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RC-18-509 ,I Inspection Worksheet Miami Shores Village 10050_N:E.2nd Avenue Miami Shores, FIL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-302296' Permit Number: RC-2-18-508 Scheduled Inspection Date:April 24,2018 Permit Type: Residential Construction Inspector. Naranjo, Ismael. Inspection Type: Final Owner: FISCHER, DIANNE Work Classification: Alteration Job Address:1250`NE 95 Street Miami Shores,FL Phone Number 'Parcel Number 1132060144070 Project: <NONE>' Contractor: PREINER DEVELOPMENT& ENTERPRISES, INC. Phone: (954)922-9505 ... 11111�1-��I II��N II�YYIIYI�Ir Building Department Comments a REMOVE OLD TILE, TOILET, VANITY, BATH TUB, n ractio Passed Comments INSPECTOR COMMENTS REPLACE FAUCETS. False Inspector Comments' Passed , ,Failed Correction Needed ..: . ..... ... Re-Inspection k Fee No Additional Inspections can be scheduled until re-inspection fee is paid. u k , , I .. April 23,2016 For Inspections please call: (305)762-4949 Page 35 of 35 Permit No. RC-2-18-508 Miami Shores Village Permit Type:Residential Construction 10050 N.E.2nd Avenue NE Work Classification:Alteration Miami Shores,FL 33138-0000 Phone: (305)795-2204 Permit Status:APPROVED Issue Date:3111=018 Fxpi ration: 0910 8/2018 Project Address Parcel Number Applicant 1250'NE 95 Street 1132060144070 DIANNE FISCHER Miami Shores, FL Block: Lot: Owner Information Address Phone Cell DIANNE FISCHER 1250 NE 95 Street MIAMI FL 33138-2550 Contractor(s) Phone Cell Phone Valuation: $ 27,890.00 PREINER DEVELOPMENT&ENTERPI (954)922-9505 (954)937-4071 Total Sq Feet: 0 Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved: :In Review Final PE Certification Date Denied: Window Door Attachment Type of Construction:REMOVE OLD TILE. TOILET,VANIT Occupancy:Single Family Framing Stories: Exterior: Insulation Front Setback: Rear Setback: Drywall Screw Left Setback: Right Setback: Window and Door Buck Bedrooms: Bathrooms: Fill Cells Columns Plans Submitted:Yes Certificate Status: Review ElectricalReview Building Certificate Date: Additional Info: Review Planning lBond Return Classification:Residential Review Structural Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Mechanical CCF $16.80 Invoice# RC-2-18-66600 Review Plumbing D8PR Fee $12.55 02/27/2018 Cash $50.00 $861.42 U 1 $1 6 Amount 8 t 0 255 DCA Fee $8.37. Education Surcharge $5.60 03/12/2018 Check#: 1606 $861.42 $0.00 Permit Fee $,]836.70 Scanning Fee $9.00 Technology Fee $22.40 Total: $911.42 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. Futhermore, I authorize the above-named contractor to do the work stated. March 12, 2018 Authorized Signature:Owner / Applicant / Contractor Agent Date t Building Department Copy March 12, 2018 I Miami Shores Village RECEWEID B 2 7 018 KP BuILding Department 10050 N.E .2rid Avenue,Miami Shores,Florida 33138 BY• \ Tel:(305)795-2204 Fax:(305)756-8972 i4 INSPECTION!UNE..PHONE NUMBER:(305)762-4949 („ J FBC 20"(- 1-Y✓ BUILDING Master Permit No.ZP T PERMIT APPLICATION` Sub Permit No. k . BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ' k []PLUMBING ❑ MECHANICAL PUBLIC WORKS M CHANGE OF [:]CANCELLATION [D SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 125-0 }City: Miami Shores L County Miami Dade zip: folio/Parcel#:1- 73.2 0-6-0 P1T�1 d 7Is the Building Historically Designated:Yes NO k Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: � "hN� 5-- _ OWNER:Name(Fee Simple Titleholder): DC� � 4- 1 S�e✓ Phone#:�S`613— 4 o Address:121go iU 1E I(3Tq-- S--!