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1226 NE 100 St (4)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 0 305- 795 -2204 Building nspection Request Date Type Insp'n - / - t ✓CJ Permit No. - PL ,00 <4 - 5 Name W Address / d ` 9 W /v E /00 c r . Company `7 - '! 6- -eQ' S ( fd G`-:, Phone# j0S) C' ---' — 3ES Inspection Date & } r`7 ill f,„,, Approved Correction Re- Insp'n Fee D5 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buildi g ection Request Date f° /°il � Type In sp' n LU 1. i C t3 Permit No. 1 L . Name C� r (1(105-H Address / . - ' /J ; Company il. kt ?of/ / Phone # Inspection Date Approved Correction Re- Insp'n Fee /09 5 Permit No 9 Fr Application is hereby made for the approval of the detailed statement of tiro plans and specifications here submitted for the building or other structure herein described. This application is made in compliance and confor may 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 c+s nr't. A copy of approved plans and specifications must be kept at building during progress of work. j .y / /1/ 7..L. Owners Name and Address. . ___!� _ _ . .QC2,/27- e — : - -__ No.. /J.6_.(Gt .._.._ Street 4T, / 749 Registered Architect and /or Engineer f � -? ./_2_4/421__/'___ -_ - S _ ... ' s 'f..--_t Employing Plumber's Name Location and Legal Description Lot Street and Number where work is to be performed —No Street Amount of Permit $ -- MIAMI SHORES VIL:,A,GE PLUMBING INSPECTION DEPARTMEi `:' APPLICATION FOR PLUMBING Block_ State work to be performed and purpose of building (By Floors)__-_-_ New Building _._.___________ _______ Remodeling___ ___ Addition Date_` /- - -_ - -- — - -- — — - --- (Signed) - — ' No.__._____._.._____ _ Street Subdivision Repairs No. of Stories Type of Tank__ Capacity Gals. Size Septic Tank Feet of Drain Tile___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well . Size of Soakage Pit Plumbing Insppee. 'ter. The undersigned applicant for this building permit does hereby certify that he understands and accepts his eGligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, 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. STATE OF FLORIDA, 1 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 Master Plumber. 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. CLOSET6 BATH TUBS SHOWERS LAVA TORIE6 SINKS S SLOP SINKS LAUNDRY TUSB U CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER Aar WELL SPRKLR. SYSTEM SWIM'O POOL CONTR. LI ST / - - -- CHECK Permit No 9 Fr Application is hereby made for the approval of the detailed statement of tiro plans and specifications here submitted for the building or other structure herein described. This application is made in compliance and confor may 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 c+s nr't. A copy of approved plans and specifications must be kept at building during progress of work. j .y / /1/ 7..L. Owners Name and Address. . ___!� _ _ . .QC2,/27- e — : - -__ No.. /J.6_.(Gt .._.._ Street 4T, / 749 Registered Architect and /or Engineer f � -? ./_2_4/421__/'___ -_ - S _ ... ' s 'f..--_t Employing Plumber's Name Location and Legal Description Lot Street and Number where work is to be performed —No Street Amount of Permit $ -- MIAMI SHORES VIL:,A,GE PLUMBING INSPECTION DEPARTMEi `:' APPLICATION FOR PLUMBING Block_ State work to be performed and purpose of building (By Floors)__-_-_ New Building _._.___________ _______ Remodeling___ ___ Addition Date_` /- - -_ - -- — - -- — — - --- (Signed) - — ' No.__._____._.._____ _ Street Subdivision Repairs No. of Stories Type of Tank__ Capacity Gals. Size Septic Tank Feet of Drain Tile___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well . Size of Soakage Pit Plumbing Insppee. 'ter. The undersigned applicant for this building permit does hereby certify that he understands and accepts his eGligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, 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. STATE OF FLORIDA, 1 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 Master Plumber. 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. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot PERMIT 11T° 2685 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA Work to be performed under this Permit B1 Subdi- vision Value of Project $ DATE Contractor's License No. Amount of Permit $ / MONISM 195 5 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 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 responsibility for work done by his agents, servants or employees. Signed. BY INSPECTOR 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ®ate' Permit No a ' '° Application is hereby made for the approval of the detailed statement of th;; 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 ar not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address ' � eerz: ° `i 7 ` -- "‘C , ' No._L. __.7 __ & Street-_ -J c G= / t Registered Architect and /or Engineer___-, _ _______ __ ____ Employing Plumber's Name s / l 4 ,---- ' -1, ' _____.