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PL-19-309Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date: 03/21/2019 Parcel Number 671 NE 105TH ST, Miami Shores, FL 33138 1122310120100 Contacts Permit NO.: PL-02-19-309 Permit Type: Plumbing - Residential Work Classification. Gas Permit Status: Approved Expiration: 09/ 17/2019 UNAM 671, INC Owner MARCO BRUZZI 671 H. BETO'S PLUMBING INC Contractor SAYDA WALESKA HERNANDEZ 8454 NW 24 PL, MIAMI, FL 33147 Business: 7863681902 Inspection Description: CONNECT GAS LINE FOR METER TO NEW BACK UP Valuation: $ 1,000.00 Inspection Requests: r55-762-4949 GENERATOR Total Sq Feet: 2,400.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 Change of Contractor $110.00 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $220.30 Payments Date Paid Amt Paid Total Fees $220.30 Credit Card 03/21/2019 $60.30 Credit Card 02/11/2019 $50.00 Credit Card 07/03/2019 $110.00 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 construction anq zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Sjgmm;Fe: Owner / Applicant / Contractor / Agent July 03, Date Page 2 of 2 Miami Shores Village r Building Department j U L o 2019 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 20171 (JA BUILDING Master Permit No. VC—a2-1q_3(�r PERMIT APPLICATION Sub Permit No.(PL- 0�— tc "3__�`1 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ®PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS N CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 671 NE 105 St. City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-2231-012-0100 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): UNAM 671, Inc. Phone#: Address: 671 NE 105 St. City: Miami Shores Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: City: Qualifier state: FI. Zip: 33138 Phone#: l ne#: State Certification or Registration #: CrC Certificate of Competency #: DESIGNER: Architect/Engineer: Victor Bruce Phone#: (305) 310-5030 Address: 370 NE 101 St. City: Miami Shores state: FI. Zip: 3313R Value of Work for this Permit: $ —2600— [Ocz• 'o Square/Linear Footage of Work: 30 L/F Type of Work: ❑ Addition ❑ Alteration ® New ❑ Repair/Replace ❑ Demolition Description of Work: Connect gas line from meter to new back up generator Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 1 V (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. Ma6oftlkWA P- UNAM-671, Inc.) Signature Uo�� Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this c9B J _ day of U 1AQ 20 I G by Marco Bruzzi who is p sonally know to me or who has produced oregoing instrument wasacknowledged before me this 2nd day of JUI7`, ,20 19 by SaNda HfIrli tad ez , who is personally known to as me or who has produced identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Prin : ,l�X'aQ '� �jC�a`1f Print: Seal: LUCIAG. ISASI Seal: VILMA SANCHEZ 1 � my commliSSION i GG 247475 (9 MY COMMISSION ri GG173087 a �� EXPIRES: Decertiber 10, 2022 EXPIRES January 07, 20M sciiC°,••' P�bicUndeMk rsIc APPROVED BY Plans Examiner Structural Review as Zoning Clerk (Revised02/24/2014) Miami shores Village Building Depais'"tment 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR I ARCHITECT Permit N.—ek ax— I _Ct� '3O f Owner's Name (Fee Simple Title Ho!der): NUAM, 671 Inc. Owner's Address: 671 NE 105 St. City: Miami Shores State : Ff. Phone #: Zip Code_- 33138 Job Address (Of where work is being done): 671 NE 105 St, City: Miami Shores State:_Florida Zip Code: 33138 Contractor's Company Name: Marino Construction Engineering Phone #: (786) 443-1685 Address: 17082 SW 91 Ave. City: Palmetto Bay State: Ff. Zip Code 33157 Qualifier's Name: Fausto E. Guerrero Lic. Number: CFC 1429169 Architect/ Engineer of Record Name: Victor Bruce Address: 370 NE 101 St. Citymi MiaShores State: FI. Describe Work: Install gas line from new generator to meter Phone #:_(305) 310-5030 Zip Code: 33138 I hereby certify that the work has been abandoned and/or the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the iami Shores harmless of all legal involvement. o Br Fau E. uer�ro Signature Signature _ �i Owner or Agent Contractor or Architect the forego:ng instrument was aknowledged before me The foregoing instrument was aknowledged before me thfs a8 dayof ,)Ur,Q 