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400 NE 102 St (9)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 5/3/95 Job Address Legal Description Master Permit # 3 7 O �3 Owner / Lessee / Tenant Mark Orlandi Owner's Address 400 Contracting Co. Qualifier Douglas Orr State # 021452 WORK DESCRIPTION Signa Date: Nota T as t My Comnissi ** * APPROVED: Douglas 400.Te1 -r,102 St . 102 St. Phone 758 -0072 Orr Plumbing, Inc. Address 301 Flagler DR., Miami Springs Municipal # Competency # 0012463 Ins.Co. 8/2/95 Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL MECHANICAL ROOFING PAVING FENCE SIGN install double sink Square Ft. Estimated Cost(value) $328.00 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. authorize the aboov -named contractor to do the work stated. l n or do President nI =F A L N; ..•r"RY SEAL • 1 : r.dnd /o'tvocdilcfookesid 4 COMMISSION NUMBER " ,, CC292465 7� � P MY COMMISSION EXP. �FF� JULY 25 i9 97 Tax Folio 11 3206 017 0620 SS# Phone 887 -1687 * * * Signature of C tractor or Owner- Builder Date: 5/3/95 /107,7,- Notary as to Cont for My Commission Expires: * * * * FEES: PERMIT ;70 RADON C.C.P. ` NOTARY Zoning Mechanical Fire Buildin Plumbin *. * ** TOTAL DUE 3O‘f Furthermore, I ` p aY P0 OFFICIAL 1AL NOTARY SEA 0 . <- DONNA P FRANTZ 2 0 N NUMBE: ▪ � � 323876 � O cQ MY COMMISSION EX- CF F\ OCT. 1 7 1997 Other Electrical Engineering tart as to Owner an My Commission Expires ** * * APPROVED: Zoning PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date _ - /S - 9 3Job Address L '` w 1 Tax Folio11 i /' 4 4.Z , Legal Description /01, '1) Fit Owner / Lessee / Tenant ( Olf` k ck r O l n `L1 Master Permit # , 3 Owner's Address L f _ S C Y•_Q Phone Contracting Co. C W h P ■C Address Qualifier SS# - State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING 1 ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN FENCE SIGN WORK DESCRIPTION 1 ? 1 r S ( I -e cL [n 0 201 w1 `e /dl flei Square Ft. Estimated Cost(value) 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. -- XIGLtA( ajc-44-, Signature of owner and /or Condo President Signature of Contractor or Owner- Builder Date: •2 — /5 -9 Mechanical . ;;A "` ° " °,4. JOSEPHINE CHURCH 1 : Nntary Puhlir StstP M fienda AtfAYPtelessidgnit April 90. 1911 No. CC197S45 Date: Phone Notary as to Contractor or Owner- Builder My Commission Expires: * * * * * * * * * ** FEES: PERMIT RADON C.C.F. ', NOTARY 1,540 TOTAL DUE P'( Fire 6;7 Bui t• ing Other Electrical Plumbin� /' Engineering b = MIAMI SHORES VILLAGE, FLA. JOB ADDRESP trd /" - INSPECTION 05 P € REMARKS: INSPECTOR N° 6057 TIME READY ' 3 ' DATE 5-5- / Permit No r7 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 Feet of Drain Tile Nature of Water Supply: City —Well. Es 5 A R. cs MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ` "m No. Registered Architect and /or Engineer Employing Plumber's Name __.61sm.2.1I-! _ E -s _ _-- 2_..trx�...L __4 No.-_ tic ___ Street _.!U •_ _ 4`1 - __ - -_ - -- Location and Legal Description Lot_.__._____- _-------- _ ---_. Block_ -- ---- .- .- __ -_ -- Subdivision ....... _____ .......... ___________ Street and Number where work is to be performed —No qe -z /J - s / Z- Street S X A State work to be performed and purpose of building (By Floors) _. Z __ APP (- .____ c - L Fc= R S P? -c .s.1 >; L_ e New Building Remodeling Addition... ___ Repairs No. of Stories Street 1 ° Size Septic Tank Type of Tank / Capacity Gals _Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit (A/ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and acceptis obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and bas 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. Amount o Permit $ -------- - -_ -_- STATE OF FLORIDA, 1 COUNTY OF DADE. My Commission Expires ( Signed)... 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 hin, stated are true. 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. CLOSETS BATH Tues SHOWERS LAVA TORIES INKB 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 .7 a --! CHECK SI (X 7 Permit No r7 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 Feet of Drain Tile Nature of Water Supply: City —Well. Es 5 A R. cs MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ` "m No. Registered Architect and /or Engineer Employing Plumber's Name __.61sm.2.1I-! _ E -s _ _-- 2_..trx�...L __4 No.-_ tic ___ Street _.!U •_ _ 4`1 - __ - -_ - -- Location and Legal Description Lot_.__._____- _-------- _ ---_. Block_ -- ---- .- .- __ -_ -- Subdivision ....... _____ .......... ___________ Street and Number where work is to be performed —No qe -z /J - s / Z- Street S X A State work to be performed and purpose of building (By Floors) _. Z __ APP (- .____ c - L Fc= R S P? -c .s.1 >; L_ e New Building Remodeling Addition... ___ Repairs No. of Stories Street 1 ° Size Septic Tank Type of Tank / Capacity Gals _Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit (A/ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and acceptis obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and bas 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. Amount o Permit $ -------- - -_ -_- STATE OF FLORIDA, 1 COUNTY OF DADE. My Commission Expires ( Signed)... 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 hin, stated are true. 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. Permit No 4 7 e 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 T om Employing Plumber's Name � � - - -- - --- - - - - -- - -- �/ yam// s %��'i iL.!? S/2-----'-"- � 64. No._ - 37® �_- ' ! . i "Street Location and Legal Description Lot____.. __..______ _______ _ ___ — Block_ Subdivision. __._.. Street and Number where work is to be performed —No 3 2i R / L . itreet State work to be performed and purpose of building (By Floors)____ —,- a. . 