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Y UR PR���R . 1� ll !J � T��Yp T �T�t FII���Ctt��,�d�►����°T 17'F�Y�UI� LE�1��R+�IR���A�T�R��Y�EF��� ��C R�tN Y 11 � fi1�CE t?�C� EN�C��Vl��IT.� ltfot���i�a,A��#� t�f; ,rts a �sd�Pa�r�tt�th�lssc�an��caf�btrrddin�p� it wtth�n��tfrrrcrted v�taae exc �'t»�r$2.��, �pptac�nt rrausi prur�rl,��Irr g#,��f�ith th�t a�ct��y�f Ch�reotic�a;f� rn��c�rrten#a�td�r�structa�n Ir+er�do�+br��hcrr�waff be��ltve t�€h��a�rs�n �s�pr�,��rtxr�s sub} t� �etrment. A�S�s��c�r�f�ed �y c��th�r�c�re�+er!r�t�t�a���,���mrr�a�rt m�nt r»ust be p te�!t�fi th���b sit� ,�►r i#t�fr insp�eti�rt whi�Ft c�e�ars s�r�n �i')d�rys���r th� bur'trling��rmit Is issu�r�. tra tls� abs�nr�Qf saxcc� pc►st�d nc�tice, th� fr�:s��et'i�n s��tl nt�t be appr� d�rra����ins�e�t��r�fe�w�N��ch� �, ��r��tur�� �� �� � � � . Se�ra�t�r� �V�tiV���r A�EMT` C�{VTRA�1°C?R Th�f ��crsr��ir��trt+t��a�t��x��kra�wl�d$�ci Et���r�rn�t�is "C�e f�r���ir����s��rt�cn��tt v�as a�4c��wi�d��d b��r�rs��t�is � , e d��c�f � ��� �~� bY �� � day of � `�� �p ��� a �� �... � � �� �"'�� t�h�15 p.rs�tt��1y ktt�wit t� r��� r���.t ��,�-'��-�',���� v�rh��s pers�r€�i#y kn�v�n t� � � 3 t�,�� ��i+�S �'t?C�ttC� � � � ������?�`��� ����;��'� �,`����k���`�'� >��`��� 'a� �t.���� � � � � i ��E��z1A��t��1��iP�t�ti�� � � t,„k '.: , �,. . � . ` � � >,.?' �SfS' '� �t ti�i�## ����nrPtc�+did t�k��rs t�. �der��CFi�tit�r��r�d�h�cl1�t�k��n�ath. t �tV 4a � '� � � � � � �� 'N A�iP�ilq�tt�� � �� � � �{ �' � ,�� � . r �� ...�,' � � � �, � �` �"t c.����� ,. , � � , �. . s���: � � � �� ,�. � � _.� � ` � � � .. �___�_____ ;�� � � �, ` ; �1 S C,� �� Peir�t. .�'�`� "� � g � �� kw .., �� � d � �,<p, •:� ���u���.� z ^�r} ��a1: � �Ytg` �t �# @A[E�+B�&��I�pb��30tE'iy�L„+��k7&dV&rtd . a� ¢�tw: � .. 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Pla�s�ac��ir��r ��n�r�� �tr�ctur�l�i�view �E�rk � �;i�oz�� canned vv�th am cann�r 1 �+ \\ "� '�i ��� 1 ����+X�� `� � � � �� ���` � :.�4�� fV�i�rr►i S�to��Vitla�e � � � r � �����i� ���� ��� � `"` � 1OOSO NE 2 Av2 � ��� �k�� � �z � ���� � ��� �� �: �� Miami Shores�13313$ �' ° � �" �����������"���`� «� �r �•,��s.�� 305-745-22Q4 ` ��'� � y }� ; �'fir�"�.,��7� � � � � \� � � ��'����'������`�����C� ;\� v �, � VA � , .. , .:, � ,.aa;:�i . , .. k{��1€� � z,. � ������"���������„ E?tpErati�tt: Q9f�Of 2022 ..�,,..�:, .; ,�,,,� ,�... ��� �. .: z ����. l�e�ti�n Addr�ss R�rc�l Number e v�. �. ..m R.��. e,.� � a_.m.�.. �_ e�� . . u�� . m n_ �,,am �W� ___��.� �.�. � �..� 910Gt NW 1ST 1�VE,M�ami Shcrres, FL 33150 113101Qi6Q�6& a .... . . ���a��?�^�'n��2Fdt4�,'�.�.a�` .. ... .. .�R. . . . . . . .. . . . . . .. �a���Rb . . . . . .. . �QRk�GtS ; PRISC(C�.�REYES Clwner Priscikia Reyes Applieanf ? 910Q 1 92Q0 NW 1st ave, Miami Shores,F!