20lq,by YCD YUZZI this ,2 day of 21 y �Y Who is p onally kno to me or who has produced who is personally known to me or who h s produced Notary Sign S--al: IS MY COMMISSION I GG 247475 EXPIRES: December 10, 2022 Bonded Thru Notary Public Umerwriiere as indentiBcation. Notary Public: Seal: A as indentification. PATRICIA ACOSTA MY COMMISSION * GG005073 EXPIRES July 24, 2020 RICK SCOTT, GOVERNOR JONATHAN ZACHEM, SECRETARY Floridpr STATE OF FLORIDA DEPARTMENT OF BUSINEStS-AN1D.:P_ROFESSIONAL REGULATION CONSTRUCTION IN,DUSTR (L--tCEN-SI,NG BOARD THE PLUMBING'CONTRACTOR HEREIN ICERTIFIED UNDER THE PROVIS10.14I 40- F?CHAPTER 489 FLORIDA STATUTES HE RN, AID DEZ, tiSi4YDA1ItA;ES {f(A BETOrS=P UN1BiNG' Wit- r 'N 8454 NW 24THYLACE ; M IAM I ' tF L,33147 EXPIRATION--QITE:CJ,GUST 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. i i 002567 Local Business Tax Receipt Miami -Dade County, State of Florida i-THIS IS NOT A BILL - CO NOT PAY 7164646 BUSINESS NAMEAOCA71ON H BETOS PLUMBING INC 8454 NW 24TH PL MIAMI FL 33147 OWNER H BETOS PLUMBING INC C/O SAYDA W HERNANDEZ Worker(s) 1 RECEIPT NO. RENEWAL 7442943 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1428937 SEPTEMBER 30, 2019 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 07/16/2018 CREDITCARD-18-054647 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holders qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above moat be displayed on all commercial vehicle, ads Code Soc 89-M For more information, vUit' ACORh� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/YYYY) 1 l 07;`01; 2019 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: It the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must 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 Ileu of such endorsements . PRODUCER CONTACT NAME: TUNON � ! ROYAL CARIBBEAI11 INSURANCE AGENCY II PHONE FAX a...Eat) 30i fi42 4541 _ ..(_(rvc. Not, 30a 6 I2 1087 E-MAIL ADDRESS: JTUNONROYALII@GMAIL.COM 1772 WEST FLAGLER STREET titIAfV1i, FL 33135 INSURERSS)_AFFORDINGCOYERAGE—_— NAIC0 INSURER A: UNITED STATES LIABILITY INS. CO. INSURED INSURER B:ASSOCIATED INDUSTRIES INS. CO. INSURERC: H. BETO'S PLUMBING, INC. INSURERD: 8454 NV`/ 24 PLACE INSURER E: MIAMI, FL 33147 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 REOUIREMENT, 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 LTR OF INSURANCE ADDLTYPE gUBR POLICY NUMBER POLICY YYY MMLI D YYP LIMITS A.._x ................ COMMERCIAL GENERAL. LIABILITY X CLAIMS -MADE OCCUR X CL17469966 04/15/201904i15/2020 EACH OCCURRENCE 5 1,000,000 PREMISES E rr n S 100.000 MED EXP (Any oneperson) S 5,000 PERSONAL & ADV INJURY S 1 .000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 POLICY ❑PRO- JECT 7LOC PRODUCTS - COMPIOP AGO S 1.000.000 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT fEa accidem) $ __ BODILY INJURY (Per person) 8 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE Per ar id S NON -OWNED HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S ` EXCESS LIAe Cl AIMS -MADE. AGGREGATE _ S L= I RETENTIONS S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N ANY PROPRIETORlPARTNEAtEXECUTIVE Y 1 OFFICERIMEMBER EXCLUDED? Y (mandatory in NH) N/A AW C 1127147 , 04/ 15i2019 4/15/2020 X STATUTE ERH E.L. EACH ACCIDENT — — E.L. DISEASE - EA EMPLOYEE S 1 ,000,000.00 $ 1 .000,000,00 II yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1,000,000.00 DESCRIPTION OF OPERATIONS J LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more apace Ie required) PLUMBING CONTRACTOR,PLUMBING STATE CONTRACTOR LICENSE# CFC1428937 HBETO'S PLUMBING INC.. SAYDA HERNANDEZ IS COVERED UNDER THIS STATE OF FLORIDA INSURANCE POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIW ON— QATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE ACC�E WIT ]H%-1qOLAY PROVISIONS, 10050 NE 2ND AVE aesENTATIVE MIAMI SHORES. FL 33138 LAURIZED 0 1988-20D CORPORATION. All rights reserved. ACORD 25 (20141011 The ACORD name and loco are reaistered marks of ACORD Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption 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 N EDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. LW�..Signature: l 41-mQ oc'A MA/ rilOwner State of Florida County of Miami -Dade The foregoing was acknowledge before