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1150 NE 100 St (6)BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date - 2 \ - ` ©3 Time _ / Permit No. 4 03- 9 Name !J C Address 11 50 /Ve MO sr Type Insp'n MIAMI SHORES VILLAG Company ��LL Phone # , 5'6 1 756 wie T For Inspector: 7 q \ 0 3 Name & Date Approved )‘ Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BZJILDING DEPARTMENT 305- 795 -2204 Building Inspection Request il Date 7 f$o Time Type Insp'n No. /5,0 ® 3 ``907 Name Address 1/ <0 /friZ— 1 btu SC/ Company _e, 4 22r L Phone # For Inspector: ""Nto j Name & Date Approved Correction Re- Insp'n Fee ❑ Date • PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305-795-2204 • Fax: 305- 756 -8972 (J S I n) Job Address 1') 6 -5--)j '� i 1O - S lTh Tax Folio ✓ 1.0 5 — N O'f 20 V mmll Legal Description Owner /Lessee/Tenet N� t£ Owner's Address I t CO N•6' (O o—i t+ Sr. Contracting Co. C Q -5' L O 1%) S1 V\ .) LT 4 ti/ I . I N G Qualifier B A ✓t' ' L- Lt) e- 051 tJ State# CCr C.org Historically Designated: Yes Master Permit # Phone l.3 oS) l� Address 9 '‘ ) CD %- SS# , Phone) b Municipal # Competency # Ins. Co IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: 40 O 1 A 9 t i - t r ruck/s A--1 /NST - -a (LC PR-V6vt, Drt,i %.11.5 p1/4. Square Ft. Estimated Cost (value) it 3 0 0 • 7 WARNING T() 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 ANY 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 jurisdiction. I understand that separate permits are required for all disciplines. 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. Furthermore, I authorize the above named contractor to do the work stated. Signature of owner and/or Condo President r3, Notary as to Owner and/or Condo President My Commission Expires / D / o3 FEES: PERMIT 1 0 3 bo, ov APPROVED: Zoning J fiu//53 - J Date Date Barney owenstein P U B : Commis #DD155135 =* . :Q= Expires: Oct 03, 2006 RADON: ..�;e' Bonde11t F . Bonding Co., Inc. ( P' 5 (r 3 Building No 20 or it21 nature Co tractor or Owne^ 1 .1 1 6e� ^y .k`gA Rate o L. _ all �.. Si ary as to ontracto My Commission Expires 0,3 ei N. Angela M Becker NOTA� Commission D0150048 (r vemper t WID () , TOTAL DUE 3 L �. Owner Builder 6 Date Electrical Mechanical Plumbing Structural Engineer • • Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/6/2003 Applicant: GENE ENG Owner: ENG GENE JOB ADDRESS: 1151 NE 100 ST Contractor C.B.J. CONSTRUCTION, INC. Contractor's Address: Local Phone: Parcel # 1132050190331 Permit Status: APPROVED Permit Expiration: 12/2/2003 Construction Value: $3,800.00 Work: REMOVE ASPHALT DRIVEWAY AND INSTALL BRICK PAVER DRIVEWAY Signe Fees: Description Amount FEE2003 -3383 Building Fee $70.00 FEE2003 -3384 Builders Bond $300.00 FEE2003 -3385 CCF $2.40 FEE2003 -3386 Notary Fee $5.00 Total Fees: $377.40 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 responisibility for all work done by either myself, my agent, servants or employes. NSPECTOR) Building Permit Permit Number: BP2003 -907 Legal Description: MIAMI SHORES SEC 8 REV PB 43 -67 LOT 11 Page 1 of 1 Total Fees: $377.40 Total Receipts: $0.00 BLK 177 LOT SIZE 75.000 X REG C01 060903 1026 MCC 007579 CHECK $377.40 (Contractor or Builder) BY: W,rW� -. :,y�., d, w.,�,,:- ,aa�a— �;w�r�.® Sec u r i t e n h a n c e d d o c u m e n t . S e e h a c k or d e t a i l s. a ».;a GENKEV CORPORATION 9420 PARK DR. MIAMI SHORES, FL 33138 PAY TO THE ORDER OF I B 11 A L 1' A II JJ>4d e� FOR 70) DATE 11 23 5 Le : 2 6 7 0 9 0 4 5 5 1 : 1 00 2000 264 5 6e . amt.(1/v 2351 5 e) 63-9045/2670 1$ 7') DOLLARS O s ^ ° . .. 