Yes Tons: 2 1/2 Classification: Residential Additional Info: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $2.40 $0.80 $5.00 $124.08 $3.00 $3.10 $138.38 Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: MC -4 -06 -1066 Phone: (305)754 -1861 1132060143410 Lot: PB: Total Square Feet: 0 Total Valuation: $ 3,545.00 Required Inspections Rough Rough Duct Ventilation Smoke Test Hood Smoke Det Test Final Invoice Number MC - 4 - 06 - 24627 Total: APR c -*-f 41-2- Amt Due $138.38 Amt Paid $138.38 $138.38 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby uinde for the approval of the detailed statc,iuent w the plans and specifications herewith submitted for the build • inc 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..._..._..•...._......._ L _... _..._.... ,19..5f._ D4 0 � 1 1.(C U .Sr e 5 l.._ . t,,e7!.ti .1.. 5.t.. Y Owner's Name and Address ........... ..._... .....:. ._ No... a. Stree .... Registered Architect and /or Engineer .,.•••,,.••.,...h.,».•. Name and address of licensed contractor... :ell.§•_ L✓• -• 0 :..4.vg Location and Legal description of lot to be built on: Lot Block Subdivision Q .- Street and Number where work is to be done /1° .G.x 1••• - - - _ - — - . � 11 _ State war to be done and pure a of �uildin (by Dora)..... ...s. .._..�6.. . ..1.. ••— .•_. -•--• and for no other purpose. Repairs No. of Stories Roof Covering New Bui!ding Remodeling L- Addition To be constructed of Kind of foundation _ Estimate Total cost of improvements $ i 1 " • `) Amount of Permit $.. Zone cubage required .Plan Cubage Distance .to next nearest building Size of Building Lot Mfaxiunum 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 F lorida Workmen Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied Stith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, o work to be performed under this pcnnit, as are licensed by Miami Shores Village. �'�_ • Remuks __._..__ (Signed) �L Disapproved Date (Signed) Building Inspector Citainnan Member 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. 2/i- 0 ( O Date � 2 • U 0 Read, Swom to and Subscribed before me. Notary Public, State of Florida My Commiuion Expires mho ...._..._.._.•■■.. -. PLANNING BOARD DATE 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 nfter approval has been obtained from the 1'Linnir.g llo.rrd. A re-inspection fee of 31.00 will be charged when such re- inspection is made necessary by Improper notice for inspection at faulty materials and/or workmanship. Permit No I 3 APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiurida, 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 C°4 Registered Architect and /or Engineer Employing Electrician's Name 47C, Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street. ..A , 7 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Site Feeders Conduit Underground Type of Installation— Conduit Tubing B4' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Amount of Permit $ (Signed) The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to licensed by Miami Shores Village. STATE OF FLORIDA, t COUNTY OP DADE. f Before me, the undersigned authority, a notary public, duly authorized to administer oaths and appeared ........ (Signed). Date... ' 7( - ) No P Street. No.. (/ + Street, `"s' ' 4 to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the therein by him stated are true. Main Sw Amps Main Fuses . Amps B.X.L Metal Moulding Elect • /1 Inspector. ccepts his obligatio; as an employer of of Florida Perm nent Supplement, and sub-contractors employed by him in the of the work such public notice or notices be performed under this permit, as are Notary Public, State of Florida Mass' Electrician. take acknowledgments, personally same, and that all facto My Commission Expires NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUO RECE•P'T'8 FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. SERVICE SERVICE CAB. TEMP. PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON RADIO TOTAL CONTR. LIST ` �:L / / - °F /'# ^ - f'��I a ip.tr /� . '�'�'Y` - • L.�r�- y- '1 / A° !/ — �„� ,�ToRANS. l �/' `%? , CHECK Permit No I 3 APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiurida, 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 C°4 Registered Architect and /or Engineer Employing Electrician's Name 47C, Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street. ..A , 7 State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Site Feeders Conduit Underground Type of Installation— Conduit Tubing B4' MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Amount of Permit $ (Signed) The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to licensed by Miami Shores Village. STATE OF FLORIDA, t COUNTY OP DADE. f Before me, the undersigned authority, a notary public, duly authorized to administer oaths and appeared ........ (Signed). Date... ' 7( - ) No P Street. No.. (/ + Street, `"s' ' 4 to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the therein by him stated are true. Main Sw Amps Main Fuses . Amps B.X.L Metal Moulding Elect • /1 Inspector. ccepts his obligatio; as an employer of of Florida Perm nent Supplement, and sub-contractors employed by him in the of the work such public notice or notices be performed under this permit, as are Notary Public, State of Florida Mass' Electrician. take acknowledgments, personally same, and that all facto My Commission Expires 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 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 berrio described. This application is made in compliance and contormity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws cf the Statt: of Florida. all ordinances of Miami Shores Village and all rules and regulations of the Building Divi:aun of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kepi at building during progress of the work. Owner's Name and Address Registered Architect and/or Engineer Name and address of licensed contractor . Location and legal description of lot to be built on: Lot. Block Subdivision Street and Number where work is to be done_ • . ct PLANNING BOARD DATE Chairman Member Member .... Member Member _ Member Council Approved .Date Disapproved .. Date 7- 1- 54 , 19 e , No Street. State work to be done d 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 2ring_ Estimated 7 ,tal 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 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 uncle signed applicant for this building permit does hereby certify ihat he understands and accepts his obligations as an employer of 1:19or under he Florida Workmen's Compensation A b Section 5966, Compiled Gent ral Laws of Florida, Permanent Supplement. and h s compled with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by hini in the wo k to be p rf .-med un this permit: and will post or cause to be posted for inspection on the site of the work such public notice or .otiies as are requir-d by the Act. The tuldt rsigned agrees to employ only such subcontretors, on work to be perform. d tinder this permit as are licensed by Miami Shores Village. Remarks.. (Signed) STATE OF FLORIDA, COUNTY OF DADE. Ss ' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally op- peared _ .to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ of th abov. de, mstruction, 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_ Notary Public, State of Florida (Signed) Building Inspector My Com:nission Expires_ ........... ••• - • ■ •-• •-• 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 rni:.le necessary by improper notice for inspecticm or fality materials and/or workmanship. i fi �. 990 A/E - wow al4r.tRt t THERMO COOL INC. 1222 NORMANDY DRIVE PHONE 86 -0547 MIAMI BEACH 41, FLA,