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RC-18-2438 (2)PERMIT # CONTRACTOR:SUBMITTAL DATE: ADDRESS: b�- NAME: ITGYlOr WY1S PROJECT TYPE: l4cy-; p r LkQki r ' vcktvt PUBLIC WORKS I� 1 I ZONING PLUMBINGII, l w STRUCTURAL MECHANICAL � rx z ELECTRICAL 8' LDI Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 66 NW 106 ST, Miami Shores, FL 33150-2246 Contacts Kim Issue Date:11/ Parcel Number 1121360050220 Permit NO.: RC-9-18-2438 Permit Type: Building (Residential) Work Classification: Alteration Permit Status: Approved Expiration: 05/14/2019 ELEANOR DOWNS Owner ELEANOR DOWNS Applicant 66 NW 106 ST, MIAMI SHORES, FL 331501246 66 NW 106 ST, MIAMI SHORES, FL 331501246 THE HOME DEPOT USA INC Contractor RAQUELSWANNER 2455 PACES PERRY RD, ATLANTA, GA 30339 Business: 9543360881 Description: NEW VALVE, TUB LINER, AND NEW ACRYLIC WALL Valuation: $ 6,335.00 Inspection Requests: LINER, (NO DEMO) 305-762-4949 Total Scl Feet: 10.00 Fees Amount CCF $4.20 DBPR Fee $2.85 DCA Fee $2.00 Education Surcharge $1.40 Permit Fee $190.05 Returned Check Fee ($30)($51-$300) $30.00 Scanning Fee $9.00 Technology Fee $5.60 Total: $245.10 Payments Date Paid Amt Paid Total Fees $245.10 Cash 09/28/2018 $80.00 Credit Card 11/15/2018 $165.10 Amount Due: $0.00 Building Department Copy 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 construcoo and zoning. Futhermore, I authorize the above named contractor to do the work stated. Owner / Applicant / Contractor / Agent Date November 15, 2018 Page 2 of 2 J� Miami Shores Village =tL.+c C-' \ SEP 13 ' 018 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 FBC 2011 BUILDING Master Permit No. _Rc i a - 243 9 PERMIT APPLICATION Sub Permit No. *BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL *PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 66 NW 106th 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): Eleanor Downs Phone#: (305) 333-7953 Address:660 NW 106th St City. Miami Shores state: Florida zip: 33150 Tenant/Lessee Name: Phone#: Email: edowns100@bellsouth.net CON' Add r City: ►— , - • . Qualifier Name: CAD U( State Certification or Registration #: of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition El Alteration ❑ New � �W Repair/Replace ❑ Demolition Description of Work: N T.W V' VE , � L I `Ee ) -bND 4CZ,4-I LlC 101_I _ 1i Nn CID,-(O. Specify color of color thru tile: Submittal Fee $ Permit Fee $ 90 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ !i ' Q J DBPR $ 2 E35 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ r� TOTALFEENOWDUE$ (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 $2500, the applicant must promise In good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the Job site for the first inspection which occurs seven (7) days after the building permit Is issued. In the absence of such posted notice, the Inspection will not be approved and a reinspection fee will be charge Signature X awxo� OWNER or AGENT The foregoing instrument was acknowledged before me this �-\\,,..day o��f�� //te�n � 20 �� , by .L�I�V � • , who Is personally known to me or who has produced E i cc n or Dawns as Identification and who did take an oath. \�\��ttltitiiiiily/rrr AVIL4 NOTARY PUBLIC: `\\ �,;,gStONF • �% Vp��rEf 1,5 A� ; Sign: w * Q= Print =; ` °,, eo ,atc��, 5$ Seal: '• .. r�gCIG •5 FZ '"�'<?ul41111N� d. Sign ONTRACTOR The foregoing Instrum t was acknowledged before me this day of . 20 119 by who is personally known to me or who has produced / GL-A-4E as Identification and who did take an oath. NOTARY PUBLIC: Sign: .cL/ 2 LCY--f-,Y!/C�LII��(' Print: 19 Seal: n.A. OFFICIAL SEAL PAULA A HOWELL Notary Public, Georgia CHEROKEE COUNTY My Commission Expire: «s««s««sssss«ss«sss«ssssss«««« «s« rs �«s««s«s«ssss«ss«««s* ss« sss*s®f33fiODin�gisg4�4� APPROVED BY Plans Examiner Zoning 0 Home Improvement Agreement: Page 1 Home Depot License Number(s)• Visit www.homedepot.com/c/SV_HS_Contractor_License_Numbers for latest license info EC0001440, CGC1514813, CAC1813767, CFC1426021, CFC1427642, 22640, CCC058327, CGC 1507093, CRC046858, CGCO25763, CRC 1330510 Salesperson Name: ohn Pardo Registration No. (if applicable): Home Depot U.S.A., Inc. ("Home Depot") or service provider named below ("Service Provider") will furnish, install or service the equipment listed below at the price, terms and conditions as outlined on this form. Downs Elly 6322 F4009345 Customer Last Name Customer First Name Store # / Branch Name Lead/Customer Order # 66 NW 106th Street