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DEMO-17-65Permit No. DEMO-1-17-65 sN°Rhs , Miami Shores Village Permit Type: Demolition 10050 N.E. 2nd Avenue NE I Work Classification: Building Miami Shores, FL 33138-0000 PerFPet2»it Status: APPROVED �M . Phone: (305)795-2204 <otitDP` issue Date:1/2712017 1 Expiration: 07/26/2017 Project Address Parcel Number Applicant 1569 NE 104 Street 1122320320160 Miami Shores, FL Block: Lot: ALAIN & CARLY GONZALEZ Owner Information Address Phone Cell ALAIN & CARLY GONZALEZ 1569 NE 104 Street (786)277-9756 MIAMI SHORES FL 33138- 1569 NE 104 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone HOME OWNER of Demo: Building itional Info: REMOVE KITCHEN CABINETS REMOVE INT ;sification: Residential nning: 3 Fees Due Amount CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 Valuation: $ 750.00 Total Sq Feet: 0 Available Inspections: Inspection Type: Final Review Building Review Plumbina Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO-1-17-62574 01/10/2017 Credit Card $ 50.00 $ 64.60 01/27/2017 Credit Card $ 64.60 $ 0.00 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. Futherrnprs-,-et�tt�ieci�e the-abay-e-named contractor to do the work stated. January 27, 2017 Authorized Signature: Owner / ontractor / Agent Date Building Department Copy January 27, 2017 R14 ,`�� Miami Shores Village � - 10050 N.E. 2nd Avenue NE " Miami Shores, FL 33138-0000 feed ` Phone: (305)795-2204 W R1DA Permit Permit No. DEMO-1-17-175 Permit Type: Demolition Work Classification: Electric Permit Status: APPROVED issue Date:112712017 1 Expiration: 07/26/2017 Project Address Parcel Number Applicant 1569 NE 104 Street 1122320320160 Miami Shores, FL Block: Lot: ALAIN & CARLY GONZALEZ Owner Information Address Phone Cell ALAIN & CARLY GONZALEZ 1569 NE 104 Street (786)277-9756 MIAMI SHORES FL 33138- 1569 NE 104 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone LONGMAN ELECTRIC INC (305)758-1211 /pe of Demo: Electric lditional Info: DISCONNECT POWER lassification: Residential -annina: 1 Fees Due Amount CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 Valuation: $ 350.00 Total Sq Feet: p Pav Date Pav Tvoe Amt Paid Amt Due I Invoice # DEMO-1-17-62695 01/27/2017 Credit Card 01/24/2017 Credit Card $ 58.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final 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. January 27, 2017 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy January 27, 2017 1 M 11 Miami Shores Village JAN 10 Z017 Building Department BY:� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING FBC 20 '(4 Master Permit No. cL )C n k-:) — (05 Sub Permit No. ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I5 'C>q N t> to ,-+ S City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Phone#: -7 8(0• �1 7 '9 -1 S(p Address:M City: / / � Gl r✓� i ��.o+S State: -L• Zip: .3313 FA7.1 . Tenant/Lessee Name: Email: one#: CONTRACTOR: Company Name: 1 COI 1 lc w3 a,4 Phone#: Address: City: State: Zip: Qualifier Name: State Certification or Registration #: ne#: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ S go Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace Demolition Description of Work: l2-E�� k-�c.�w� C4�► aG T3 12E +K o.�� 1 nI� • �X t �A 1i�j Specify color of color thru tile: Permit Fee $ 1 (30 CCF $ - (00 CO/CC $ Scanning Fee $ Radon Fee $ Z DBPR $ Z— Notary $ '--- Technology Fee $ Training/Education Fee $ Z Q Double Fee $ Submittal Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature CD Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of 20 k-1- by w is�—personallyo me or who has produced identification and who did take an oath. CONTRACTOR The foregoing instr ment was acknowledged before me this or - L day of �a4n! J A 2=!- j 20 1:1=by AA. &,,J l.2A A � (A-�Z-_. who ' personally know to as me or who has produced NOTARY PUBLIC: Sign: ,,,,, Print: :�� MY COMMISSION # GG 03143S EXPIRES: December 3, 2020 Seal: 80did Uru Notary Pubic UrAemY4am identification and who did take an oath. NOTARY PUBLIC: Sign: Print: BARD MY COMMISSION # GG 031435 Seal: {;y •*l EXPIRES: December 3, 2020 bonded thro Notary Public UrWervrritert APPROVED BY ` Plans Examiner Zoning as Structural Review Clerk (Revised02/24/2014) -4 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: alj&'. A &o � f,AA3✓-Z_ DATE: I ' 0� • I _�-" ADDRESS: I & Ce 9 (J4--' ( tit: SE. Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one -family or two-family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with -holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner -builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 3. 