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ELECTRICALBUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE, FLORIDA ❑ PERMIT N9 5556 0 ❑ Work to be performed under this Permit y " Owner of Building f c�. Architect Contractor or Builder`` Legal Lot Description II Bl CONTRACTOR OR BUILDER Subdi- vision Address of Value of I Amount of Building i'� � ` Project $ I Permit $ di' 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. DATE Contractor's License No. 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 as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. v.E BY AUTHORITY ROBOT ..^�' I PERMIT APPLICATION FOR MIAMI SHORES VILLAGE `7 y/ /t) - /o/ S T Tax Folio Legal Description Historically Designated: Yes No le Owner/Lessee / Tenant Xi-e X/ 3 Be 4 /. /( 1.1 Master Permit # Y Date Job Address Owner's Address N4 / »E /57 Contracting Co. / / '4i !/e rid i 4. //06. Qualifier .. /0 'V / I State # G e. 200//99 • Municipal # Architect/Engineer Bonding Company Signature o owner and/or undo President Date \ 0 Q t- q(a `Q(g Notary as to Owner and/or Condo sident Date My Commis FEES: PERMIT 0 4( U OFFICIAL NOTARY SEAL B < NICOLE A BERGERT * COMMISSION NUMBER 4 Q CC661267 MY COMMISSION EXPIRES OF Ft° JULY 2,2001 1 111' N'•, 0 • 0 RADON Address SS# Phone Competency # Address Address Mortgagor Address Permit Type (circle one): BUILDIN ELECTRICAL/ PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIP'T'ION et..0 Phone 0IJ5" -76 S3 57 3os S9'- i371/, Ins. Co. /P2T1�,ect L/ Square Ft. Estimated Cost (value) 5-GO WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize • - : , •ve -named contractor to do the work stated. Signature of Contractor or Owner -Build Notary as to Contractor or Ownr' Builde My Commission Expire C.C.F. , 6 6 NOTARY OFFICIAL NOTARY SEAL s ky p OFFICIAL NICOLE A BERGERT A 1 ` 0 COMMISSION NUMBER CC66126 qll' • i Q MISSION EXPIRES i<' OF R P JU LY 2 2001 BOND TOTAL DUE Date ck (ag ( ck - ate APPROVED: Zoning Building Electric Mechanical Plumbing Engineering • Date 4 / /I (57 Job Address Qualifier Architect/Engineer Notary as to Owner and/or Condo President My Commission Evire -- ti t , ...a r ` '. .� ? t ( 1 7.:7 FEES: PERMIT .3..4 ' pe' RADON owner and/or APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE /'-f4' / Legal Description / Tenant M / //1' E7t fi74 t�l / N Owner's Address / 44/ N E /0 / Sr: Contracting Co. 00Zil e '7` [C / A State # EC-000 // 99 Municipal # 4 1/4- Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELF.. PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION �Q /44/ F -- �rz ` 2 S C 7) 1 A4it�1�X Square Ft. WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. ndo President 4/6 /d / S7 Tax Folio Historically Designated: Yes No 41 '4 7 4114lq Date C.C.F. Master Permit # Phone 75 535/ Address 669 .uliJ 9os SS# - Phone 8'q(-- / 3 7if Competency # Ins. Co.f # 0 l 3. a4 d Address Estimated Cost (value) Signature of Contractor or Owner - Builder Notary as to ' ontractor or Owner - Builder My Commission Expires: i` • r" r'fr B S AL nriaoi 4 V OF `\.P g NOTARY BOND TOTAL DUE Building Electrica /' 4 a " Plumbing Engineering Permit No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifi ations her with submi ed 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 'V 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. r� Owner's Name and Address � No 1 ' Street Registered Architect and /or Engineer Employing Electrician's Name 2 1 / (/ / ? No Location and Legal Description Lot Block Subdivision 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 Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P P Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. a 7o ss. (Signed) (Signed),. Street Repairs No. of Stories • s t rfcal Inspector. Master Electrician. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. • 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, and 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. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST �I / t/ /) O rY �� /CO U CHECK / _ C7 ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. h 1 /r ' '✓ , _ MOTORS 0.1 HP MOTORS 1•5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK ' Permit No MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifi ations her with submi ed 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 'V 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. r� Owner's Name and Address � No 1 ' Street Registered Architect and /or Engineer Employing Electrician's Name 2 1 / (/ / ? No Location and Legal Description Lot Block Subdivision 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 Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground P P Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. a 7o ss. (Signed) (Signed),. Street Repairs No. of Stories • s t rfcal Inspector. Master Electrician. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. • 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, and 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. Permit No 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 Engineer Employing Electrician's Name. Location and Legal Description Lot Street and Number where work is to be performed —No STATE OF FLORIDA, l COUNTY OF DADE. I j Amount of Permit $ APPLICATION FOR ELECTRICAL PERMIT Date Site Feeders Type of Installation— Conduit ss. / MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT /® 4 .No 1 No (Signed) 1 Block Subdivision Street Ai State work to be performed and purpose of building (By Floors) New Building „ Remodeling Addition Repairs No. of Stories Conduit....!( Main Sw rr ® Amps Tubing B.X.L Metal Moulding Street Air 1 b Street 1 1/ Main Fuses :..,1" , ; E lecil'IrTsp� A Amps The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatf'is as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. (Signed) Muter Electrician. 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, and 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. SWITCH OUTLETS LIGHT OUTLETS PLUG RECCES P''TT'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SCACE HEATER STRIP HEATER TOTAL CL LIST /� � _ _ / Y G 1 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. O M k!!