�3315C1 Nome:7865546259 peiscillasamerviEle@gmaii.com HO[�E C3WNER �ontractar " HQME OWNER I E k. . . . . . . . . . . � ... �:1��.:'�`�i'm.� . . . ,�.,,`A*. ..` r�'@'aP.��.�'e.�,.`Y. �0.... n54a��.`§�.�."'"�' �A;.a. , S."l4'e.c'�'.Yi3?3:.L.S':.'..., '��. . ,_....._._.__.�..-_..,..._..._...................._...._......:._.,�..__.n__._.._........._..,..,..e......,,_,_,..,....,.....,.,...._.._......__._._._.....�_.._._��..........._..,,._....,e..__,.........,.,�.......�., ..,...�,,.,._. _........__._._...,e.._..me.,..._._,...._..„..,.,...........�,..,.� . ... . . . _...� � ` It15 E'Ct10R R� tA@StS � �escri��or,:�E�o���iN�FcooRF��2 g�THRo�n�s AN� �� va��,a�on: $ ��,o�o,ao ��������� �i ; KITCHEN REP�ACING CABINETS AND APPIIANCES � j � Tot�i Sq Feet: 2,5�2.04 �� _, ` ; �",\, ` �. � Fe�s Amaunt payments C►ate Paid Amt Faid 50%Renewal Fee $225.d0 Tpt�f Fees $225.0� Tatal. Credit Card 03J30J2022 $225.00 $225.OQ Am�unt Dt�e: $O.QQ �� � �,. ,:..,. ,., � �� �.: �uildirtg ���ar�m�nt GapY In c�nsideratior� of the issuance ta m� of this permit, I agree to perfiorm the wark eovered hereunder in compliance with alI ordinanc�� and e�guiations pertaining thereto and in striet c�nformity wifih the plans, drawings, statements ar specifications submitted ta the praper authorities c�f f�iami Shaees Vill�ge. In accepting this permit I assum� respansibi(ity for all work done by either mysel�, my agent, s�rvants, or emplaye�. I under�tand that separate permits ar�r�quired f�r ELECTRICA�, �LUM�I€4G,�tiECHANi�A�,VrfIRIDOWS, C}OORS, RQC�FING and SWfMMlNG POOl�werk. � QWNEF2 FFI[JAVIT ertifiy a alI the fareg�ing infarm�tion is aeGurate and that a!I work wi(I be do�� in compliance with a!I applicabl� laws r gulat g onstructi zoni g. uthermore, I autharize the aboue named contractor to do the work stated. A � c�ri d Signature:Qwne Applicant 1 � Gontractor ! Agent Date Mareh 30,202� Page 2 a#2 � C � i� i hores Vill� � � � ��a �� J ;�� �� i' � ���� � �� � �� � � �� � ���� �� ul��111 �paC°��1"l�r1t ' ' ' � � �' �� �i2� � ,' t � � � � 1 10C15Q N.E.2nd Aver�ue, fVliami Shares, Florida 33138 Y �.a � ����'... _ � �r�i: (�as)7��-2zo�Fa�:{3as}��s-���� _ � � � � ° � �rvs��cr�ory���v���c��v�rvun����:(�os)��z-a��s �v �� :��� FBC 2Q �"`� U I L I �laster R�rmit No ���. � -��` `�.�`"� � � � '�' � PE IT APPLI�ATI sub�errr�it No.` ���� �� �.�, �" �' � �BUILDINC � ELECTRIC � RQCIFING � REVISION � EXTENSION EW�L [���u�ao�� ❑ �ECHaN���� ❑P��L�cwo��s ❑ c����� Q� ❑ ca�cE�L�-rio�a ❑ s�+o� corv���c-r�� ���wi�v�s � � �o�aa���ss, � ��� ��� � � �itv: Miami Shares Countv� Miami Dade Zip „��� �� Folio/Pareel#:�_.��� � �� �`� ��i,� � Is the Building Historically Designated:�es N� � Qceupancy Type: �1�� ��Coad: Constructian Type: Flaad�ane: BFE: FFE: �;� OWNER.Name(�ee Simpfe TiClehalder�: �� � � C.