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EL-15-1897VA/4\ BUILDING PERMIT APPLICATION ❑ BUILDING ELECTRIC El PLUMBING ❑ MECHANICAL JOB ADDRESS: City: /tog ivE Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ROOFING ❑ PUBLIC WORKS 9S' S' 5411 FBC 20H Master Permit No. Re -7-15 -1E3'95 Sub Permit No. EL -15.— 16 11 ❑ REVISION �HANGE OF CONTRACTOR ❑ EXTENSION ❑ CANCELLATION ❑ RENEWAL ❑ SHOP DRAWINGS Miami Shores County: Miami Dade Zip: Folio/Parcel#: Occupancy Type: Load: OWNER: Name (Fee Simple Titleholder): Address: / 2®'a 141.- 41141.111 City: "P1)ks+v i J lko r44 Tenant/Lessee Name: Email: Is the Building Historically Designated: Yes NO Construction Type: Flood Zone: Pedrp de /tie,1 BFE: FFE: Phone#: 305" 713 .C1031 State: Zip: Phone CONTRACTOR: Company Name: Pe04e..1 C C L' Phone#: 3a---14707 3 iC Address: City: {'SAA K tA, L' State: ,_— Zip: `3 L &2 Qualifier Name: Q' •C l b s a �y c) 4J 24L. c,Phone#: State Certification or Registration #: C-/100 1 c( l Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: -' 196,1( - Type of Work: ❑ Addition Ps Alteration Description of Work: N �✓`` ❑ New ❑ Repair/Replace ❑ Demolition .o.✓ (1 LtKrA- *V £ -ro o1,1 8-e et Yb ) Specify color of c Submittal Fee $ 40:$ Scanning Fee $ or thru tile: Permit Fee $ >' S ' CCF $ CO/CC $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $& R a) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of, all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property -is subject -to attachment. Also, a certified copy of the-recarded rratice of commencement must be posted at the jog site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2:L. day of 4p0 -(L. , 20 by —2 day of ,/ rLL-- , 20 t , by Rs46 I &)Xb , who is personally known to Q ori O S jau:771&- , who is personally known to me or who has produced as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: /� Print: (& 1 0,4 - LARA E RODRIGUEZ Seal: MY COMMISSION #FF138588 EXPIRES July 5, 2018 (407) 398'0153 FluridallotarvService.com APPROVED BY (Revlsed02/24/2014) RPS identification and who did take an oath. NOTAR Sign: Print: Seal: EINA CECIBE NUNEZ bY CCIMMISSION #FF166669 I S • ct bser 7, 2018 1 7) 398-0353 FI ' Id eleVi 'r - as Plans Examiner Zoning Structural Review Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. 'EL- 7'> Owner's Name (Fee Simple Title Holder): /'ed°ia d2 mg- 16' Phone #: 30r 7S3 £3'® y Owner's Address: /2o16 ti![ qg't k' City: fir` k$41 S WY' ' State : Zip Code: /2OS /S t` Job Address (Of where work is being done): City: Miami Shores State: Florida Zip Code: Contractor's Company Name: APYLut '`� rc?� `e l� +'t Phone #: Address: 3eC( it).' /rill' ervACe City:4a.144".' State: Zip Code: Qualifier's Name : Otteno4r4. 6b1,-Qotpu-ef Lic. Number: Ef2COa 4'o ZS. Architect/ Engineer of Record Name: Phone #: Address: City: Describe Worlc State: Zip • de: I hereby certify that the work has been abandoned and/ is unable or unwilling to complete the contract. I hol Miami Shores harmless of all lega Signature er or Agent The foregoing instrument was aknowledged before me this2 iday of ";2011 by PX -90-A /7X -V-0 Who is p o me or who has produced Signature ntractor/architect Co The foregoing instrument was this 2.-b' day of owledged before me 201y who is personally kno' h to me or who has produced as indentification.7D1414(440-44441111. 