PLUMBING PERMITMIAMI SHORES VILLAGE
BUILDING DEPARTMENT V\
305- 795 -2204
Building Inspection Request
Date
Type Insp'n L./
Permit No.
Name AA
Address
Company
Phone # ") E
Inspection Date
Approved
Correction ❑
Re- Insp'n Fee ❑
NellA DO
GA`? P -' O' 6
Ga% NElc --
��IAMI SHORES VILLAGE
\ BUILDING DEPARTMENT
305- 795 -2204
Buil ing Inspection Request
Date 9
Type Insp'n (�
Permit No. ( 1 , `- (-) LJ
Name ao'i do
Address tc NIL, 10 1_3
Company f (Jai tC-1
Phone #
Inspection Date C3
Approved
Correction
Re- Insp'n Fee
Owner's Name and Address..
Location and legal description of lot to be built on:
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.
'4) - ,t,,cuLitft..,
Lot Block Subdivision
Street and Number where work is to be done 44:--C- - T a
Date
1 U 8 -6237
7 <yam' r°1
No. Street ...!l...��� r
Registered Architect and /or Engineer ' ; ,.
Name and address of licensed contractor FLOTUEA SPRIKEET & SUPPLY CO., Z.
2570 N. W. 14Ist STREET
OPA- LOCKA, FLA.
State work t be done and purpose of building (by, fl rs)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total 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
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 5966, 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 subcontrfttors, on work t. . .erfor ed and this
licensed b Miami Shores •
permit, as are icense y M iam► ores ll
,age.
Remarks (Signed)._
STATE OF FLORIDA,
COUNTY OF DADE. J 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 / 7 Date - Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Notary Public, State of Florida
Building Inspector My Commission Expires
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
MIAMI SHORES VILLAGE. FLORIDA
PERMIT
Lot
CONTRACTOR OR BUILDER
B1
N° 2422
DATF f "
Contractor's
License No.
Work to be performed under this Permit
Subdi-
vision
Value of I I Amount of
Project $ I Permit $
195
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 cr 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
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE j ,'195_
gPERMIT N° 2569 Contractor s
License No.
❑ Work to be performed under this Permit
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
BL
Subdi-
vision
Value of
Project $
Amount of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A 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
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 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 ............ , _ -- ` _ ° _ ". ,. • No. - - - -- Street.._
Registered Architect and /or Engineer__--
, e f, —fi-- ---
Employing Plumber's Name ; " No.
Size Septic Tank ------------------------- - - - - -- -Type of
Feet of Drain Tile_ ____ Dist. Feet of Tank or Drain Field from Well.
Nature of Water Sup l'ell.___�__ y_ _ -__ -•
- ' ° s { � I " e — - - -
(Signed)
Amount of Permit $__
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Repairs
Street_
Capacity Gals
No. of Star
My Commission Expires Notary Public, State of Florida
Location and Legal Description Lot_- _________ i_ _ j __.__ __Block t Subdivision_____— „,;_.. -:_ r ___? . 1 1 . _.,_
Street and Number where work is to be performed —No `tA le _t— Street 1 a) t
State work to be performed and purpose of building (By Floors) _. ____
New Building_____.___ Remodeling — ________ Addition_
- Size of Soakage Pit
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 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 permit, us are,.
licensed by Miami Shores Village. ` , ,
1/4 i
9 V
�
�, ( Signed )- - ,� ----� - - -- -- -�* �:-��- .,
�� f / . P }umker. f
STATE OF FLORIDA, E. f : "'' il -�
COUNTY OF DADE. I
as. (�
Before me, the undersigned authority, a'ndtary 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.
OTE: A re- inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
terials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
S INKS
LAUNDRY
TUB&
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
, 4 ; �°
�p5t34s
( �d
/- TOTAL
FIXTURES
CONTR.
L ,
LIST
y
y
F
1
P
L
I x {
CHECK
ry <
/ a3 irk
-+ ~`8
ra >
C �a
3
E'3
—
/ C c
SEPTIC
TANK
SEWER
CONN.
`
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
/ 1( -tJ
t�_,A9 .
, p
4 -;'
, , t ;
'
CLNTR.
LIST
"
�
/
, .y
CHECK
/ / '
� y
•
E 6 F' `
i 02
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 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 ............ , _ -- ` _ ° _ ". ,. • No. - - - -- Street.._
Registered Architect and /or Engineer__--
, e f, —fi-- ---
Employing Plumber's Name ; " No.
Size Septic Tank ------------------------- - - - - -- -Type of
Feet of Drain Tile_ ____ Dist. Feet of Tank or Drain Field from Well.
Nature of Water Sup l'ell.___�__ y_ _ -__ -•
- ' ° s { � I " e — - - -
(Signed)
Amount of Permit $__
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Repairs
Street_
Capacity Gals
No. of Star
My Commission Expires Notary Public, State of Florida
Location and Legal Description Lot_- _________ i_ _ j __.__ __Block t Subdivision_____— „,;_.. -:_ r ___? . 1 1 . _.,_
Street and Number where work is to be performed —No `tA le _t— Street 1 a) t
State work to be performed and purpose of building (By Floors) _. ____
New Building_____.___ Remodeling — ________ Addition_
- Size of Soakage Pit
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 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 permit, us are,.
licensed by Miami Shores Village. ` , ,
1/4 i
9 V
�
�, ( Signed )- - ,� ----� - - -- -- -�* �:-��- .,
�� f / . P }umker. f
STATE OF FLORIDA, E. f : "'' il -�
COUNTY OF DADE. I
as. (�
Before me, the undersigned authority, a'ndtary 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.