��t �.� C� �� Phone#; �`��``�`���- ��_�� Address: � � ��� '� �.� � ���� C��.�»� c—�.. City: ��,��'�'�1 C `_.��,���-°� State: ��� Zip: `>��.>�" Tenant�l�ess2e Name: {"E� -�.-�`��r�`l�l Q Phone#: Email: �Ct�NTRACI'OR: Company Name: Rhone#: Address: City: State; Zip: Quafifier Name: Rhone#: State Certificatian or Registratian#: Certificate of Competency#: DESIGNER:ArchifiectJEngineer: Ph€�ne#: Address: City: State: Zip: r Value of Work for this Fermit:$ 1"�.�� �� Squaref t�inear Footage Qf 1Nork: f�' �� Type of Work: ❑ Addition ❑ Alteration ❑ N w � Repair/RepEace ❑ [}emafitian � / e � -�-a F'�. Deseripfiion of Wock; �` � �� t l:U��}f`� �.�- ,�_.. . ''�'� -�"C��� � ,F? � �' �J ? '' C.,� , r��--� �.. _ `��`«'i . �� � � _ ��.�. ��� Spe�ify color of�ofar thru tile: SubmittaE Fe�$ '�� Permit Fee$ C�F$ CG►jGC� Scanning Fee$ Radon Fee$ DBPR� Notary$ Technolagy Fee$ Training/Education Fee$ [�ouble Fee$ Structural Revievus$ Bond$ Tt�TAL FEE IVOW Dt1E$ ���, �� {Revis�dQ2f24f2014j Bondin��ompany's fVame{if applicable} Bonding Company's Address _ �i��J ��3�E ZI�? Mcsrtgage lender's Name(if appfieable} iViort�age Lender's Address City State Zip Applic�tion is hereby made to obtain a permit to c!a the work and installations as indicated. ! certify that no wark or installatican has commenced priar ta the issuance of a permit and that aN wt�rk will be performed to meet the standards of all laws regulating construction in this jurisdietion. I understand that a separate permit must be secured for ELECTRIC, PLIJMBING, Sf�NS, POOLS, FURNACES, SO(LERS, HEAT�RS,TANKS,AiR CQNDITIONERS, ETC..... QWNER'S AFFIQAVIT: ! certify that a!I the foregoin� informatian is accurate and that all work vuill be done in compliance w6th all applieable laws regulating constructi�n and zoning. "WARNING TQ QWIVER: YQUR FAl1.URE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IM YE�UR PAYING TWICE FOR IMPROVENIENTS TC� YE)UR PROPERTY. IF YQU INTENQ TQ t)BTAIN FINANCiIVG, CQIVSULT WITM YQUR LEPV�ER QR AN �► QRNEY �EFQRE RECC)RQING YQUR NOTICE OF CQMMENCEMENT." Notice to Applicont: ,4s a conditican tc� the rssuance of a bui/ding�errrait with an estimated value exceeding$25Q�, the appticanf must promis� in good fafth that a copy of the notic� of carrrmeneerrrent and construction fien taw brochure witt be detivered to the person whose prop�rty is subject to attachment. Atso, a eertified copy of the recorded nofice of commencement rraust�e posted at the jc�b site for the first inspection which occurs sevgn (7) days after the bui/ding permit is issued. tn the absence of such posted notiee, the inspeetican witl nat be ap,nroved and a r�inspection fee wili be charged. � � � r ,� � ��,,. Signature ��' =-' � Signature OWNER or AGEf�T � CONTRACTOR The foregoing instrument was ackncawi�dged before rr�e this The for�going instrumer�t was acknowled�ed before me this � day of , 20 �.