1111 ' ik t ch O . t<` •- ® �,' x/Nun 1111100 Seal: Notary Public Sign: —0 Seal: Change of Contractor/Architect or Engineer • Miami Shores Village Building Department 10050 N.E. 2N0 Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 A change of contractor, architect or engineer must be done under a permit number. There is a $75.00 charge for a change of contractor. The owner will submit a Change of Contractor Form completed with notarized signatures. If the signature of the previous contractor cannot be obtained the owner must send a certified letter/return receipt notifying the previous contractor, architect or engineer the reason for the change. The owner must allow 10 business days for the contractor, architect or engineer to respond. A permit application must accompany the change of contractor form, with the information and signature of the new contractor. The new contractor must be registered with the Village,or must .Submit the required documents to register with the Village. I . Change of Contractor form completed, signed and notarized. 2. Permit application by new contractor. 3. Required fees. 4. Copy of original letter sent via certified mail along with the returned receipt. In addition to the requirements above the architect or engineer of record must authorized the new architect or engineer to reproduce his documents. The authorization must be in writing and must be signed and sealed. from architects to yacht brokers, from boxers to barbegrie restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business h order to serve you better. For information about our services, please log onto www.myfloridaticeri!se.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations an your new license! RICK SCOTT, GOVERNOR LICENSE NUMBER EC13003181 DETACH HERE DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION EC13003181 ISSUED: 08/24/2014 CERTIFIED ELECTRICAL CONTRACTOR GONZALEZ, CARLOS R SS POWER & LIGHT ELECTRIC INC IS CERTIFIED under the provisions of Ch.489 FS. Expiration date AUG 31 2018 11409240004473 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 GONZALEZ, CARLOS R SS POWER & LIGHT ELECTRIC INC 7760 SW 26TH ST MIAMI FL 33155 PId 0iq:ZO NOW/9IOZ/9Z/ddV I LN 3 'MMzN wn3a , 002174' Local Business Tax Receipt Miami Dade County, State of Flori -THIS is NOTA RILL - DO NOT PAY 5877072 Sus,N ss moodmi .omknoN s s POWER & uc1:1r ELECTRIC INC 7760 SW 26 5T MIAMI FL 33155 °lemma S OWER $ UGIIT ELECTRIC WC REOCIPT No. RENEWAL 6130017 EXPIRES SEPTEMBER 30, 3016 Mug be di/Val/ad at place of bueinaya Annus= to County Cade CivpterSA—Art. S& 112 SEC. TYPE OF BUSINESS E ELECTRICAL, CONTRACTOR PA etatiT men 8Y TAX cou. cTOR $75.00 09/O8/20I5 ECHECK--15-161870�Tex �ptetc patOtte Lopail Tax. The F kaaotffie1sest tlY et assonsiessang 1lars W icia.Dp teak soy geressesetei acapr al. sham emsbs displayed ee all solonistsialvehicles— Cads Seees-ve..xlsit Forman yatardebaidaftlestaamumac ZOO 'd 0059 1719 OIZ '°N XV I LN Nd 0f7 : ZO N0 /9I OZ/5ZMV CERTIFICATE OF LIABILITY INSURANCE Nww 1/5/2016 Date Producer, Plymouth Insurance Agency 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938-5562 Insured: South East Personnel Leasing, Inc. & Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Coverages This Certifies is Issued as a matter of hifn tjan only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage insurer A: Uon Insurance Company Insurer B. Insular C: NAIC # 11075 insurer D: Insurer E: The polish= cdtnsWence listed below have bean Reined to the insured named above for the policy period indicated. Notwithstanding any requirement, term or mindtpon of any contract of other document with respect to which thin certificate may be Issued or may pertain. the ineuranbe afforded by the policies described herein is subject to all the terms, exclusions. end conditions*? Such policies. Aggregate limits shown may have been reduced id dolma. ISR ADOL Poll Bc ration LTR INSRD Type of Insurance C1 pI Policy Effective Dater (MM/DD/YY) Policy Number GENERAL LIABILITY �-- Commercial General Liability Claims Made Occur s General aggregate limit applies per; Policy ❑ Project ❑ LOC AUTOMOBILE LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Non -Owned Autos EXCESS/UMBRELLA LIABILITY ROccur claims Made Deductible Date (MM/DID/yy) Limits Each Occurrence a Damage to rented premises (EA oocwrence) $ Med sera Personal Adv Injury $ a General Aggregate 3 