- City I"'(CI M I State 4:L zip: Tenant/Lessee Name: Phone#: Email:_Dee-Af(e. .��SC �2Y� IC�►,y1�CZIn co✓Y, CONTRACTOR:Company Name:Pr I ne✓ DeyeLo p yye--4 a-hd F-y1TCW)1'644 hone#: _ —T Address: 154 S Q. 14111 ler✓ e City: Hc>RL" c��ci State: -7F L Zip: 3'3020 Qualifier Name: rT� �04L- PP2,t j V R, Phone#:q�t(— State Certification or Registration M C&G 15 2 2 51J0 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address City: —State: Zip': Value of Work for this Permit:$ �,/TIM r '-Y Square/Linear Footage of Work: Type of Work: ElAddition ❑ Alteration 11❑ New Repair/Replace Demolition 3 Description of Work: Re►�o�e OW �l le , '`C71 L�-� ✓C.�ytc�' ba 1 ,` i�w�G�e .C&L,Lce4r� , Specify color of color thru tile: dq Submittal Fee$ E;O 06 Permit Fee$`� ' 1%--/ CF$ CO/CC$ Scanning Fee$ Radon Fee$ z DBPR$ Notary$ Technology Fee$, Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ K IT �- ( ed02/24/2014) 1 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'ali 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature _, Signature��-( -e OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument rwas acknowledged before me this 2 let' day of F'e(.Zy ,a .w 20 S by 2� day of ��y�C��► 20 by 1]IC-Ly%il a r-J ckQ ✓ .who i personally'known k!t'�'�P�L'�('lu�j'C�who is personally known to me or who has produced as me or who has produ as ' an Ah BETH BEALE identification and who did take an oath. identification and wh '9 114Y COMMISSION X FF232163 NOTARY PUBLIC: NOTARY PUBLIC: " EXPIRES-16lay 18.2019 NC/�3WLC:y3 iw0In'*)CRNs1.v1:0.con. Si Sign'_ Print: '✓ Print: Seal: ': Notary Public-State of Florida Seal' Commission 9 GG 16579' My Comm.Expires Dec 9.2021 Bonded trough Nation.Nmary Assn, ssssssssssssssssssssssssssss ssssssssssssissssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss APPROVED BY Plans Examiner Zoning Structural Review Clerk (Reviseo102/24/2014) Property Search Application- Miami-Dade County Page 1 of 1 f U F 1'6 E 'U F T OH"E 'P"R 0 P E R'01='aY'* "A' ""Ph OF" R An I S E R `r Summary Report Generated On:2/27/2018 Property Information {' Folio: 11-3206-0144070 1250 NE 95 ST ti Property Address: Miami Shores,FL 33138-2550 Owner DIANNE O FISHER Mailing Address 1250 NE 95 ST �� t MIAMI SHORES,FL 33138-2550 PA Primary Zone 1400 SGL FAMILY-3001-3250 SQ sF _:l Primary Land Use 0101 RESIDENTIAL-SINGLE FAMILY: 1 UNIT Beds/Baths/Half 4/5/0 f 4, Floors 2 Living Units 1 Actual Area 4,521 Sq.Ft Living Area 3,340 Sq.Ft ft Adjusted Area 3,638 Sq.Ft Taxable Value Information Lot Size 12,500 Sq.Ft 2017 2016 2015 Year Built 1959 County Assessment Information Exemption Value $50,000 $50,000 $50,000 Year 2017 2016 2015 Taxable Value 1 $388,876 $379,850 $376,862 Land Value $450,495 $462,210 $381,270 School Board Building Value $253,205 $253,205 $253,205 Exemption Value $25,000 $25,000 $25,000 XF Value $18,013 $18,013 $12,940 Taxable Value $413,876 $404,850 $401,862 city Market Value $721,713 $733,428 $647,415 $50,000 $50,000 Assessed Value $438,876 $429,850 $426,8621Exemption Value $50,000 Taxable Value 1 $388,876 $379,8501 $376,862 Benefits Information Regional Benefit Type 2017 2016 2015 Exemption Value 1 $50,000 $50,000 $50,000 Save Our Homes Assessment Taxable Value $388,876 $379,850 $376,862 Cap Reduction $282,837 $303,578 $220,553 Homestead Exemption $25,000 $25,000 $25,000 Sales Information Second Previous Sale Price OR Book-Page Qualification Description Homestead Exemption $25,000 $25,000 $25,000 02/01/2006 $925,000 24286-0505 1 Sales which are qualified Note:Not all benefits are applicable to all Taxable Values(i.e.County, School Board,City, Regional). Short Legal Description 5-6 53 42 MIAMI SHORES SEC 3 PB 10-37 W1/2 OF LOT 7&LOTS 8&9 BLK 85 LOT SIZE IRREGULAR COC 24286-0505 02 2006 1 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at hftp://www.miamidade.gov/info/disclaimer.asp Version: http:IHwww.miamidade.gov/propertysearch/ 2/27/2018 I l 'RICK SCOTT,GOVERNOR V KEN LAWSON,SECRETARY .. ARTMENT OF BUSIN SS AND'PR SSI %, `` ,4 `•.' � -� -� ONAL REGULATION �•� , -- - " CONSTRUCTION:INDUSTRY;LICENSING BOARD . `^ , . ` �,�'rCGC1522540✓ ;,-"•^" „+,,,... �..,.�.:, ,.„,..,,,,,•,'+ `w �_a •-, a s. �`'� ;� r ; ,The,GENERA_L^CONTRACTOR,.^” Nam'ed'belbw.dS•CERTIFIED"""^� .. ,, Y 1r, Undertheaprovisions of•Cha ter 489 FS -- "" ``' �:� 'Ex ir`ation`date "AUG..31`2018 +,.' t'` °� „x P.,,. "waw .n• "�w"'�"IA'""�y„�'^+Y' K�.:.-..,�"'^�`�''�.�*a.",p�`"- x�`Y,'`````�"��`'��.,''4, 'hp'`,, ��••.`�0'•e:"�°'> ""'�'""�r1-�„^" ,F fir',-,'" '��""*�++�+�,. r�""-^.x'*ws�IO°�� S""�!".;..�M` �"�'^w„��""y'w,.•*w� 'W,` �'•,,,,,,�`.`�.�"'r'+'"�,+y+,�,�k., °`'��`��' - ILK . I .«<....Hq, rf,,.,ti�i1��~� `�"•,t,. ,'+a`K,,• 'h �+ "`''+, �y,1j�, �'a`�h.�'5�,�`R ` .' tet,, '�. �� �7 PRENER,ANTAL� •�-�„ �= ,,.�' ��..`,m`0. ^,°�M1,��,� � �,�, � � * �, .� PREINER DEVELOPMENTB:ENTERPRISES`jNC ""� `Y•". � "� ` �`'��, � �`' e . 1545,NORTMl1,4THrTERRACE' �`',� '""�a,;;,,,'"`'�,� z_FL.33020. .. N. ISSUED: 06/21/2016 DISPLAY AS REQUIRED BY LAW sEQ# L1606210001178 ; ; ; ; BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2017 THROUGH SEPTEMBER 30,2018 DBA: PREINER DEVELOPMENT & ENTERPRISES Receipt#:GENERALS CONTRACTOR (GENE Business Name: INC Business Type: Owner Name:ANTAL PREINER Business Opened:11/06/2014 Business Location: 1545 N 14TH TERR State/County/Cert/Reg:CGC1522540 HOLLYWOOD Exemption Code: Business Phone: Rooms seats Employees" Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years d Collection Cost Total Paid 27.00 0.00 " 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: PREINER DEVELOPMENT & ENTERPRISES Receipt #lCP-16-00011846 1545 N 14TH TERR Paid 07/13/2017 27.00 HOLLYWOOD, FL 33020 2017 - 2018 ' ! l AC'�® DATE(MMIDDIYYYY) �� CERTIFICATE OF LIABILITY INSURANCE 02/26/2018 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 certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisionsor be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:CT Stephanie Harrison PHONFinney Insurance Corporation ".. ; 954-966-5533 FAX No):954-989-8208 5601 Sheridan Street " ADDRESS: steph@finneyinsurancecorp.com Hollywood, FL 33021 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Intl Ins Comp of Hannover Ltd. INSURED INSURER B Preiner Development&Enterprises,Inc. DBA Preiner Development&Enterprises,Inc INSURERC: 1545 N 14th Terrace INSURER D: Hollywood, FL 33020 INSURER E: INSURER F: + COVERAGES CERTIFICATE NUMBER: 00000000-102392 REVISION NUMBER: 7 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 HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY IG06AO13090-01 09/26/2017 09/26/2018 EACH OCCURRENCE $ 11000,000 �OCCUR AMA T RENTED CLAIMS-MADE PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECT 71 