- , by day�f , 2Q , by � �"�ho is personally known to ,who is personaliy kn�wn to me or wh� h�s produced as me or who has produced as identificatit�n and who did tak�an oath. identification and who did take an oath. NQTARY PU� C: NOTARY PUBLIC� Sign: Sign: Print: `� �'f 4 � � Print: Seal: ��+��pµ Stf�C�l�A�VAF�EZ Seal: w�p i�x ��C���IESSE6}fi����235273 �'�• ��", ����,�pt��sb�s��2�22 Y'°�.';"�saffk�;��°' � $� #iG tlts *�**��:�k�:������****�� �k *�**�x**�**�k*�c*sk�p*�k***��*�a����*��a�*���*���k*��*�*#��k***��*��*��***�*�:****��: RPPROVEQ BY Plans Examiner Zoning Structural Review C(erk {R2visedQ2f24/2014) � � �,.x� ,•������'��~,M" 4���M-�4� t� ���;.,L� M,�. �� � k� ���`' I I'1'1 I ��S 1'�� � � �E� � � ��t���� �, ��� a ,�`��_� �� � ' � �� � E�uildin De �rtr�ent � ��.������� � � � � ��� � ._ ��� 10054 N.E,2nd Avenu�, Miami Sh�res, �lorida 3313� � ����,�� � TeL(3Q5}795-22Q4 Fax:(305)756-$972 m.�-�"°"`. ����� INSPECTION LINE PHONE NUMB�ER:(305}752-4949 ���� ,���� FB� 2C1 �� B►�J(�(����i Master Permit Na. 1��.-I � � ,��� ,� �"� �T ����� �� Sub P�rmit N�. �u��Qirv� � ��Ec-r��c � RaoFi�� � ��v�s�oN � �xrErvs���► ���rv�wa� �P�um�irv� ❑ r��c�a�ica� ��u���cwoR�s ❑ cwan�GE o� � cA�cE��aTfo� � s�ca� CONTRACTQR DRA11111NGS �oa�,Qr�REss: �� � C���r ��`�� � �� �� �``�.������ P ��`� ��F�'�',� -� � � �; � Cit ; Miami Shores Count : Miami Dad� Zi : �� �,> � �� . � ', Folio/ParceE#: � � � `�� � �� � �� � (,,�"� ��°���;"�.� Is the�uilding Nistorically Resignat�d:Yes NO Qccupancy Type: ���� Load: CQnstruction Type: Flood Zone: �FE: FFE: OWNER: N�me Fee Sim le Titlehalder : � � ����-`�'g �. ���.. � � � � ' `���� ` �'� �-� �� ( p ) � ����� � Phone#: � ��� � Addr�ss� � � C.�� �_ ""�� `,���i _�t,. �� � � City: >� �.�.��`�'�,�, State: �^ _ Zip:.�.? �.��„ .�Tenan�Less�e i�ame: Phone#: :: ,� r Em�il: _� �`��� -�t � ��°�� � t. � '�� � � -�. � �`�l� [ � �� ,� � �� � � j ��`��� � COkVTRACTAR:Company Name: � �` � '�� `� '� Phone#: ������� ���..���"� Address: City: State: Zip: Qualifier Name: Phane#: State Certifieation or Regi�tration#: Certificate af Competency#: €3EStGNER:�rchitect/En�ine�r: Phone#; Address: City: S�ate: Zip: � �'� f �-��''1 ��� Value o€Work for this Permit:$ ��-�� < ��°��r�� � SquarejLinear Faotage of We�rk: ��� ��� Type of Work. ❑ Rddition ❑ Alteration � New � RepairJReplace ❑ D�molition § pA � , � � � Description of 1Nark; '� ,� �` ' �� � ° � �� t �`, - •-, � ``'� � � , = r r� � � �� � r , � a � � � �, . . : '' '�� � �� '`' f�1 � ��' `; �'} � �> �. � ,� '� E:�::<� S�ecify color of�olar tf�ru