1 understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates the exemption. Initial 5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. Initial 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county nicipal ordinance. Initial _� --- I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner -builder permit that erroneously implies that the property owner is providing his or her own labor and materials. 1, as an owner -builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that i must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial—� 9. 1 agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govern owner -builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial ��—� 10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http:/Iwww.myfloridalicense.com/dbpr/pro/cilb/index.html Initial 11. 1 am aware of, and consent to; an owner -builder building permit applied for In my name and understands that 1 am the party legally and financially responsible for the proposed construction activity at the following address: IS&.9 tJE 1-0`t yr Initial 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial C� �J Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, If an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this day of Pg4jo,#- 20 l'1-- By A \.A, tJ who wa personally kno o me or who has Produced there License or as identification. OWNER NOTARY ELIZABETH HU' "R"' MY COMMISSION # GG 031435 EXPIRES: December 3, 2020 Bonded Thtu NotuY Pu: +w Undenvii m Property Search Application - Miami -Dade County , t Page 1 of 3 When buying real estate property, you should not assume that property taxes will remain the same. Whenever there is a change in ownership, the IMPORTANT assessed value of the property may reset to full market value, which could result in higher property taxes. Please use our Tax Estimator to MESSAGE approximate your new property taxes. The Property Appraiser does not send tax bills and does not set or collect taxes. Please visit the Tax Collector's website directly for additional information. Owner j ALAIN GONZALEZ CARLY GONZALEZ Mailing Address 12035 NE 2 AVE A106 MIAMI, FL 33161 Primary Zone 1300 SGL FAMILY - 2801-3000 SO Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY:1 UNIT Beds l Baths/Half 4/3/0 Floors 2 Living Units 1 Actual Area 4,580 Sq.Ft Living Area 2.911 Sq.Ft Adjusted Area 3,296 Sq.Ft Lot Size 8,925 Sq.Ft Year Built 1967 Featured Online Tools Comparable Sales Glossary Non -Ad Valorem Assessments Tax Comparison Tax Estimator TRIM Notice ASSESSMENT INFORMATION 9 Year 2016 2015 2014 Land Value $339,136 $312,324 $294,208 Building Value $271,426 $273,650 $242,770 Extra Feature Value $27,317 $17,798 $17,970 Market Value $637,879 $603,772 $554,948 Assessed Value $347,317 $344 903 $342 166 i. 0 o q PA Additional Online Tools Property Record Cards Property Search Help Property Taxes Report Discrepancies Report Homestead Fraud Value Adjustment Board BENEFITS INFORMATION 9 Benefit Type 2016 2015 2014 Save Our Homes Cap Assessment Reduction $290,562 $258,869 $212,782 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Senior Homestead Exemption $50,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, j City, Regional). http://www.miamidade.gov/propertysearch/ 1/10/2017 Property Search Application - Miami -Dade County ti Page 2 of 3 TAXABLE VALUE INFORMATION 9 r 2016 2015 2014 COUNTY i Exemption Value $100,000 $50000z $50,000 Taxable Value $247,317 $294,903 $292,166 _. SCHOOL BOARD...... ,,......_ ......................_ ._._ .... __.,....._._......-,.. Exemption Value $25,000 $25 000 $25 000 Taxable Value $322,317 $319,903 $317,166 Exemption Value $50,000 $50,000 _ $50,000 j Taxable Value . $297,317 $294,903 $292,166 ". ............ ............._..._...___�__........_._.,,. REGIONAL _..._ _._..._. Exemption Value $50,000 $50,000 $50,000 Taxable Value $297,317 $294,903 $292,166 F SALES INFORMATION 9 Previous Sale Price OR Book -Page 11/222016 $1,050.000 30341-3921 For more information about the Department of Revenue's Sol" Qualification Codes, 2016 2015 2014 LAND INFORMATION 9 FULL LEGAL DESCRIPTION 9 RIVER BAY PARK ADDN PB 40-72 LOT 17 BLK 3 LOT SIZE 75.000 X 119 OR 13018 2636 0986 4 Qualification Description Qual by exam of deed I Land Use Muni Zone PA Zone i GENERAL R-22.5, R-23 1300 - SGL FAMILY - 2801-3000 SO BUILDING INFORMATION Building Number Sub Area Year Built Actual Sq.Ft. 1 1 1967 4,580 ......... -...,. Building Sketches Available' EXTRA FEATURES 9 Description Dock -Wood Girders on Concrete Pilings Patio - Concrete Slab Pool 8' res BETTER 3-8' dpth, file 650-1000 of Well -CBS unreinforced Unit Type Front Ft. Previous Owner 1 EDITH K DONALDSON Units Calc Value 75.00 $339,136 Living Sq.Ft. Adj Sq.Ft. Calc Value 2,911 3,296 $271,426 Year Built 1967 1967 1967 1967 Units 176 1,123 1 140 ADDITIONAL INFORMATION The information listed below is not derived from the Property Appraisers Office records. It is provided for convenience and is derived from other government agencies. Calc Value $2,614 $2,466 I $21,960 $277 LAND USE AND RESTRICTIONS Community Development District: NONE Community Redevelopment Area: NONE Empowerment Zone: NONE Enterprise Zone: NONE if Urban Development: INSIDE URBAN DEVELOPMENT Zoning Code: R22.5 - BOUNDARY Existing Land Use: 10-SINGLE-FAMILY, MED.