0 al Wei Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: BP2003 -907 Printed: 6/6/2003 Applicant: GENE Owner: ENG JOB ADDRESS: 1156 NE 100 Contractor C.B.J. CONSTF" Local Phone: Parcel # 1132050190331 Fees: FEE2003 -3383 FEE2003 -3384 FEE2003 -3385 FEE2003 -3386 Permit Status: APPROVED 1 Work: REMOVE ASPHALT 3 Signed: Signed: In consideration of the issuance to: ,conformity with the plans, drawings, : Y done by either myself, my agent, set\ PAY ENG ■ GENE ST • --i J_..* J1 — GENKEV CORPORATION 9420 PARK DR. MIAMI SHORES, FL 33138 TO THE ORDER OF 4 Building Permit FOR PAY TO THE ORDER OF WIB11ALTAR n A 1V a{ /5/5 Moe . f .Donnas Wrons/ /u, Sihne s 5.1/11 NO3-3 > - ,.. -.. ..- ...,...�,.. ..dm S ecurity enhanced document See back for details. ®l - GENKEV CORPORATION 9420 PARK DR. SHORES, FL 33138 WIRRALTAR NomozociENIEN 4515 ✓ras 4.rrcro .haft re �,,y gym/ L.,, .9/se1o JJi6 � g FOR ` e - ��O f/03 - to7 / "00 235 LH' 1:2670904551: ® S e c u r i t y e n h a n c e d document. See back for details. B Page 1 of 1 DATE sa te s azaa'4>to DATE 00 2000 264 So' 3 ,2 2 63- 9045/267 $ 3 ez) .q DOLLARS 2351 .O GL 63- 9045/2670 J 02 $ 7 14.-/ v DOLLARS ..9gaztilztp 2352 a a 0.NY to Nil. tooliso A/C CONC CBS COL BT CB 0 FIP 1/2 1 o NO ID 3.50' LEGEND 0 0 if; b ON PL ON PL FIP 1/2 " a. NO ID z o LOT 6 BLOCK 178 0 0 0 AIR CONDITIONER CONCRETE CONCRETE BLOCK STRUCTURE COLUMN BUILDING TIE CATCH BASIN CENTER UNE TREE 0 rn 0 9.90' - TREE- LOCATION MAP NOT TO SCALE LOT 7 BLOCK 178 VI9.12'(R &M 9.00 4.50' ELEC ELECTRICAL TEL TELEPHONE FIP FOUND IRON PIPE LB UCENSED BUSINESS FDH FOUND DRILL HOLE PL PROPERTY UNE FH FIRE HYDRANT OHL OVERHEAD UNE SS SANITARY SEWER 28 65' .h BT g 1 FIP 1/2" NO ID LOT 5 BLOCK 178 PSM UE FPL M R &M R/W WP WM FND ASPHALT DRIVEWAY 25.00' BT O O i 3 c 50.00 .SPH 50. 20' 10' 0' GRAPHIC SCALE SCALE: 1"=20' PROFESSIONAL SURVEYOR & MAPPER UTIUTY EASEMENT FLORIDA POWER & UGHT MEASURED RECORD AND MEASURED RIGHT OF WAY WOOD POLE WATER METER FOUND R RADIUS A ARC D DELTA T TANGENT -ir- WOOD FEN -x- CHAIN UNI CE -0- IRON FENC 1 P4 / 2 ELEVATION V ALT 12.00' \ - ao w c > c o O O . CL LU W Ce '- CA J a a F— Q: O o 1 0 0 Z SURVEYOR'S NOTES: PSM & ASSOCIATES, P.A. PROFESSIONAL SURVEYOR AND MAPPER & DEVELOPMENT CONSULTANT 311 NW 136TH AVENUE, MIAMI. FLORIDA 33182 Telefax: 305 - 226 - 4337 Cellular. 305 - 979 - 6087 E - moll: diosolgstis.net BOUNDARY SURVEY PROPERTY ADDRESS: 1155 NE 10077 STREET, MIAMI SHORES FLORIDA 33138 -2602 LEGAL DESCRIPTION: LOT 6, BLOCK 178 , OF REVISED PLAT OF TRACTS 175A, 1758, 175C, 176A, 176B, 176C, 777A, 177B, 178A, OF THE REVISED PLA T OF MIAMI SHORES SECTION 8, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 43, PAGE 67 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA FOLIO No. 11- 3205- 019 - 0420 FLOOD INFORMATION: COMMUNITY / 120652, PANEL: 0093, SUFFIX "J ", FLOOD ZONE. "AE ", DATED MARCH 02, 1994 REVISED: JULY 17, 1995. THE ABOVE CAPTIONED PROPERTY WAS SURVEYED AND DESCRIBED BASED ON THE ABOVE LEGAL DESCRIPTION PROVIDED BY THE CLIENT. 2. - THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. EXAMINATION OF ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERM /NE RECORQED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. 3.- OWNERSHIP SUBJECT TO OPINION OF TITLE. 4.- ACCURACY: THE MINIMUM RELATIVE DISTANCE ACCURACY FOR THIS TYPE OF BOUNDARY SURVEY IS 1 FOOT IN 7,500 FEET. THE ACCURACY OBTAINED BY MEASUREMENT AND CALCULATION OF A CLOSED GEOMETRIC FIGURE WAS FOUND TO EXCEED THIS REQUIREMENT. 5.- THIS PLAN OF SURVEY DOES REFLECT ALL EASEMENTS AND RIGHTS OF WAY AS SHOWN ON REFERENCED PLAT. 6.