RF-07-19-1618RE: Permit # i tt-1-q.- �� L $
PEDRO L. ACEBO
(Print name and circle License Type)
License #: CCC058112
Miami shores Village
Building Department
10050 N. E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
INSPECTION AFFIDAVIT
DATE: J� � � 4
licensed as a (n) Contractor / Engineer / Architect,
FS 468 Building Inspector
On or about - i j ( Q
I did personally inspect the roof deck nailing
(Date & time)
work at 401 NE 95th Street, Miami Shores, FL 33138
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.844 F.S)
Signature
State of Florida
County of Dade:
The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above property
mentioned.
Sworn to and subscribed before me this Z2- d - - -
a'�`tiot�` r'erY PAOLA BASSI
Notary Public, Sate of Florida at Lar g e _ Nota,y Public - State of Florida
�.
;ammission - FF 966911 3
p My Comm. Expir..s ,far 13, 2020
r `q;' of f� an Mar � l+rsnn
`General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S, to make such an inspection, Include photographs of each plane of the roof with
permit # and address # clearly shown marked on the deck for each inspection
Ge 1-4— MinMnieiirninnno
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. 11-3206-014-0600
STATE OF FLORIDA:
COUNTY OF MIAMI-DADE:
THE UNDERSIGNED hereby gives notice that improvements will N%"W6
property, and In accordance with Chapter 713, Florida Statutes, tUfn'ilagimi
is provided in this Notice of Commencement. original Vjjj in
OR BK 31':36 F'3 1133 (1P3si
I-IAR1:?EY RUVILH- 1_LE:RI,. nF C011J :'i
NIANI-DACE COUNTY- FLORIDA
TY OF MIAMI-DADE .+ri Couu
is a true copy of the ur�K
_day of t
AD20
WITNESS my hand an+V ial Seal. � o
IlAI{I.f�V ;ii,:l
:Ldt and County Courts
4 F
TM �IA L!qf2&"served for rding office
Legal description of property and street/address: RESIDENTIAL - SINGLE FAMILY. 1 UNIT
401 NE 95th Street. Miami Shores. FL. 33138
2. Description of improvement:
3. Owner(s) name and address: MIA ) SHORES BAPTIST CHURCH INC.
Interest In property: _OWNER_
Name and address of fee simple titleholder:
4. Contractor's name, address and phone number: ACEBO ROOFING CORP. 4305 E 10 LANE HIALEAH FL. 33013
rznGiaar_1.)F1%d
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number: N/A
Amount of bond
6. Lender's name and address: NIA
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, address and phone number: N/A
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section
713.13(i)(b), Florida Statutes.
Name, address and phone number: NIA
9. Expiration date of this Notice of Commencement:
(the expiration date is 1 year from the date of recording unless a different date Is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OFTHE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature(s) of OfmisorQner(s%�Ijgrized Officer/Director/Partner/Manager
Prepared By �'1 1�1 L _ Prepared By
Print Name • � V Print Name
Title/Offlce . __ S. (� Title/Office
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The foregoing instrument was acknowledged before me this °���' day of-2-,0 (
❑ Individually, or 2Q a�,9 5 t "+ for '116kt"i -%Or(s ('_humA
Personally known, or ❑ produced the following type of identif(c tsson:
Signature of Notary Public: Notary Public 5eele
Print Name: eQiaea to y
(SEAL) +ti Expires 0411 wil
VERIFICATI!2bi PURSUANT TO SECTION 92.525. Ft_ORtaA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in It are true, to the best of my knowledge and belief.
Signature(s) of Owner(s) or Zsi's Authorized Officer/Director/Partner/Manager who signed above:
By - � By
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