-DENSITY (2-5 ' (" ii DU/GROSS ACRE). Government Agencies and Community Services L- ......... ,_, _......_-.. _ ...... —_. ---„_, _._... ............. ..... _ ...-.. _ r.THER.DVERN.ENTALJURISDICTIONSiness Incentives Childrens Trust City of Miami Shores Environmental Considerations ' Florida Department Of Revenue Florida Inland Navigation District PA Bulletin Board Non -Ad Valorem Assessments I I School Board South Florida Water Mgmt District Tax Collector 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 Miam-Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.govAnfo/disclaimer.asp http://www.miamidade.gov/propertysearch/ 1 / 10/2017 Property Search Application - Miami -Dade County M Page 3 of 3 For inquiries and suggestions email us at http:/Aw .miarridede.goy/PAPortaVContectForMContactFormMain.aspx. Version: 2.0.3 EXEMPTIONS B REAL ESTATE BENEFITS Deployed Military 40 Yr Building Re -Certification Disability Exemptions Appealing Your Homestead Assessment Institutional Defective Drywall Senior Citizens Folio Numbers Mortgage Fraud More > More > TANGIBLE PERSONAL PUBLIC RECORDS ONLINE TOOLS TAX ROLL PROPERTY ADMINISTRATION Appealing your Address Blocking Property Search Appealing your Assessment Assessment Change of Name Property Sales Assessment Reports Information Search Change of Address Tax Estimator Exemptions Change of Ownership Tax Comparison & Title Extension Requests Homestead Declaration of Exemption and Filing Returns Condominium Portability More > More > More > More > Home Privacy Statement Disclaimer About Us ADA Notice Contact Us '.1'.. r 02014 Miami -Dade County. All rights reserved. a; http://www.miamidade.gov/propertysearch/ 1 / 10/2017 0 i� 0 CO pool play area 16'-10" 18'-0" 10'-11" living room lower patio I � I dining d foyer ! Upper patio family room powder maid's room kitchen b hall 3 bath 3 5'-0" L 19'-0" L 13'-2° 19'-4" L 35'-8" 1. Remove existing kitchen cabinets 2. Remove interior paneling. 3. Remove dry wall. 4. Remove popcorn ceiling. 5. Remove existing floor tile. 6. Remove exterior paneling. 41b-XP — ! — e-�L pt=c'TL garage 0 I N RCEC.� IVED JAN 10 20H 17 BY:t�A X W ~ Q Q z O 1 � w Qw � ,I .JJ Q W !L + Ch 1d != mLj z z Q d z LI VN W0 C) o L c�m < \ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JAN 2 2017 f Tel: (305) 795-2204 Fax: (305) 756-8972 BY: jel INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201U BUILDING Master Permit No. bt✓non [ -"" Iz 's PERMIT APPLICATION Sub Permit No. ( 06A-f V 17 -405 . ❑BUILDING P§ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I5c0a VAC LOLl ST_ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Phone#: Address:--/►-�ISCI. s Ce Ok �; i,01 i City: r 1, & .-% "Ag:;s State: 4-- 1 Zip: n:2, � .2, Q- _ Tenant/Lessee Name: Email ne#: CONTRACTOR: Company Name: L©/V Q M Q w E i 'ec�fh L Phone#: 305-7-50 — )A Address: q,s N E, ) (0 to .5/- City: /VQ q/h! , State: rz-- Zip: 3 3 b Qualifier Name: hone#:3e>5- 758.- l a// State Certification or Registration #: L 13 ob 3 7 l 3 Certificate of Competency #: DESIGNER: Architect/Engineer: Ad Phone#: City: State: Zip: Value of Work for this Permit: $ 35113 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Er Demolition Description of Work: Is-c �0 a G CT {� � Specify color of color thru tile: Submittal Fee $ 50 P i ri t> Permit Fee $ 1 G m' m!, CCF $ CO/CC $ Scanning Fee $ Radon Fee $ L DBPR $ Notary $ Technology Fee $ Training/Education Fee $ 2 Double Fee $ --------- Structural Reviews $ Bond $ l� O TOTAL FEE NOW DUE $ 5 e (Revised02/24/2014) Ilk eta a Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 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 // 3 day of --3—IqIVL AJI/L 20 1 by 'D-7 day of J-gNVQ Ly 20 ) 7, by �A: nl � ter► �. Z who '' ne ly knot' o Mir 6- LoNa 9� � , who is sons y know to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: ? Sign: Print: %Vi f G� F,) I C_ PGy e Z Print: % f C �,-)1 e 19 e i- e z Seal: Seal: 00 Notary pubic State of Florida u Notary Pubic State of Florida :y . Michelle Perez . Michelle Perez My Commission FF 000321 My Commission FF 000321 NOR Expires 04/08/2017 or Expires 04/08/2017 ********** * * * * * * * * ********************** ********** APPROVED BY� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)