- FOUNDATIONS AND /OR FOOTINGS THAT MAY CROSS BEYOND THE BOUNDARY LINES OF THE PARCEL HEREIN DESCRIBED ARE NOT SHOWN HEREON. 7.- THERE ARE NO ABOVE GROUND ENCROACHMENTS UNLESS SHOWN HEREON. 8. - THE SURVEYOR DOES NOT DETERMINE FENCE AND /OR WALL OWNERSHIP. 9.- TYPE OF SURVEY. BOUNDARY SURVEY. 10. - NORTH ARROW DIRECTION AND BEARINGS SHOWN HEREON ARE BASED ON RECORDED PLAT BOOK 43 AT PAGE 67 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA. 11. - THIS SURVEY IS NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF FLORIDA LICENSED SURVEYOR AND MAPPER. ADDI TIONS AND DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT THE WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES. 12.- ELEVATIONS WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM. 13. - BENCH MARK USED: N/A 14.- THIS SURVEY MEETS ALL APPLICABLES REOUIREMENTES OF THE FLORIDA MINIMUM TECHNICAL STANDARDS AS CONTAINED IN CHAPTER 61G17 -6 FAC. 15.- THIS SURVEY WAS PREPARED FOR MORTGAGE PURPOSES ONLY. 16.- THIS SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY. 17.- THIS PLAN OF SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF ENTITIES NAMED HEREON. 11-IE CER TIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY. DR. GENE ENG. 1. - FIELD DATE: 05 -19 -03 FIELD BOOK: FILE JOB NO: PS -309 REVISED: REVISED: 1 PILAR SOLER, PSM STATE OF FLORIDA No. 6310 LB # 7149 DATE: j- t;)/`6;% a a FIP 1/2 " o NO ID 3.50' Q z D_ w w a 1- J a 2 J J a ' ON PL ON PL FIP 1/2" I a NO ID z LOT 6 BLOCK 178 0 0 0 N LEGEND A/C AIR CONDITIONER CONC CONCRETE CBS CONCRETE BLOCK STRUCTURE COL COLUMN BT BUILDING TIE CB CATCH BASIN CENTER LINE 11.60' - 0 w 0 0 ai ELEC TEL FIP LB FDH PL FH OHL SS 0 rn 9.90' �TREE� -0— -o 0 / 0 TREE_- LOCATION MAP NOT TO SCALE LOT 7 BLOCK 178 119.12' R &M ELECTRICAL TELEPHONE FOUND IRON PIPE LICENSED BUSINESS FOUND DRILL HOLE PROPERTY LINE FIRE HYDRANT OVERHEAD LINE SANITARY SEWER CONC STAIR A/C n � .. L 4.50' LOT 5 BLOCK 178 42.80' An 0 / m In / W Cr) p ON LLJ 119.12' (R &M) PSM UE FPL M R &M R/W WP WM FND - J EL z 0 3.75' 0 N/ /42.00 1 o f A/C n co I CONC /GENERATOR 8.0' I II 20' 28.65' BT 0 25.00' BT ASPHALT. DRIVEWAY. .I 9000? 3S (M FIP 1/2" NO ID 10' 0' GRAPHIC SCALE SCALE: 1"=20' PROFESSIONAL SURVEYOR & MAPPER UTILITY EASEMENT FLORIDA POWER & UGHT MEASURED RECORD AND MEASURED RIGHT OF WAY WOOD POLE WATER METER FOUND ASPHALT 20' R RADIUS A ARC 0 DELTA T TANGENT - , -. WOOD FENCE - x- CHAIN UNK FENCE - O - IRON FENCE / Of ELEVATION W UU OIC a w a nc f- O Q r 0 UU 0 Z PSM & ASSOCIATES, P.A. PROFESSIONAL SURVEYOR AND MAPPER & DEVELOPMENT CONSULTANT 311 NW 136TH AVENUE, MIAMI, FLORIDA 33182 Telefax: 305- 226 -4337 Cellular: 305- 979 -6087 E -mail: diasol@stis.net BOUNDARY SURVEY PROPERTY ADDRESS: 1155 NE 100TH STREET, MIAMI SHORES FLORIDA 33138 -2602 LEGAL DESCRIPTION: LOT 6, BLOCK 178 , OF REVISED PLAT OF TRACTS 175A, 175B, 175C, 176A, 176B, 176C, 177A, 177B, 178A, OF THE REVISED PLAT OF MIAMI SHORES SECTION 8, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 43, PAGE 67 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA FOLIO No. 11- 3205 - 019 -0420 FLOOD INFORMATION: COMMUNITY # 120652, PANEL: 0093, SUFFIX "J ", FLOOD ZONE: "AE'; DATED MARCH 02, 1994 REVISED: JULY 17, 1995. SURVEYOR'S NOTES: 1. - THE ABOVE CAPTIONED PROPERTY WAS SURVEYED AND DESCRIBED BASED ON THE ABOVE LEGAL DESCRIPTION PROVIDED BY THE CLIENT. 2.- THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. EXAMINATION OF ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. 3.- OWNERSHIP SUBJECT TO OPINION OF TITLE. 