Products - Comp/Op A99 $ A Workers Compensation and Employers' Liability Any proprtetodpartrterrexeafive officer/member excluded? No If Yes, destxlbe under special provisions below. Combined Single Limit (EA Accident) Bodily Injury (Per Person) 3 Bodily Injury (Per Accident) t$ Property Damage (Per Accident) Seth Occurrence 3 Aseregate WC 71948 01/01/2016 01/01/2017 X WC Matte- f tory Limits 0T14 ER E.L. Each Accident g1.0oo,000 E.L Dineric - Ea Employee $1,000,OOp E.L. Disease - Policy Limits $1.000,000 Other Uon Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of OperationsILocationsNeh101e5/Exclusions added by Endorsement/Special Provisions: Client ID: 91-68-441 Coverage only appites to active employee(s) of South East Personnel Leasing, Inc & Subsidiaries that are leased to the following "Client Company": SS Power & Light Electric Inc Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s), while working in: FL Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or by calling (727) 938-5552. Project name: ISSUE 12-23-15 (TD) REISSUE 12-30-15 (MV) / REISSUE 01.04-16 (TLC). REISSUE 01-05-16 (PH) CERTIFICATE HOLDER CANCELLATION Miami Shores Village (Building Department) 7.0050 N E 2 nd Avenue , Miami Shores, Florida 33138 1L�tt Hare 8/1O/xo1s Should any of the above deavaibed palides be cancelled berate the expiration dorsi thereof, the Issuing Insurer will endeavor to mail 30 days written notice to the certificate holds r named to Inc left. but failure to do so Mall impose no obligation or liability of any kind upon the insurer. Ice a9arrls or representatives, NMI X00 'd 0099 f7I9 OIZ '°N XV HIND D 'Itl3INawma d lig:ZO NOW//9I0Z/9Z/ddV May. 3. 2016 12:04PM FIRST CLASS INS No. 5736 P. 1/1 ASC Rte® CERTIFICATE OF LIABILITY INSURANCE DATE (MMJbDIYYYY) 05/03/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW: THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the CorUticate holder is an ADDITIONAL INSURED, the policy(lea) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the polity, certain policies may require an endorsement. A statement on thle certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER First Class Insurance Market 4101 NW 9th Street Miami, FL 33126 Phone (305) 441-2997 INSURED S&S POWER & ELECTRIC CORP 7418 NW 8TH STREET MIAMI, FL 33126 Fax (305) 441-6443 CNAMNTEACT pet. No. Fxq; (305) 441-2997 DD ESS; fcimc@aol.com (CAC. N,1: (305) 441-6443 INSURER(S) AFFORDING COVERAGE INSURERA: WESTERN WORLD INS COMPANY NAIL 4 INSURERS ; INSURER C ; INSURER 0 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MIS▪ R TYPE OF INSURANCE POLICY EXP (MMmn1WYYl LIMITS COMMERCIAL GENERAL LIABILITY $ 1,000,000.00 p CLAIMS -MADE ❑Q OCCUR DAMAGE TO RENTED 100 000.00 ❑ PREMISES (Ea 0 urrencet $ , MED EXP (Any One person) $ 5,000.00 AODLSUBR ISR MCI (MM/DDYIYYYYI POLICY NUMBER GEN'L AGGREGATE LIMIT APPLIES PER ❑ POLICY 0 !Et 0 JECT ❑ OTHER AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ UTOS O ❑ HIRED AUTOS LOC SCHEDULED AUTOS NON -OWNED AUTOS LISRK 12/04/2015 12/04/2016 EACH OCCURRENCE PERSONAL &ADV INJURY GENERAL AGGREGATE $ 1,000,000.00 s 2,000,000.00 PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ ❑ UMBRELLA EIA$ ❑ EXCESS LIAR ❑ OCCUR ❑ CLAIMS-IAADE ETENTIONS Q.OMIONEDISINGLE LIMIT tee scciaenl $ BODILY INJURY (Per person) $ BODILY INJURY (Per aocldent) $ PROPERTY DAMAGE /Peraeeidentt $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETORIPARTNER/EXECUTN EE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) 1f yes, describe under DESCRIPTION OP OPERATIONS belay N IA EACH OCCURRENCE AGGREGATE $ $ $ ❑ PER 1-1 ER EL EACH ACCIDENT $ E.L DISEASE - EA EMPLOYE 5 E.LDISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS, LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule. If more space Is required) ELECTRICAL CONTRACOR LICENSE # EC13003161 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE (BUILDING DEPARTMENT) 10050 NE 2ND AVE MAIMI SHORES, FL 33138 ACORD 26 (2014/01) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE IRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AC ORD CE WITH THE POLICY PROVISIONS, AUTH 0 R RE$ENTATIVE ®18884014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 al - Residential Clfassi ca on Additioeration Pe ► t'', r APPROVED Parcel Number Expiration: 07/06/2016 Applicant 1208 NE 95 Street Miami Shores, FL 1132060144100 Block: Lot: PEDRO DE MELLO Owner Information Address Phone CeII PEDRO DE MELLO 1208 NE 95 Street MIAMI SHORES FL 33138- (305)753-5504 1208 NE 95 Street MIAMI SHORES FL 33138- Contractor(s) AMENGUAL ELECTRIC INC Phone Cell Phone (954)410-6364 Valuation: Total Sq Feet: $ 11,372.15 00 Type of Work: NEW ELECTRICAL CABLE FOR LIGHTS AND Additional Info: Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $7.20 $5.97 $5.97 $2.40 $398.03 $9.00 $9.60 $438.17 Pay Date Pay Type Invoice # EL -7-15-56503 07/28/2015 Check #: 404 01/08/2016 Credit Card Amt Paid Amt Due $ 50.00 $ 388.17 $ 388.17 $ 0.00 Available Inspections: Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical Underground W. W. 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, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning,..Euttaerratare. I authorize the above-named contractor to do the work stated. C"------Aoed Signature: Owner / Applicant / Contractor / Agent Building Department Copy January 08, 2016 Date January 08, 2016 1 BUILDING PERMIT APPLICATION ❑ BUILDING /'/ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ELECTRIC ❑ ROOFING ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS RECF TVED JUL 2 S 2015 FB'C 20)9 Master Permit No. ") '95 Sub Permit No.Ei 15 s / KcP ❑ REVISION ❑ EXTENSION ❑RENEWAL CHANGE OF ❑ CANCELLATION ❑ SHOP f-� (;� `� �j G'� CONTRACTOR DRAWINGS JOB ADDRESS: /20(g t/ ` S ed City: Folio/Parcel#: Miami Shores County: //-3204 -0l'/-'%/60 Miami Dade zip: 33138 Occupancy Type: Load: Construction Type: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple TittIeholder):r/dIrO7v�'1�tii'Y/ o'e &lre6 de,-/e/ieq S Address: /105 A tF 7f4 City: 1414A gi..or") State: ` Zip: 33/38 BFE: FFE: Phone#: c' i 7 3 3 .Ci Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Address: City: int M 14' \ L kiL pholleiteprV W0' gP37,siJ lz M / --)91/4 i Sty Qualifier Name: Zip: 13 /74 Phone#: State Certification or Registration #: e oeo /J . i( Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ )1111- 1-1 Square/Linear Footage of Work: Type of Work: ❑ AdditionA❑ Alteration (�fo❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Alm � 16 eL14ov /� 4 RA t % S(C-Krt-vit-,,, 0) h -/-,S i vt t..c 1.e 4 4o-1/ Grptti ow71/21) aced)),�, Specify color of color thru tile: Submittal Fee $ : ®6 Permit Fee $ CCF $ Scanning Fee $ o I/" 1 Radon Fee $ ,„e?DBPR $ Technology Fee $ Training/Education Fee $ 2,„ -10 Structural Reviews $ (Revised02/24/2014) CO/CC $ Notary $ Double Fee $ Bond $ 7 TOTAL FEE NOW DUE $ o Bonding Company's Name (if applicable) Bonding Company's Address City State 1 Zip Mortgage Lender's Name (if applicable) ,NUJ Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the abs ce j h posted notice, the inspection will not be approved and a reinspection fee will be charged. OWNER or AGENT The foregoing instrument was acknowledged before me this day of M r, ,20 IT— , by �. t vim Gbh is personally known to P � me or who has produced D 3' V oGI9 92 % t{ 0 identification and who did take an oath. NOTARY PUBI : Sign: Print: Seal: ********************** APPROVED BY (Revised02/24/2014) as JORGE ROSSt U MY COMMISSION hti> "i; x;r < `g :.ter CONTRACTORt (10 The foregoing instrument was acknowledged before me this day of Ai 414' , 20 /5 , by fr , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: SEAU Mts210N ii'F1i9415 04661 V i Plans Examiner Zoning Structural Review Clerk