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MC-03-20-591
� . � i i r i I I ����r�-����������:rv� �-.��4 �� �f� �#�_� i I � rt �.�r�� �� � i}� ��� ��c�� �.� 1f�050 N,E,2nd Aven�e, Miami Shores, Florida 3�I3$ °� Tei: (�as)���-220�Fax:(�o��7s�-ss�2 ��� ` ',�-�-� ���-� � ����A� EN�PE�TIC}(�LINE P�It'�EVE NUM�ER:(305)762-4949 �e�� � � �� � ��,. � Mast�r Perrnit N�. � � � ��� �"� P"E���� J4�R�.��/Q���� Sub Permit No. � '� ���"�� ����� �auE���r�� � t��c-r�Ec � Rc�c�Fir�� � �Ev€s�o� � �x-�E�s�ca� ���n��w�� ❑��.u�nss�� n��c�A��c�� ��u��EcwoRKs � cH��v�� oF � c,a�eE��a-r�ory � sNo� CONTRACTC?R DRAWifV�S 106 AD[}RESS: � � �} r� Citv� Miami Shares Countv' Miami Dade Zi�� �� � FoliajParcel#: � ����1 ��� � C.,� Is the Building Historically C�esigr�ated:Yes NO Occupancy Type: laad: �onstructiran Type: Flood Zone: B�E: FFE: � �WNER: Nam�(Fee Simple Titleholder): � �.�� � Ph�ne#: Address: � � �..-� � � f� �� City: � ��. � �� State: Zip: � Tenantj�essee Name: Phc�ne#: Emai(: CONTRACTOR:Company Name: �� � � � Phone#:�s��.� �� Address; �� � ��� � c � �m City: � State: Zip: � �°�— 4ualifi�r Name: �_��'1�'� � � � Phone#.���`�� �� State Certificatior�or Re�istration#: ��� � �� � ��____ Certificate of Competency#: ,. E�ESEGNE�:ArehitectJEn�ineer: Phane#: N.. Address: : City: State: Zip: �,.xF� � � � Value of Wark for this �rmit:$ � ,����< .� r�"j��near Footage o�Work: � � �a...� �.�w T e of Work: �� dditior� �� �.,� YP , AlteraE�on ....,..,.u��� �le�nr � ❑ Repairf Replace ❑ DemQlitiar� , �� � Descriptian of Work: �°������.� � Sp�cify colar�of colvr thru tile: Submittal Fee$��� Permit�ee$ � �"� ��-'`�".� CCF$ ��'"'� ' CO/CC$ ��`� Scanning Fee$ � . ��,,� Radon F�e$ � . ��`"� RBPR$ � � ` ��� � Not�ry$ �"� � T`echn�l��y Fee$ � � • ��"� Tr�i�ingJEducation Fee$ �^ ` �� E?oable Fee$ �-� E�1 Structural Reviaws$ �� �ond$ �,� � � Tt?TAL FEE NOW DUE$ ����� ��-� � � � �4 �� �;� (Revised02/2412014) ��'a, `�9' , . E3onding Company's Name(if applicable� Bondin�Campany`s Addr�ss _ Ci�y State Zip �lortg�ge E.ender's f�ame(if�pplicable} Mortgag��ender's Addr�ss � City State Zip I�pplieatic�n is hereby made ta obtain a permit ta e!o the wark and installations as indicated. I �ertify that nea wrork or installation has commenced prior tQ the issuance of a permit and that all work will be performed �a meet the standards of all laws r��ulating construetion in this jurisdietion= l unders[and that a separa2e perrrrit mus2 be secured for EL�CTRIC, P�UM�IN�, �IGNS, PO�LS, FURNACES, ��ILERS, NEATERS,TfiNKS,AIR CONDITIQNER5, ETC..... C}WNER'S �FFI��V(T: I certify that alf the faregoing information is accurat� and that al( wc�rk will be done in campliane2 with all applieabie laws regulating construction and zoning. ,•WARNIN� TC? QWNER: YC?UR FAILURE TU RECC3RD A NOTICE QF GQMMENCE ENT AY RESU�T tN YQUR PAYING TWI�E Ft�R IMPRC}VEM�NTS TQ YOUR ��QPERI`Y. IF