tile: Submitt�l Fee$ �.:.. � � Rermit Fee$ CCF$ � . C'OjCC$ � Scanning Fee$ � Radon Fee$ �BFR$ Notary$ TechnoEogy Fee$ TrainingjEducation Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAt.F�E N4W DUE$ (Reviseddzlz4l241a) � Bonding Company's Name(if appiieablej Bor�din�Company's Address City State Zip Mortgage Lender's Name(if applicable} Nte,rtga�e L�nder's Address City State Zip Application is hereby made to okatain a permit to do the work and installations as indicated. I certify that na work or installafiion has commeneed prior to the issuance af a p�rmit and that all work will be perf�rmed to meet the standards of alE laws regulatin� eonstruction in this jurisdiction. ! understand that a separate permit must be secured for ELECTRIC, PCUMBiNG, SIGNS, PaQI.S, FURNACES, BC�ILERS, HEATERS,TANKS,AIR CQNQITIt�NERS, ETC..... OWNER°5 AFFI�AVET: i certify that all the foregc�ing information is accurate and tMat all wark will be done in eompliance with all applicable laws regulating construction and zoning. "WARNING TQ QWNERa Yt}UR FAIl.URE TO RECt?RD A NOTICE OF CQMMENCEMENT MAY RESULT IN Y�UR PAYING ICE F�R IMPRtaVEMENTS TC? Yt�UR PROPERTY. IF Yt)U INTEND TC} QBTAIN FINANCING, CONSULT WI?H YUUR LENDER OrR AN AT�"QRN�Y BEFC}RE R�COR�ING Yt)UR NQTICE OF COMMENCEMENT." Ntatice to Applier�nt: As a condiiion tv the issuance of a building permit with trn estimated value exceeding$25t3Q, th�t�ppticant must promise in good faith that a copy caf th�notiee of corrarrrencemenT and construction lien /caw brachure wi!!be delivered to the person svhose property is subject to atfachment. APsa,a certified c�py of the recorded notice of commencerrtent must be posted crt the job site for the first inspeetion whieh e�ccurs seven (7) dc�ys after �he buildtng permit is issued. ln the absenee trf sucia pt�sied notfee, the inspeetion wit!not be appraved and a reinspection fee will be charged. � '' � �g' � �,� , �V � P� Signature � .���"., � � -�`" � �`' Signature �' �,1' OWNERor�GENT,� GOPlTRACTOR The foregoing instrumen�was aeknowledged befare me this The foregoing instrument was acknowledged before me this � ' day of � w� ,20 6 � , by day of ,20____�_, by �'`'�"`� --�^�^^.�44 t� ��.� ��io is personaliy known t� ,who is personafly known�c� me or�uhc�has produced `� �{ - �., ����-°as me ar who has produced �s identifieati�n and who did�ake an oath. identificatiot�and who did take an oath. NOTARY BLIC: NOTARY PUBl.IC: Sig : Sign: Print: ` ��- �� Peint; ,���,�^�sR tdtl��RJFPt��YPU'T6ro� � . ... Seal: :� ;�: �Y��dut{3S��td���239�73 Seal: a��° �:'` �PIRE3,9�pt�r�b�'�,2Q2� ""A�O!