me this _X� day of H rA V rl 1 , 20—E-1 - By E mon1 i 6 GG ►" i c l vo ZZ l who is rsonally ""o to me or has produced as identification. Notary: -L"G.1.S a WCOMMMM#00247475 E2 MS. Decanter 10, 2022 Marino Construction Engineering, Inc. DBA Marino Plumbing Solutions License # CFC7429769 17082 SW 91 Avenue, Palmetto Bay FL. 33757 * PHONES. (786) 4431685 * FAX.' (305) 9710240 GENERAL CONSTRUCTION Date. - State of Florida County of Miami Dade To whom it may concern: Before me this day personally appeared �STO �. �U�'22�,�0--_- who being ---------------------- - duly sworn, disposes and says: That he will be the only person working on the project located at.Ape --- — ---------------- - Sworn to affi me a subscribed before me this � 7 ___ day of__r�_%_, ----------------- Personally Known to me ____- OR Produced Identification ____`_� Type of Identification Produced All�� _�1_� Type, Print or Stamp Name of Notary ; �► �° PATRICIA AC08TA My COMMISSION # GG005073 EXPIRES July 24, 2020 (407) 8.0153 FkWWgftt8ry3erv1Ce.00M j a p Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date: 03/21/2019 Parcel Number 671 NE 105TH ST, Miami Shores, FL 33138 1122310120100 .ontacts Permit NO.: PL-02-19-309 Permit Type: Plumbing - Residential Work Classification: Gas Permit Status: Approved Expiration: 09/17/2019 UNAM 671, INC Owner MARINO CONSTRUCTION ENGINEERING Contractor MARCO BRUZZI INC 671 FAUSTO E GUERRERO 17082 SW 91 AVE, PALMETTO BAY, FL 33157 Business: 7864431685 17- Description: CONNECT GAS LINE FOR METER TO NEW BACK UP Valuation: $ 1,000.00 on Requests: GENERATOR 4949 TotalSq Feet: 2,400.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 03/21/2019 $60.30 Credit Card 02/11/2019 $50.00 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 construction dad-4oning. Futhermore, I authorize the above named contractor to do the work stated. Owner / Applicant / Contractor / Agent Date 21, 2019 Page 2 of 2 RECEIVED Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING F B 11 2019 BY: fBC 20 I� Master Permit No. (W- 6 2 " «- 30 Sub Permit No.` — b Z - I q 30 ❑ REVISION ❑ EXTENSION [:]RENEWAL ®PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION [:]SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 671 NE 105 St. City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-2231-012-0100 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): UNAM 671, Inc. Address: 671 NE 105 St. City Miami Shores one#: state: FI. zip: 33138 Tenant/Lessee Name: Phone#: Email: cc r T�--++ CONTRACTOR: Company Name: A A R 1 fd 0 a S CEO 1 Ij:t a sy Phone#: �jOJ — Sa - 6 603 Address: 1-1 g IS 0 91 At1E • t City: t R Yi•t State: r- L , Zip: ,3 3 1 S -1 Qualifier Name: ra[ 5To l fd'cQ g lz Phone#: �3 c.Y �geZ O S a3 State Certification or Registration #: C r C.. 1y A9 I (A 1 Certificate of Competency #: DESIGNER: Architect/Engineer: Victor Bruce Phone#: (305) 310-5030 Address: 370 NE 101 St. City: Miami Shores State: Fl. Zip: 33138 Value of Work for this Permit: $�_(rr7 O • Square/Linear Footage of Work: *V L/F Type of Work: ❑ Addition ❑ Alteration ® New ❑ Repair/Replace ❑ Demolition Description of work: Connect gas line from meter to new back up generator Specify color of color thru tile: Submittal Fee Scanning Fee $ Technology Fee 5 Structural Reviews $ Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $, DBPR $ Co/CC $ Notary $ Double Fee $ Bond $ _ TOTAL FEE NOW DUE $ 60 3(-) (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. Marco ru VP- UNAM-671, Inc.) Signature GO OWNER or AGENT The foregoing instrument was acknowledged before me this —22— day of s V 20 J C1 , by Marco Bruzzi A is pe sonally know to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Lur J G Signature CONTRACTOR The foregoing instrument was acknowledged before me this 010 day of � 01 20 / 9 by Q G• who is personally known to me or who has produced /WX as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: I Seal: '-*'-MY COMMISSION it 000050T3 LUCiA G. ISASI �?�;,��e EXPtRES July 24, 2020 ,*= MY COMMISSION 4 GG 247475 (407) 3W 1 W FloAdeN016 SOMCCcan =?; '.: EXPIRES: Neember 10. 2022 ******** ... Qr4'l�4f+iId4QP4 ****************r************************************************* APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)