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED IN LE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accdent) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAR H OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY �,I N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ { DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space is required) License#CGC 1522540 CERTIFICATE HOLDER CANCELLATION I , SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Miami Shores Village BLDG department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 Northeast 2nd Avenue Miami Shores, FL 33138 AUTHORIZE REPRESENT (SMH ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by SMH on February 26,2018 at 03:26PM JEFF ATWATER WE CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. i EFFECTIVE DATE: 10/20/2016 EXPIRATION DATE: 10/20/2018 PERSON: PREINER ANTAL SR FEIN: 364775374 BUSINESS NAME AND ADDRESS: PREINER DEVELOPMENT&ENTERPRISES INC. { 1545 N 14 TERR HOLLYWOOD FL 33020 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR I Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only r within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 i Preiner Development & Enterprises Inc. p p Date: State Of:-FL 0 R 1 V 4 County of: &90 W/1g12 1) Before me this day personally appeared 19 A11—JR L PRE who being sworn deposes and say: That he or she will be the only person working on the project located at: j2�c7 Iv I_ . R5 I I� s� ►���� � i C.yyi i S�� i-p� �� Contractor's Signature worn to(or affirmed)and subscribed before me this 2 Gday of t?62018by AW Qq— Personally know Or Produced Identification Type Ica MY COMMISSION#FF232153 EXPIRES May 18.2019 I♦i,i 1,.1:,1!:•(•ji YM1fM{lN4:TVSMVICf:.::CN1' Print,Type of Stamp Name of Notary t a Miami shores Village NNNN NNNN. Building Department 10050 N.E.2nd Avenue �CORIDp` Miami Shores, Florida 33138 Tel:;(305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Worke'rs' Compensation Insurance Exemption t: Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami-Dade , The foregoing was acknowledge before me this 274"'day of_ r-61-y.ar.t 20 By �.�h.�a ��CwCwho is rsonally known me or has produced F as identification. Nota SEAL: JEANE77E MARTINEZ Nota Public—State of Florida t; ry My Comm.Expires Dec 9.2021 ........... Bonded:hrugh Na9ona No:aryAssn. 1 Ma 5�e Y B ccl�vocp rv--% Remo i n g f lew.o✓ toAee v it4 I ZIC2v�t',G✓' 4JLf j nel,y ee1 yayzA �ooYitt e- Acuter' 32` 3© I qw 60 ��o L Pc��IeT f vlcj i t 1 I r 5 W/1-Tc-H �- I-ce+est J p Li � 1f� n < > \ ...... . .. ...... 6272018 . . .... . .. ..... ...... ... . ..... BATHROOM RECEPTACLE ON 2U P CKT . . ...:. ...... AND G.f.1 PROTECTED ADD SMOKE/CARBON MONOXIDE DETECTORS. 3 AND ALL CLOTH AND RUBBER r(" 6 d AM CI _ o8 Miami Shores Village 17 �V APPROVED BY DATE ZONING DEPT �J BLDG-DEPT >UI1.IF;, )COMPIJ �. WITHALLF— C ALj MICkWt l 5 oyes -�--L. J 3 13 d °;1 A W ANI)C01JN FY RULES AND RF-GUI ATIONS f tC, EJC rooy, ,iernocl2L( V\ - - �ere,ove io i t e�j van( f L-Aoyf--vlcf Ac>v e✓ �►nS Cr�� new,, vavtc: Y, ShOe-ev t �s t tet. r � � t �- 0000.. 0000.. 0000 .. 00.00 00000 00:0 0 I Sh+'��V� . 000000 0000 0 . 0 0000.. .. .. gIi �LeC���c U� SI.v r �c 1n BATHROOM RECEPTACLE1 AND G.FI PRp�p AMP CKT ELECTRICAL RE ' N � ,J APPROVED ATE,___ ADD SMOKE/CARBON MONOXIDE DETECTORS. ANY AND ALL CLOTH AND RUBBER 990N qcJ � S�' INSULATED CONDUCTORS TO BE REPLACED. MiCL*21 S1 oreS -�l--_ 3313 o,