%ib,i�s`�� �tU Pitb4�R�#1'�{I�pPi ix�:���**��*���:*��***�*�:***���**x��a� ��� ��*��**�:����***�*�**���:*a�*�***z�**�rt*�**m�:����:����x��****a�****�*�*�** t p ��� �#� APFRC7�JED BY Rlans Examin�r Zoning Struetural Review Clerk {ReV�seaozl�4laoia� ¢ �i � q�$� i�m� hores iila�e ��� ��1 i � ��t �. ���.�.��������,� �. f��ar�i St�c�r��, FE�rid��313� l'�!;(3C}S}795.22C14 ���a�3�5}756.�'�72 � t��� ��J����� �95�L�SLl�E ST°�7'E E�T" �,�r��: .� � �� ���5____� � ����: � ' �� �E��REss. �� ' ' �� � t3c�hereby p�Rifican the Villa�e o�l�iami Sha�res co ac�as t�y awn ec�ntr�etor pursuar€t to the i�wrs af the Se�ce c�f�{c,rida,F.S 489.103{7).�nd I haue reaci anc!und�rsYoc�d the fc�Ila+arin�discBQsu�e sta�err�ent,whieh entitles me te�work as r�y awn c�antracte��;!further ur�derstand tt���I a�the ou�ner must appe�r fe�persor�ta cc�mpl�te�EI�ppPicatie�r�s, St�te Law requ#res canstructiran tc�b�dcane by a Iicensed car�tr�c�or.Yc�u haue appEied for a pees�'st under a��xcepeiee�tc�the Ia�.The�xcmptie,r� aPla�rs yc�e�.as�h�ov�nec a0�c�ur pec��serEy,to ae�ax�t��ar e��rrr�ctarriracts�r eu�n ihough+pou dc�ac�t have a Iieer+s�,Yc�u m�ast sup�ruise t�re constrz�etior�ya�urself.You c»ay buiid or impro�e a flne-family ar o-fami3y resic#enc�.You may��Iso tsuild or impre�v�a cc�mmercial iauildin�aC� cost€�f$25,t3�C�.QO c�r Pess(TPse r���frc�rm st�tes 75,f�fl€�}. ���e, �a�;��±b-a,��r��������c�s�G��:�,���r��:������*�:�€�,���r���.t�r���a�€����;����v����r�€°����.�a �a��s�,t#yc�u sell ar I�ase a building you have k�e�ilt yn�arsel{s�ithie��ne ye�r after the ec�nsYructian is comp9ece,the Iawa v�il!pres�arn�thaC yc+u kauilt ftrr saE�c��-lease,u�ttich is a�rica#�tso»c�fi ehis e�em�s�ipra.���,�e��+�a��a���n~�.�€�s,�a�s�:���e*s��,4��������ss$��a��a�...4�������������€�s��;�������;s�a����a� ��� ��cr��.c�����:€�€��s���t��:��`�ss���a�;�;�'s����,re.����€��ta����a�3���xs�������asr���s�������������ka��:.������a��s���������:,�,.An}r persorr u�arkit��on gre�ur buitdin��r#�€��s nt�t Ei�ensa�t�must s�sa��ur�der yc�ur supenaisis�n arrd musE be err�ployed hy yota,which �ar�s that ypu mu��deducfi F.3.C.A and �ith-h�ldan�s��x�rrd pro�+'rde�rcarkers'com�aensatican fit�r thai e�picay��,ati as preseribed by�aw.!'our cans�ructic�r�rnust compiy u�ith alt appticable la�vs,c�rdsn�nces,bsaitd�n�s ccrdes ane4 zt�nin�regula€ic�r�s. P�����r��d�a�d is�i2��1���#���a���r��h. 2. !�ndersiar�d th�t stat�Ia�,r r�q��res cor�structit�r�tc�be don�by�licensed cernfir�ctos�nd hav���aplied fc�r an aw�er-t�uiid�r pa�rrr�6c und�r an exeen�tti�r�frc�m�k��la�r.Th�ex�rrsp8ic�n speei#rtes ihat k,as ttse owner caf the�ro�rerty Eisied,rnay act as my awn ccanYractc�r w±4ih certain r�strFctirans even i#�oug�1 dra not have a dicen�e. insEia€ �. 1 unt9�rstand ghat buildieag perrriits are r�flt r�quiced tc�b€��igned by a peaperty ca�ner unless h�or she is resp�nsi�a6e fcar the canstructi�rn and �s not hi�En��(�censed ccantraet�r t�ass��rne r�spc�r�si�iil6t�. #nitia� --� 3. 