Sho Miami FL 33150� Customer Address City State Zip 3053337963 downs100@bellsouth.net Home Phone# Work Phone# Cell Phone# Customer Email Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE_ TO HOME DEPOT AT HOME DEPOT USA INC., 2455 PACES FERRY ROAD, BLDG. B-3, ATLANTA, GEORGIA 30339 or EMAIL The Home Depot I @ hdi_miamicc@homedepot.com SUPPLEMENT PROVIDES A DIFFERENT CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENTS WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR SERVICE PROVIDER, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY'THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT HOME DEPOT GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OFXi3 M RIGHT TO CAITCELA Acknowledged by: ( ( 107/02/2018 CusTomer's Signature I IFDate Contract Price and Payment Schedule : Payment of the Contract Price is due upon signing unless a different payment schedule is required by law, specified below or in a payment addendum. Contract Price: 1$6335.00 Includes all applicable taxes. Excludes finance charges.' Sales Tax: 1$0.00 (If applicable) *Maximum deposit ONLY applicable in MD, MA, ME (33%), NJ, WI (99%) Dep. 1100,00 % Deposit Amount 1$6335.00 jRemaining Contract Balance $0.00 The Home Depot - 2455 Paces Eerry Road, N.W. Bldg. B-3, Atlanta, Georgia 30339 - Customer Care: 1-800-466-3337 Customer Agreement (C,E,I) (31 Jan. 1a) v 50.1.2 Home Improvement Agreement: Page 2 * Finance Charges : Any interest payments or other finance charges will be determined by Customer's separate cardholder or loan agreement, to which Home Depot is NOT a party, and will be in addition to Customer's payment under this Agreement. Customer is subject to the terms and conditions of the cardholder or loan agreement, as applicable. No funds should be made payable to Service Provider; however, Service Provider may collect Customer's payments made payable to Home Depot. Insurance proceeds will will not ✓ be used to pay some or all of the total amount of sale. Description of Work to be Performed : A detailed description of the work to be performed is included in the paragraph entitled Scope of Work or Specification which is included in this Agreement. Anticipated Delivery Date / Installation Schedule Approximate Start Date: 4105 wks Approximate Finish Date: 5106 wks All dates are approximate and subject to change based on unforeseen events including inclement weather, permitting delays, and delays in confirming insurance coverage of Your claim for any repair, if applicable. Electronic Records Authorization : You are entitled to a paper copy of this Agreement if you choose. If you consent to an e-mailed copy, your consent applies to this Agreement and all subsequent documents and written communications related to this Agreement. By contacting your Service Provider, you may update your email address, withdraw your consent, or obtain a paper copy of the Agreement or related documents at no charge. By providing your consent and verifying your email address above, you con 'rm that you have access to a computer that can receive and open emails and PDF documents. By I ling this paragraph, I consent to receive only electronic records related to this transaction. M Id Initial Acceptance and Authorization : By signing below, you authorize Home Depot to: (a) arrange for Service Provider to perform any Services or (b) order and arrange for the delivery of special order merchandise, including special order merchandise that may be custom made, as specified in this Agreement. Do not sign if blank or incomplete. (Service Provider's or permitting information may need to be provided to You later.) By signing, you acknowledge that: (1) You have read, understand, and accept this Agreement in its entirety, including the General Conditions and State Supplement, if any; (ii) You are receiving a complete copy of this Agreement; and (ili) all rights and interests under his Agreement are s�ollely vested in th�son listed as "Customer" above. �� , X�Zlm 07/02/2018 he Home Depot Customer's Simature_ Date Service Provider Name X 1 07/02/2018 500 NW 12th Avenue, Suites 110 & 112 Co-50ner appl' ab ) Date Service Provider Address X07/02/2018 Fort Lauderdale FL 33309 e On alf drl-fonip Depot Date City State Zip 3518012 _ 2 7-S- Vendor /Service Provider Phone # Service Provider License Number The Home Depot - 2455 Paces Ferry Road, N.W. Bldg. B-3, Atlanta, Georgia 30339 - Customer Care: 1-800-466-3337 Customer Agreement (C,E,I) (31 Jan. 18) v 50.1.2