__ No. Location and Legal Description Lot__ _____- _ _ . _ __ _____ Block Street and Number where work is to be performed- No..._____— _______ —_ _ _ . _ Street. State work to be performed and purpose of building (By Floors)-- New Building _ -- Remodeling---- __--------- _- _ - -___ Addition------- _._._ -_ -- - - -_ -. 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 - ell. a Size of Soakage Pit Amount of Permit $ MIAMI SHORES VIL AGE PLUMBING INSPECTION DEPARTMEo <'; APPLICATION FOR PLUMBING MrT (Signed) Date 1G! Street._. _ . — - - - -•-- Subdivision - Capacity Gals Master Plumber. 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. (Signed) Plumbing Inspector. 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 bus 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. rJ STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 INK SLOP SINKS LAUNDRY TUBS R INALS URINALS CATCH BASIN FLOOR DRAIN DRINKI 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'O POOL CONTR. LIST - CHECK Permit No a ' '° Application is hereby made for the approval of the detailed statement of th;; 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 ar not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address ' � eerz: ° `i 7 ` -- "‘C , ' No._L. __.7 __ & Street-_ -J c G= / t Registered Architect and /or Engineer___-, _ _______ __ ____ Employing Plumber's Name s / l 4 ,---- ' -1, ' _____.__ No. Location and Legal Description Lot__ _____- _ _ . _ __ _____ Block Street and Number where work is to be performed- No..._____— _______ —_ _ _ . _ Street. State work to be performed and purpose of building (By Floors)-- New Building _ -- Remodeling---- __--------- _- _ - -___ Addition------- _._._ -_ -- - - -_ -. 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 - ell. a Size of Soakage Pit Amount of Permit $ MIAMI SHORES VIL AGE PLUMBING INSPECTION DEPARTMEo <'; APPLICATION FOR PLUMBING MrT (Signed) Date 1G! Street._. _ . — - - - -•-- Subdivision - Capacity Gals Master Plumber. 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. (Signed) Plumbing Inspector. 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 bus 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. rJ STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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. STATE OF FLORIDA, COUNTY OF DADE. Permit No Disapproved (Signed) ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. \ M AA Date / J ._ 3 a .55 , 19 Owner's Name and Address.. 1'�+�e No Street Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done _ LQ i/ State work to be done and purpose of building (by floors) ^° 2 • -' and for no other purpose. Repairs No. of Stories Kind of foundation Roof Covering New Building Remodeling To be constructed of Estimated Total cost of improvements $ Addition 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 pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed' under this pennit, as are licensed by Miami Shores Village. Remarks (Signed) C � " ' ' e 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. Date 1/- / � � Read, Sworn to and Subscribed before me. ate icy ing Inspector My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. MIAMI SHORES VILLAGE, FLORIDA Owner of Building BUILDING ❑ DATE / 7 = 195 ELECTRICAL ❑ PERMIT N° 15496 Contractor's PLUMBING 04:1 License No ROOFING ❑ Work to be performed under this Permit .., 1 - S. c i ,. Architect j -� Contractor or Builder Legal Lot il Bl Subdi- Description vision Address of Value of I Amt. of Building t ;'._ 'i L ! ° "'4 -.....,-c4k Project $ 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 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 drawin s or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. / Signed • �, r .. l i ti BY l . c " .- 1 --'- ._ Y INSPBCTOR In consideration of the issuance to me of this permit I agree to pekform the work covered hereunder in complianc with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, state tits or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit 4 assume responsibility for all work done by either, myself, my agent, servant or employee. r 1 r - s - t OONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description. Address of Building MIAMI SHORES VILLAGE, FLORIDA , ❑ DATE �' �✓� 1953_ ROOFING ❑ Work to be performed Owner of Building PERMIT N° 15370 This permit is granted to the contractor or builder named above to construct herefor in strict compliance with all ordinances—pertaining thereto and with drawings, statements or specifications that