1 u��d�rs�arad thai��s an sa�rrrer builder,i arn�he res nsibt�party of rectard c�rr a permit.I understancf thaC 1 er�ay pratect enysef��rc�m�aa2�r�tia� fnar��iai rtsk t��P�irin�a ii�er�sed cc�niracior and h�ving the permif fit�d En his ar her nam�insE�ad c��rv�y o��r s�,�rv�e,(aisc�u�+de�stand t�«at fihe ec�ntr�cic�r is r�qu'sred by Iaent 4ca b�Iicea�sec4 in Fi€arlda�nd Yo list his�sr#ice�}se numbers on permits ae�d coz�tracts. lniti�I.� �, !understand that i re}ay buEld or irr�prove a one f�mity�r twrc�-f�miPy res6d€�nee or a farm ouibuiltfing.3 rnay a€sc�builti err improve a comrrs�rcial 6ui1dir7g if the costs rft�r�tat exceed$75, .The bui6dirtg ar r�sider�ce musi be Pcar rr,y use ar e��cupancy. it rr�ay na�Y be bui�[or subsB�n4sa6l� imprc� � fc�r ie c�r I�ase.If a buildin�c�r r�slderace thaY i h�v�buit4 ea€subs#antiaily ampr �d rny�el�is sodd or 4eased�itF�an 1 year�#E�r th�! cc�nStruet'scan is eompleYe,the Eaw wii4�r�sum�that t tauil�car s�abstant���ty improved i#for sale or 1<�e,�hich ui�l�tes�he ex��nptian. Ee�itial 5. i undersfand that,as the€�avn�r-buitder,I must provide d'srect,e�nsi4e supervi�ion of the cc�nsirucCia�. a Er�it�aE 6. I uns3ersfand fh�t I ena�r ncat hire an uv7!'scer�s�d persort to act as my et�nir�cic�a or ts�su�er�rise persorss�avcarkir�g vn my building eae res�denee.t� is my r�spansabilify tc�ensur�that the p�rsor€s vvhom I e�ple�y have th�lieense r�quired k�y lae�€anc4 b c 2y csr rr€ur��eip�i ardtr�arte�, r tndtRai � , . �t 7, i u�d€�rsc�rrd tha�i#is�re�u�r�t practices c�f un€�censed perstrr�s to have the prc�p�r�ov�ner c�t�tair�an oavner-h�rtEti�r p�rnti��hat�rronec�c+styr i€tzpli�:s thaf�he pr�ag�erty awner is pro�rieiinp his ar i�er ca�uun iabczr arsd rr,at�*rials,I,�s an c+wner-buifd�t�,rnay be Ps�id Ii�bl�ar�d suErj�etee�tc� ser3t�us fic��ncia#ris�for ara�injurS�s sustain�d by�n dsnEicer�sed persdn t�e his ar em�ic�y�es v�hii� ?r�orkin�on rray prtz�t�rfy.h�9y ht�rz�ec��ner's insura�c�rriay nc�F�Sravide cc�v�rage�c�r thtase dr�}uries. 4�m vdillfulty ac#ing�z ar�cr�er�r-buitcter and�a���!are ofi 2t�e li€�its n#rr�y insurar�ee ec�verage fo�ir�jcsries to workers on my�rop�rt�. trtskaal � �� �. i�nt9eestar7d that i may nt�C e!ele�ate�he resptansibiiity f�r scapervising wpr�ta be a tiee�sed eor��raetc�r wrht�Fs�ot#�cens�s to p�rform che �ucark b�ir�g de�ne.Any p€��sca� e�a�irrg can�y b�ildic��u,€3�ca is not Iieerss�d must�aaark under re�y c3irecfi su�aerwistor�and rnessi tae�mployec#bp rr�e,v�hieh r�e�rts fha�!rz�usY cea�rs�sky�aitfi�larvs requieietg th�withhold3ng caf fet�e�ral€ncr�m�t�x a�k scarial s�cvrit�{cc�nYrdb�s�icsns urxi�e th€� F�dera�l�sutanee Contributit�ns�cY(FtC��ar�d n�ust pro�ide amfa�#e�rs ccxer�pensa�i�s�fc�r the��pk3y��.i ui�sd�rs#anc4 that s�y fa64ur��sa i�ile�c� ehese may subje�t Yc�sep ious frnar�cda!risk. Ini�ia� � 9. E agree tl�at,�s thre party le�ally and financially responsible for thts pr�pased Cpnsfs�cYio�aeiivaty,!