YtJU INTEND TA 4BTA1lV FINAN�ING, CQNSl1LT WITM YQUR LEN�ER QR �►N A ORNEY �EF�RE FtECQR�ING YQl1R N�D'TI�E QF C� ENCEMENT.,' Notice to Applicant: As a conditiart to the issuanee af a burtding perr»it with an estimated vatue exceeding$2500, the applicant must promise in good faith fhat a copy of�he natice of commencement and constructican lien (a4v brcachure wji(f tae detivered ta the person w6a€�se propeety is subject ta att-�chr�rent. Atsv, r�certified copy c�f the reearded rrotiee caf corrtmeneerr�eni must be posted aP the job site for ehe first irrs�aectron which occurs s�ven (7f days afcer the building permit is issued. tn the absence af such pcasted nvtice, the inspection wilt not be appraved and cr reinspectrt�rr fee wi(t be charged. � �'`" �f' " , , � �,,. �;� Signature ' _ Signa�ure� � ��~� � ER ar,AGENT CC?(�TRACT�}R The fore oing instru�ment was acknowledged before m��his The foregaing instrum�nt was�eknowledged before me this i d�y of ��., �... �_..��,;"�Y ���day of ig ��. ,2Q � , bY ` �„' ,��...� � --s�- � ��. �`'�- � ��,..� w ei'�wae�sanally k to � � �,,whe�i ersan�Ely k o "°°�� _ ..�. m�or wh�a h�s pro�ie�l -�-�n���a�� rr�e or wha has pro ueed as identifieati�n an ��h��did take an oath. idenEification a ho did take an oath. NQTARY RUBLIC �_����� �C}TARY P IC � ��; �,r.Rs � � 5ign: = Sign: Print: � "� Print: v� �°`��°��`�� L�R�°R COME� SeaE: ��q°�>a��r�, �„�fl�'A�ME� Seal: � " � �r ISS�Q€��FF �dY CC31�tISSIQN A FF��&4 � � EX�E��S:Match 21,2��G ��P����:���lt 29,2U2� � ���'g �'� � � et N� �'`�s,����,�° �a T�na 5�e:�ata�r 5�r�" �� � �i"�era' ����:�*����a��a�x**�s**�*�����*������**������*���m��sm����x�nm����*���:�:�����*z�*����x****�:*��:**��x��*�*������*��*������n � t .M.�t ,� ti � ��"� � �� ��� �,"" � �`� 3 � ,� � ��,�a� APFR�YED BY F� �0 �� '�z � � � ���, P�ans Examiner Zor�ing `,� < 1 Structural Review Clerk (Revised02j24J2014) �� � �.� ������ � '` .����Q �� ��J� �lf�,, {�Ic�t`Tlf ��. ��Q�� SeptECrtbG'r 16, 2029 State of Flarida caunty�f Miama-Qade �efare m� this day p�rsonally app�ared ��rnar�o P1� who, bein� duly sworn, c��pc�ses and s�ys: Thafi he will b� �he or�ly p�rso� vd�arkin��n �he�roject lacat�d �t: 431 �E 94� Stre�t Miami Shc�res, FL 3313� ��' �� Sv��rn t€� �r�d s�bscrib�d b��c�re me�his � c4�y �� , 20 �� by ��°���`��..�`"� �,' � n ����. �� � `��� �� ��� � �. �:::�_. Contractor Signatur� Oii�Il�t IfCi(}WYi � OR Pr uc fd Id�n�ific�tic�n Typ� of I � fic �c�n Prsadueed ��` Prin ;Type or Stamp Name of Notary ����a��'�� �� A G�#�ES � ,� �Y CQ�IMI�SIQ��FF �4 � ����R��:M�rch 29,202� ��a���,�� 9�nc�d'��u�u�g�f��rrySer�� �.�'� �'�� 1 �ra� �a�l� � �P � 1���� � . �,-c ��. �� � �'��I'��� �Q��C} �,�,�nd Av�r��� �'"'" 14�i�rr�i ��c�r��, Fl�rid� 3��3� 1°�[: (3��) 79�.���4 F��c: {3C}5� 7��.��72 1 �" � C C ' 1 � 1 , , u ,«t ,: , , ,. , , , � ;a , }� .1 � � � „ fi , �� ,,, , �,. � rt� s#SZ�c r,�3 r;���,� n��tii�. �:C�� 2��., ti ? �t�,� E � � � � � � �il s� �s�t� :� �tt � � ,� �.