may have been submitted to and 'me if the work is not done.in compliance with such ordinances or if the pl a nted is the understanding that the contractor-04 builder na hove a ne by his agents, servants or employees. rtaining to the cork covered hereby whether show2r • " dra In consideration of the issuance to me this permit taining thereto and in strict conformity with the dr accepting this permit I assume respo4sibility for all • CONTRACTOR,. OR BUILDER under this Permit n • erst proved by the pro s are change mes the responsibility gs or in the Sig ed: BY Contractor's License No Amt. of Permit uilding or to install the equipment or device described in the appll!ation a that the work will be performed in compliance with any plans, . r municipal authorities. This Permit may be revoked at any d without : uthorization. A further condition upon which this permit is or a thorough knowledge of the ordinances and regulations teme or specifications and that he assumes r •onsibility for work INSPECTOR I a . ee to perform the work covered hereunder in compliance with all o inances and regulations gs, statements or specifications submitted to the proper authorities o Miami Shores Village. done by either, my my agent, servant or employee. • AUTHORITY Permit No. 1 - My Commission Expires MIAMI SHORES VILLAGE ' PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby node for the approval of the detailed statement of the plans and specifications herewith submitted for the building or of in 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 Divisior 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 Enginyer rr / _ _ sue A . n Employing Plumber's Name e, No. L Street = - ...' / o_ !i: Location and Legal Description Lot__ _ Block+_ —_ __ -___ -- - - _ -_ - -- Subdivision__ 'A' t - t k4- -, a Street and Number where work is to be perfo d—No _ _.�'.- ._ _ /✓ ii street / ® \ State work to be performed and purpose of building -F1oors) ell . Amount of Permit $_ ...... _____ - -• - New Building L. Remodeling Addition.--------------- __ -_.. Repairs. - -- -...._ . -• - -._ -- No. of Stories / .. .... . Size Septic Tank Type of Tank_ -_ Capacity Gals. Feet of Drain Tile Nature of Water Sup Dist. Feet of Tank or Drain Field from Well .— Size of Soakage (Si — — Plumbing Inspector. The undersigned applicant for this building permit does hereby certify tha _ : 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 wor to be performed under this permit, as are licensed by Miami Shores Village. (Signed)._ Date .. - Master Plumber. STATE OF FLORIDA, ss, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare 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 name, and that all tac therein by him stated are true. 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 f:lul materials a /or workmanship. CLOSITO BATH TUBS SHOWIRO LAVA• TORIES SINKS SLOP SINKS LAUNDRY Tulle URINALS CATCH SABIN FLOOR DRAIN DRINKING FOUNT' NS f- ,e Ffe 1 ld / A I 1 / � M C � TOTAL FIETUR[I _L LIST CHECK 3 1 -.1...-...... _ Z' \ 16 g SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DRIP WILL SPRKLR. SYSTEM SWIM'O POOL 4 , vt J� t 111 ��• . CONTR. LIST CHICK —T.- , - 50 ,t Permit No. 1 - My Commission Expires MIAMI SHORES VILLAGE ' PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby node for the approval of the detailed statement of the plans and specifications herewith submitted for the building or of in 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 Divisior 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 Enginyer rr / _ _ sue A . n Employing Plumber's Name e, No. L Street = - ...' / o_ !i: Location and Legal Description Lot__ _ Block+_ —_ __ -___ -- - - _ -_ - -- Subdivision__ 'A' t - t k4- -, a Street and Number where work is to be perfo d—No _ _.�'.- ._ _ /✓ ii street / ® \ State work to be performed and purpose of building -F1oors) ell . Amount of Permit $_ ...... _____ - -• - New Building L. Remodeling Addition.--------------- __ -_.. Repairs. - -- -...._ . -• - -._ -- No. of Stories / .. .... . Size Septic Tank Type of Tank_ -_ Capacity Gals. Feet of Drain Tile Nature of Water Sup Dist. Feet of Tank or Drain Field from Well .— Size of Soakage (Si — — Plumbing Inspector. The undersigned applicant for this building permit does hereby certify tha _ : 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 wor to be performed under this permit, as are licensed by Miami Shores Village. (Signed)._ Date .. - Master Plumber. STATE OF FLORIDA, ss, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare 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 name, and that all tac therein by him stated are true. 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 f:lul materials a /or workmanship. .'• / . �� �� • ~ e -` . •, ° .� �