<9 Ax (�y��J'' ..�,�•�{q. +OTORS l am`.// Y �e0, :1 HP kk MOTORS t•0 HP N EON TRANS. /�, � V y tly l RADIO TOTAL CONTR. LIST LIST / CHECK Permit No 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 Engineer Employing Electrician's Name. Location and Legal Description Lot Street and Number where work is to be performed —No STATE OF FLORIDA, l COUNTY OF DADE. I j Amount of Permit $ APPLICATION FOR ELECTRICAL PERMIT Date Site Feeders Type of Installation— Conduit ss. / MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT /® 4 .No 1 No (Signed) 1 Block Subdivision Street Ai State work to be performed and purpose of building (By Floors) New Building „ Remodeling Addition Repairs No. of Stories Conduit....!( Main Sw rr ® Amps Tubing B.X.L Metal Moulding Street Air 1 b Street 1 1/ Main Fuses :..,1" , ; E lecil'IrTsp� A Amps The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatf'is as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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. (Signed) Muter Electrician. 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, and 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. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Lot In consideration of the issuance to me pertaining thereto and in strict conformity with cepting this permit I assume responsibility for CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA B- PERMIT 0 ?�A :11myp ill ag of o f Miami I I d w 1 o i Al Bl -1 i IOB I � Building j ` ' / / ADDRESS This permit is granted to the contractor or builder named above 1 herefor in strict compliance with all ordinances pertaining thereto an drawings, statements or specifications that may have been submitted 1 IN ' � PE CTION time if the work is not done in compliance with such ordinances or if 1 granted is the understanding that the contractor or builder named ab ► TIME READ pertaining to the work covered hereby whether shown on the plans oil done by his agents, servants or employees. 1 / L Signed.- of this permit I agree 1 the plans, drawings, st all work done by eitli 0 Work I 1 1 1 N? 3581 R EMARKS I NSPECTOR Shores iavni Shores DATE DATE Contractor's / License No. 4134 4319 Qillct - of Miami Shores N° 4319 JOB 2 a) -S ADDRESS 0/411 INSPECTION re cat-, ( A/ 7 TIME READY i; a C REMARKS INSPECTOR DATE S `� o Village of Miami Shores .JOB ADDRESS N? 4134 INSPECTION - TIME READY _ ...----- ,.- (- , i . 16 REMARKS INSPECTOR DATE 1 BUILDING ELECTRICAL PLUMBING ROOFING Contractor or Builder ; Legal Lot Description Address of Building / ' ' / 1 MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 3581 0 Owner of Building .' f Architect Bl. DATE 2 4 Contractor's License No. 195_(. Work to be performed under this Permit Subdi- vision ;' Value of II Amount of .. Project $ II Permit $ ' • This permit is granted to the contractor or builder named above to construc 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 cr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER Signed• rBY - INSPECTOR K' In consideration of the issuance to me of this permit I agree to perform the work covered hrWunder 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. L " ".'" ;G. BY AUTHORITY 6o Owner's Name and Address Registered Architect and /or Engi � Employing Electrician's Name" STATE OF FLORIDA, 1 COUNTY OF DADE. I MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 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 coynpl• d with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. 65. My Commission Expires V Amount of Permit $ No � Street / 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. Street Street / l./ Notary Public, State of Florida Master Electrician. Location and Legal Description Lot 11 Block Subdivision .. .M. •. .p , Street and Number where work is to be performed —No State work 'to be performed'and purpose of building (By Floors) New Building v Remodeling - Addition Repairs No. of Stories // Service Overhead Site Feeders ���� C onduit C" M ain Sw l' �� Amps ✓ Main Fuses ���" ` (9 Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding (Signed) Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and sub-contractors employed by him in the of the work such public notice or notices be performed under this permit, as are 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, and 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. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'8 FIXTURES NO. LAMPS 7 , 7 5 REFRIO. OUTLET / IRON OUTLET RANGE OUTLET [! O RANGE CONN. WATER HEATER W. HEAT. CONN. A CE H HATTER " STRIP HEATER „)1� TOTAL CONTR. UsT U /' � 7 3 , ,) �� CHECK • ENT. SW. DIET. CAB. SERVICE TEMP. SERVICE PERM. �q ti d P ' ,, ° ti 37' 6›. MPTORS DrYHP MOTORS 1.8 HP NEON TRANS. RADIO TOTAL CONTR. 18T L Isr / • CHECK Owner's Name and Address Registered Architect and /or Engi � Employing Electrician's Name" STATE OF FLORIDA, 1 COUNTY OF DADE. I MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 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 coynpl• d with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. 65. My Commission Expires V Amount of Permit $ No � Street / 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. Street Street / l./ Notary Public, State of Florida Master Electrician. Location and Legal Description Lot 11 Block Subdivision .. .M. •. .p , Street and Number where work is to be performed —No State work 'to be performed'and purpose of building (By Floors) New Building v Remodeling - Addition Repairs No. of Stories // Service Overhead Site Feeders ���� C onduit C" M ain Sw l' �� Amps ✓ Main Fuses ���" ` (9 Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding (Signed) Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and sub-contractors employed by him in the of the work such public notice or notices be performed under this permit, as are 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, and 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.