� 1� 4 .au : 1 �s � r,,, `;\`�i ���� �1 y lt�� ��^��, 1 :.��� \l,��`Z. .-.1n.e�', \L...} � � iSa`�s 1 {c`Z; � \ S, �.11*���'���`^s,��.�\��, �, la:��.�,'°.,i'�;`'. '�t �.i��,ti... ����a,fi�a,k"��`�m��,��. ��,,, a�\�i. 1. ,s,: t�. �..v,•�, „t ti ��. .���t�i.?�,� t.<,..� 1.«E, u,�,�,���,�,e,`��5.�}���,�c �v���`��,�,,� t'���" � ��� ��c�rid� I,�u,� r�qtaires Wrrrk�rs' ��rr�np�ns�tion zn�ur�nc� �c�ver��e �nd�r Ch�pt�r 444 �f th� �Ic�rie�a "�ta�t�s. �1�. St�t. � �4p.Q5 �ilc�ws�c�rpo t�o�'ic�t�iaa tl�e c:c�n� c�ican iz�dustt�-yy tc��xerrkpt mselv�s frcar�thi�re��ir�zz�e�t fc��°any eozas cti��prc�j�ct p�i�r tc� c�bt�ir�in�a buildan�p� it. P�arsuaszt�c�the�lc�rida Ilivisac�n c�f��t���kers' Ct��pens�tit�n�rnpic��er Facts�rochure� � emplayer in th� �ons ctic�n irzclu�try w�o e loys orze ar mor� p -ti e e�� f�ail-tiz�� eznplc�yees,zrsciuding the c� �r,zraust ob�ain wc�rkers'catnpezasatia�a cc�ver�g�. �c�rpa�rat�€ai�`ie�rs €�r membr�rs a�� liznited liability cozzzparAy (I,LC} in the cozzs ctic�n indnst�yy tnay �lect to be exemgG sf: 1. The caf�c�r o s at le�st iQ p�r��r�t of'th�stc�ck of th�cc�rpor�tic�za, ca�°zn th�c�s�caf LL�,a�taterz�er�t��estizz�to�lae rni�im�z�n ICD gx:rc�nt c� �rshz�sp 2. �`t�� c�f�ices is li�ted �s �z� c��ficer Qf tla� �ozpcar��ic�r� an th� z�cords �f th� �'�oz�t�� I3epa��zezat of�caee,Liviszo�c�f Corpc�rati�ans, d 3. The cor�gzatifln is r��z�t�red a�d listed �s �cti�e tivii� th� Flcsrida D�p e�t caf Sta�t�,T�ivision o�`Corp€ar�t�csns. �It� znoz� th t�re� corporate ca�"ic�rs p�r cQ ra�ian ar�irz�ited liabi�i2y comp y ����ab�rs ar� ailov���d tc� b� �x�rzzpt. Cons�-uctzc�r� �x�rr�pcions are v�id fc�a� a �aeric�d a�'twc� y�ar� or unti� a volunt revc�c�tiic�n is fi1�d t�r�e ex��zapt��az is r�vokced by t����3i�isicrn. ! Yc�ur cc�r�er�ctcar is req�ae�iin���ae �t und�r tl�zs�v�rkers'��rn�e�isat'sc��ex�rraptic�n�r�d h�s a� wl���th�t�e c�r sh�wi1l nc�t�rs� i day I��rc�r,p -�zsae�sn�ri�y��s c�z subcc�ntract�rs fo.r yc�tar�rc��pect.Th�co�t��c�car has grc�videci ��fid�vit�t� � �tta�t h�o�she "�1 b��z�c�n1�perso�a��lorue�3 tc��voxk Qza ys�ur grc�je�t. zn daese circu�sst c�s,NIr i�hores Vzllage d s ncat z��quir�verific�tacrr�c�� w�rk�rs' c€sznpensatiotx iz�sur ��cc�vera�e frcam the caz�tr�ctcar's ct�rt�patty fQr dav labc�r,p t-�i�a��tn�alc�y� €�r�ub�c�s� cec�rs. BY �IG�TIN�'r B�I�tt�}W YC}L! ��I�NC?WI....EI:1Ca� `T'H�'I' XC7LT F3AV� `�i�IIS NC)"I'IC� �. �ktST 'I} ITS Ct� � �. r' � �i�a�� �: ' �ww e� Stat�of�`Icarid� Co�r�ty o��iaqni-T}ade � � � � 'I'�ie f�re�oi�g u�as a� �c�wt�e bef ���e this � day of ��������,2Q j � �,���� : �.�.�.�.�a �,�m� i �y � � _w . p�rsc�r�3lly k�awn�o��oz��s prc�d�zc�d �� , � � „..� � .���� ��..... �s id�ntificatiori. �� ..��, ��A�,: � Q � MY C{�t��CSSI�}N�FF�46f�r EXPERE�:�ar�h 2i,2024 ��a����ar�°� �o Thr��ud��F(�aryServ'