4 -v - 'i New Building Remodeling_____ __._____ Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals. Feet of Drain Tile._ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well ._______ _______._______ __.Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, ad. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEI` . APPLICATION FOR PLUMBING r'''':k‘UVIIT p. C SSA APO No _ Street /14 e / ® s r (Signed) _ Date l 1- Li - "7 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 this permit, as are licensed by Miami Shores Village. CO • (Signed)l_ a j- • — it Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to ine 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: 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 U RINALS 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'O POOL CONTR. LIST 4' gig (o CH ECK 1 i, DO Permit No 4 7 e 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 T om Employing Plumber's Name � � - - -- - --- - - - - -- - -- �/ yam// s %��'i iL.!? S/2-----'-"- � 64. No._ - 37® �_- ' ! . i "Street Location and Legal Description Lot____.. __..______ _______ _ ___ — Block_ Subdivision. __._.. Street and Number where work is to be performed —No 3 2i R / L . itreet State work to be performed and purpose of building (By Floors)____ —,- a. . 4 -v - 'i New Building Remodeling_____ __._____ Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals. Feet of Drain Tile._ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well ._______ _______._______ __.Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, ad. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEI` . APPLICATION FOR PLUMBING r'''':k‘UVIIT p. C SSA APO No _ Street /14 e / ® s r (Signed) _ Date l 1- Li - "7 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 this permit, as are licensed by Miami Shores Village. CO • (Signed)l_ a j- • — it Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to ine 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: 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 , -r Building ": MIAMI SHORES VILLAGE. FLORIDA DATE 4 PERMIT N° 5370 Architect Contractor <^ or Builder Legal Lot Description Bl Address of Building CONTRACTOR OR BUILDER Work to be performed under this Permit BY Contractor's License No. 42 /�i i, I Subdi- vision Value of Project $ *7 This permit is granted to the contractor or builder named above to construct the biiilding 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 wick 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 thoro h knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the atements or specificai and that he assumes responsibility for work done by his agents, servants or employees. / •0 q �� Signed o : • INSPECTOR Amount of Permit $ e� • ' In consideration of the issuance to me of this permit I agree to perform the work cover hereunder in compliance with all ordina ces and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications witted 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. . ,+ Y 2 i AUTHORITY 195 BUILDING ❑ ELECTRICAL PLUMBING ROOFING Owner of Building ❑ PERMIT N? 14860 ❑ Work to be performed under this Permit Architect Contractor or Builder r • j ` ' Legal Lot z II BL Description Address of Building CONTRACTOR OR BUIbbE MIAMI SHORES VILLAGE. FLORIDA Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. 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,j d 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. "4c.. BY AUTHORITY 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address Registered Architect and /or Engineer ,�ttss�� . // ,// �� H.G. m._ Employing Plumber's Nae__ 2 elk. d/etPoNo.___ Block - - Subdivision_. Location and Legal Description Lot._ - Street and Number where work is to be performed -No 0 ___ _ _ _._ Street_ A 2 .5 tr. 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 -Well _ Size of Soakage Pit Amount of Permit $ b � My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT --- -- _ No. £ - L�.� _ Street ..... /i °S21 Capacity Cals. Date Vt' / 9. / , Street__ - -- _.D • lx_Ze_._ "le ( 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 5988, 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 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. e �� , __. _.. , 4f i a .___ _ ((� �s ( Signed) Master Plumber. STATE OF FLORIDA, I COUNTY OF DADE. as. 49 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 same, and that all lac 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 faul materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SKS N SINKS 'rues LAUNDRY Uea U CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS ta)ater fil`:47i ./.. TOTAL FIXTURCI CONTR. LIST f7I SETS p A/ / / / — —_—I.— [J {� / CHECK / .4- � 1 l' 7 �° , DRAIN FIELD j Vi \ SOAKAGE PIT SEPTIC TANK SEWER CONN. GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL No Sm .. III?, e (3Cry, erb , Qre IP �eti. Fr�,e / Pi, CONTR. LIST CHECK / " "r 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address Registered Architect and /or Engineer ,�ttss�� . // ,// �� H.G. m._ Employing Plumber's Nae__ 2 elk. d/etPoNo.___ Block - - Subdivision_. Location and Legal Description Lot._ - Street and Number where work is to be performed -No 0 ___ _ _ _._ Street_ A 2 .5 tr. 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 -Well _ Size of Soakage Pit Amount of Permit $ b � My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT --- -- _ No. £ - L�.� _ Street ..... /i °S21 Capacity Cals. Date Vt' / 9. / , Street__ - -- _.D • lx_Ze_._ "le ( 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 5988, 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 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. e �� , __. _.. , 4f i a .___ _ ((� �s ( Signed) Master Plumber. STATE OF FLORIDA, I COUNTY OF DADE. as. 49 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 same, and that all lac 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 faul materials and /or workmanship.