REV-16-1642 (3)o//0u/j, i0:1,6.�m.
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, January 5, 2017
City of Miami Shores
10050 NE 2"d AV.
Miami Shores FI 33138
Permit number: RC-6-15-1624
Job site address : 1201 NE 94th street
Miami Shores FI 33138
Who may it concern
I certify that I revise all calculations of the above permit plans.
As per the requirements of the Florida Statutes and F.A.C. 61G15-27 and/or 61G1-18.002 (authorizing
the re -use of plans from one professional to another), I hereby give notice of my intentions to reuse the
engineering work and I will take full responsibility of your drawings in order to comply with this law.
Please let me know if ``\\,�i�iv�/319yiquestions.
\ O D E L G /
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•
Regards, *
0Sss f1. 0RIOP G`���\\
Delgado. P/���lfftl����.
Lic. No. 76040
1240 SW 177th Terrace
Pembroke Pines, FL 33029
(786) 251-1044
No 76040
STATE OF ! �il
•
JAN 062!16
BY:
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. 1rrc-V - ‘6282 •
Owner's Name (Fee Simple Title Holder): Bernard Lee
Owner's Address: 1201 NE 94 ST
Phone #:954-673-6513
City: Miami Shores
State : FL
Job Address (Of where work is being done):1201 NE 94 ST
City: Miami Shores
Contractor's Company Name: I-4.15.. .
Address:
State: Florida
Phone #:
Zip Code:33138
Zip Code:33138
City: State: Zip Code:
Qualifier's Name : Lic. Number:
Architect/ Engineer of Record Name: Cesar M. Cano
Address: 4906 Campo Sano CT
Phone #:305-740-7929
City: Coral Gables
State: FL
Zip Code: 33146
Describe Work: t'tto14 o' Lib.vL` Y MEt, P- :10P1 640C.A •
I hereby certify that the work has been abandoned and/or the•-cen$r/architect
is unable or unwilling to complete the contract. I hold the Building Official and the
M� i Shores harmless of all legal involvement.
Signature
orAg
The foregoing instrument was knowledged before me
this c day of -54,20«,byDz-iTR.c c.CY21S
Who is personally known to me or who has produced
Signature '
Notary Public:
Sign:
Seal:
dentification.
or Architect
The foregoing instrument was aknowledged before me
this 25 day of December , 20 by 2016
who is personally known to me or who has produced
00iii limo/
Notary Public:
Sign:
Seal:
'pNv ssioy•' • fir' '.