OTE: A re- inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
terials and /or workmanship.
• .-//114-- Date..._ ......
Apcticetion is herby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
:c' --ui a herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
.zd 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
Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
;>„tiiding during progress of work.
C sn .r's Name and Address
Registered Architect and /or Engineer ... .____
Employing Plumber's Name_• - 1111461L- t[_!e'le 22ZL11ii_0"1-I- No..__.___1 76._.- Street. WC
Block Subdivision _______________._.
State work to be performed and purpose of building (By Floors)_____. QC X
Location and Legal Description Lot___ _
Street and Number where work is to be performed —No
New Building _----- - - -- -- - -- - ---_ -- Remodeling_ _- _- - - -._. ___ - -- Addition.
Size Septic Tank
Feet of Drain Tile._
Net'rre of Water Supply: City —Well
Amount of Permit $_
mitring 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 5968, Compiled General Laws of Florida Pennanent Supplement, and has com-
pied with the pro signs thereof, and will require similar compliance from all contractors or sub - contractors plo ed by him in the work to be
performed marler this permit; and will post or cause to be posted' for inspection on the site of the wor uch blic notice or notices as are
acr;utred by the Act. The undersigned agrees to employ only such sub- contract s, . work to b per : ed under this permit, as are
Jecnsed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. j as.
Dist. Feet of Tank or Drain Field from Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank_ Capacity Gals.
Size of Soakage Pit
(Signed)_- _.....
(Sign
Repairs
- -
No — C F E _ Al i — Street. • s
t - -n_ 61016 -
No. of Stories
My Commission Expires Notary Public, State of Florida
aster Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
UR
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR•
LIST
C..4ECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
C'
LIST
-
CHECK
• .-//114-- Date..._ ......
Apcticetion is herby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
:c' --ui a herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
.zd 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
Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
;>„tiiding during progress of work.
C sn .r's Name and Address
Registered Architect and /or Engineer ... .____
Employing Plumber's Name_• - 1111461L- t[_!e'le 22ZL11ii_0"1-I- No..__.___1 76._.- Street. WC
Block Subdivision _______________._.
State work to be performed and purpose of building (By Floors)_____. QC X
Location and Legal Description Lot___ _
Street and Number where work is to be performed —No
New Building _----- - - -- -- - -- - ---_ -- Remodeling_ _- _- - - -._. ___ - -- Addition.
Size Septic Tank
Feet of Drain Tile._
Net'rre of Water Supply: City —Well
Amount of Permit $_
mitring 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 5968, Compiled General Laws of Florida Pennanent Supplement, and has com-
pied with the pro signs thereof, and will require similar compliance from all contractors or sub - contractors plo ed by him in the work to be
performed marler this permit; and will post or cause to be posted' for inspection on the site of the wor uch blic notice or notices as are
acr;utred by the Act. The undersigned agrees to employ only such sub- contract s, . work to b per : ed under this permit, as are
Jecnsed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE. j as.
Dist. Feet of Tank or Drain Field from Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank_ Capacity Gals.
Size of Soakage Pit
(Signed)_- _.....
(Sign
Repairs
- -
No — C F E _ Al i — Street. • s
t - -n_ 61016 -
No. of Stories
My Commission Expires Notary Public, State of Florida
aster Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No. ‘ - Date ) /L. 2/
Application is hereby madelfor 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 Plumber's Name
Size Septic Tank..
/ 3
Feet of Drain Tile___
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
4
ett
g
Street
Street-_.
Location and Legal Description Lot____.__ _ __________ � Block_ Subdivision
/ •!� I
Street and Number where work is to be performed —No (9 /d) / Street
State work to be performed and purpose of building (By Floors)_._____ ____________._____
New Building Remodeling____ Addition Repairs No. of Stories. . ........ ........... ..
T e of Tank____ `y Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.__-_____ ....... __ .... _______..... _.______ ___. Size of Soakage Pit
( 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 has coin -
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 tlie 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.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: Pre- inspection fee of $1.00 will be made when such re-inspection is made •necessary by improper notice for inspection, or faulty
materials aad/or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
SE
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
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
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CNECK
Permit No. ‘ - Date ) /L. 2/
Application is hereby madelfor 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 Plumber's Name
Size Septic Tank..
/ 3
Feet of Drain Tile___
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
4
ett
g
Street
Street-_.
Location and Legal Description Lot____.__ _ __________ � Block_ Subdivision
/ •!� I
Street and Number where work is to be performed —No (9 /d) / Street
State work to be performed and purpose of building (By Floors)_._____ ____________._____
New Building Remodeling____ Addition Repairs No. of Stories. . ........ ........... ..
T e of Tank____ `y Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.__-_____ ....... __ .... _______..... _.______ ___. Size of Soakage Pit
( 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 has coin -
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 tlie 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.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: Pre- inspection fee of $1.00 will be made when such re-inspection is made •necessary by improper notice for inspection, or faulty
materials aad/or workmanship.