4. - ACCURACY. THE MINIMUM RELATIVE DISTANCE ACCURACY FOR THIS TYPE OF BOUNDARY SURVEY IS 1 FOOT IN 7,500 FEET. THE ACCURACY OBTAINED BY MEASUREMENT AND CALCULATION OF A CLOSED GEOMETRIC FIGURE WAS FOUND TO EXCEED THIS REQUIREMENT. 5.- THIS PLAN OF SURVEY DOES REFLECT ALL EASEMENTS AND RIGHTS OF WAY AS SHOWN ON REFERENCED PLAT. 6.- FOUNDATIONS AND /OR FOOTINGS THAT MAY CROSS BEYOND THE BOUNDARY LINES OF THE PARCEL HEREIN DESCRIBED ARE NOT SHOWN HEREON. 7.- THERE ARE NO ABOVE GROUND ENCROACHMENTS UNLESS SHOWN HEREON. 8.- THE SURVEYOR DOES NOT DETERMINE FENCE AND /OR WALL OWNERSHIP. 9. - TYPE OF SURVEY: BOUNDARY SURVEY. 10.- NORTH ARROW DIRECTION AND BEARINGS SHOWN HEREON ARE BASED ON RECORDED PLAT BOOK 43 AT PAGE 67 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA. 11.- THIS SURVEY IS NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF FLORIDA LICENSED SURVEYOR AND MAPPER. ADDITIONS AND DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT THE WRITTEN CONSENT OF THE SIGNING PARTY 01? PARTIES. 12.- ELEVATIONS WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM. 13.- BENCH MARK USED: N/A 14. - THIS SURVEY MEETS ALL APPLICABLES REQUIREMENTES OF THE FLORIDA MINIMUM TECHNICAL STANDARDS AS CONTAINED IN CHAPTER 61G17 -6 FAC. 15.- 71-1I5 SURVEY WAS PREPARED FOR MORTGAGE PURPOSES ONLY. 16.- THIS SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY. 17.- THIS PLAN OF SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF EN NAMED HEREON. THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY. * DR. GENE ENG. FIELD DATE: 05 -19 -03 FIELD BOOK: FILE JOB NO: PS -309 REVISED: REVISED: PILAR SOLED PSM STATE OF FLORIDA No. 6310 1.13# 7149 D A T E : BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ PERMIT Np ROOFING ❑ Owner of Building Architect Contractor r or Builder Legal Lo.t Description I I B1 Address of Building CONTRACTOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA 9981 Date Contractor's License No. Subdi- vision Sq. Ft. Value of P < <4.- I I Amount of Pro ect $ 6' 6 I Permit $ BY AUTHORITY 19_4 7GrC/ Work to be performed under this 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 applica- tion 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 above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed ,4 e . (INSPECTOR) BY /'fr` In consideration of the issuance to me of this permit =f agree to perform the work covered hereunder in compliance with all ordinances and regulation; pertaining thereto and in strict conformity with the plans, drawin 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, servant or employee. 1 11 Date.. \� - -1 _ , 19 6 6 Owner's Name and Address .......... Y\. No Street Registered Architect and /or Engineer ,�,,11 Name and address of licensed contractor__ _0 ' \L'L C - �_�� f\�5 2 `4' E. (' Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 1_•,�g? -_t__1 State work to be done and purpose of building, (by floors) 3 LAX" mac- ots, - - - - -- and for no other purpose. New Building Remodeling Addition Repairs__.. No. of Stones To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 3 0 Ce • ®e — 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, Pennanent 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) (Signed) - -- -- - - -- -- -- - STATE OF FLORIDA, I COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Building I ctor 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 99 - 7 Date -5--- p ,� � Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida (Signed) My Commission Expires to me well known, 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.