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RC08-1488 Miami Shores pillage Building Department 10050 NX.2nd Avenue,Miami Shores,.Florida 33138 Tel• 6.8972 BUILDING Permit No. ��`� � � . 2005 PERMIT APPLICATION r Permit No. FBC 2004 Permit Type(circle): uil Rooting Owner's Name(Fee Simple TitleholderH�R®/����� Tl Phone#c�L�.s 7�9'- /4 Owner's Address /219-O U /'✓� /03/�.D vim-%� City Ll �,5� State l`"'Z- Zip Tenant&,essee Name Phone# r Job Address(where the work is being done) 49 $I/ZE /l)c3/Q 57 /�•cs. /�� City Miami Shores Village County Miami-Dade Zip 13-3/ FOLIO/PARCEL# //'•307010 °49,3 5�-�0�91> "W' PB /174 Is Building historically Designated YES NO CELL 7�Y.o -oZo2-f- �7aZ 8' Contractor's Company Name c®tis7�41K7lGA/Phone#3a-:5'02.3 24-,3 0 Contractor's Address !d4ra 77-1 457- 4/, City./2/29-/7 Z -- State �,- Zip Qualifier Name Phone# C��L State Certificate or Registration No.• 5�_ Certificate of Competency No. Architect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$ Square/Linear Footage Of Work: • 170 Type of Work: FlAddition 0Aitera on ONew J !Replace Demol` Describe Work: • o ee���e��e��e�eee�eel ee�e��eee��exeF����+�e+xexa�e�x��ee��x�x�eseee*a*��eees�xeaxsa ti p Submittal Fee$ Permit Feed$ 2 CCF$ 4 C0/CC- Notary$Aoj� Trainiag/Education Fee$ LM Technology Fee$5.4 Scanning$&y•(b Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ e; S t�t1S •�.. �' Reverse side-4 c, 2" rn (Ar Vi �� Bondinj 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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. i "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 COhD4E ICEMENT." 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature Owner or Agent Contrac The fore o' instrument was ackn11o__w��,,ledged before me this The foregoing instrument was ac owledged before me this day of ,0�byS4/L�l� ?�je � � day of t 28 01,by CST COMM , who is rso ally knownme or who has produced who is personally known to me or who has producedA,12'li/O As identification and who did take an oath. r lGl/1780) as identification and who did take an oath. NOTARY LIC: • NOTARY PUB14C: Q� g5 Sign: Sign: 1 ` ®p Print: Print: y 4���` •. °' My Commission Expires: HAQ 9 My Commissio e*ems*eee * e =#t aeeex �* ee* e *ee saee*ee *ee * APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 07/1o/07) OR Bk 26565 Pa 2569; (las) NOTICE OF RECORDED 09/121208 11:22:49 HARVEY RUVINr CLERK OF COURT COMMENCEMENT LASTMIAM COUNTY. FLORIDA LAST PAGE L A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TM OF FBIST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA COUNTY OF DADE THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Chapter 713,Florida Statutes, the following information is provided in this Notice of Commencement: 1.Legal description of property and street address:_t 0 7 i / jeer o"o'l �E14T' j�'� •d9 lJc �'�i//9�i S'jlr'.�� s�rl��v' �jE�a.��1� �'f�Ct(�� �C-�z4�. -cay-r �jt% 2.Description of improvement: 3.Owner(s)name and address: e. +A l + 5_/ v `2r Interest in property: Nate and address of fee simple titleholder. ) 4.Contractor's name and address: le S.Surety:(Payment bond required by caner from contractor,if any) Name and address: / --- Amount of bond:$ 6.Lender's name and address: 7.Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1)(a)7.,Florida Statutes: Name and address: 8.In addition to himself,Owner designates the following person(s)to receive a copy of the Lienor's Notice as provided in Section 713.13(1) (b)7.,Florida Statutes: Name and address: 9.Expiration date of this Notice of Commemment(the expiration date is 1 year from the date of recording unless a different date is specified) Signature of % Print Owner's Name Prepared by: [ j '� ` ��y�Tl�• Sworn to and subscribed befo a this day of 20 � Notary Public Address: t LGi' Print Notary's Name My Commission Expires: ' . RailYta Cuellar Qk", :CIO ssion 2010 IF==104 JUNE{15, � yyWy�,{�ARONNOTABY.c M STATE OF i=LOTIT.-A CCU"F{IDF PAVE I HEREBY('f_'1?i,FY t°-Db'+L`1.t6 iv$it co}s'w OII 5th GftQ t7i3 / fj �'� yf tw°'fti Nr!{'✓�ri°�c1���`.�. 7F,!�� T��! �P/ r r i Inspection Worksheet Miami Shores Village :-------°/Jf 10050 N.E. 2nd Avenue Miami Shores, FL 1 �Catr' `6 Phone: (305)795-2204 Fax: (305)756-8972 ...:.:..:.,:.: Inspection Date: 10/02/2008 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Framing Owner: GENTILE,GARY Work Classification: Alteration Job Address: 1200 103 Street NE Miami Shores Village, FL Phone Number 305-754-6024 Parcel Number 1132060340290 Project: <NONE> Block: Lot: Contractor: G LC3 INC Phone: {305}234-3460 Building Department Comments RENOVATION OF EXISTING BATHROOM APROX170 SQ FT. AND WALK IN CLOSET OCT 0 3 2000 Inspector Comments Passed 0'"- Failed E]_ Correction Needed ❑ Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid. Wednesday, October 1, 2008 Page 2 of 2