�ui€t abide by aII a�apticabie iaro�s�nd requirem�nt that �c�vern�tiwner-bualders as vde#!as employers.I also�nderstand ihaC the Cor�sYrucYsc�n must com�st+g w,�Pth a�#�pp(icakafe lawrs,ordinanct�s,b�adldin�ccrdes, arad znr�i�g re�Gatafic�ns. lr��2i�i � l�l. #understar�d th�e 1 rnay aEatain mc�r�;in�orm�tion r�garding my ok�Iig�ti�ns as a�em�loyer frc�ar�th�:Int�rnai Reven�ae Servic�,the U�ited States SmaEl �us'rraess QdmPniscr�Yic�r,,anc#the FEo�id�Departan�nt of Reu�±nues,I alsca und�rseand e#�at I may cc�ntact the F�or`sda Consiguction Indus�r� Cicensin�6caaec4 a4 85t1.4c�7.2395 ear htt : 'w�uvw,rr� Ictr6etaiicense.com db r €o cilb ]rsde�rh�mE �rsfiYi�I _ ll. I am aa�rar�of,�nd consent#ca,an sa�r�er-b�aiider buildEn�permii applied for in rny rsam�and s�rrclers�ands tP�at I�m t�e party E��ally�nd finaracially res�rctnsi6le tor th�pr�pt��ed cc�nstructi�as��ctiviPy at Che ft�ttc�wing address: 1 � �� �,�'� �� #�ritiaf � 22. i a��ee�o nat�f�h�iae�si� ���d����[crsmed�tely c�f�nr�ade�itians,d�letions.cre c6�at�g�s�a ar�y c�4 tt��E r. e�c�c�t6�at 1 haw��rc�vsdecf on this di�cirasure. �Cltf�.dr'3I � I.i�er�s�d ctsr�irac�c�rs 3re r�gul�t�zi by lav�s t3es`s�;r�ec!to protect th�p�bl#c,If you ce�r��ract wiYh a pers+an v�ht�de�es ncat have�Iic�nse,the �c�nstr4�cYit�n(rretustry Licensin��3 tt�and C1�partrv�enY of�usin�ss�nd Ps�fess�cczr�a]€te�ulaFic�ee may�ez un�tbde�ta assist yc�u wreth ar���i€�ancial loss th�t ytau ssasCain�s�resulY csf csa�tra�tor ma�be 9n ci�ri3 cot�rt,!L!s atso impt�r4an€�or ynu et�t�ndersiand C�Sat.i#aa�unlie�rtsed cs�nkraeitae or esnpic�ye�c�f an ins§ivadua(or firrre is o-n�ured wfhile�rt�rklr�g c�ra yc�ur p€�perfy,yau rv�ay be hetd Iiable for dam��es.3f you c�biain an Q�rv�er-builc4e� per€r3it anti v�ish to hire a I�cea�s�d contr�etor�you wRS!be r�spc�nsib�e ficzr v�rifying+�hether th�ct�ntr�etor is prca�rly Iicc�r�sed and Che status o# the carr��actar's�uc�rk�es ec�mp�t�sakiern eovera�e. ��3tae�a bucldir��permifi e�n be issued>thls disclosur�statem�r�t mus�be cc�mplefi�d a€�d si�raed�a�the pra�r�y a+�rser�nd r�ttasned trr the#acal p�rmiftin�agency resp�r�sib�e�t�r isstaic��the p�rmi�.�cc�py c�f clte pr�perC}r ca�sner's driver lic�nse,th�notarized si�n�8ure a€th�gsroperty oeuner,c�r tai4�er t�+�xe of��rp�i 4ion aeceptat�€�to the Iocal permittan�a�eney ds r�quired�hen the p�rmit is kssu�tf. �V�s�cknc��4�d��d b���r� r��this `�� day a�f � ~� �p �� ,�,- ,F, ..�`p �F � �� ������"'�� ' .�' � � � .,..-�` ���a v��s person��[y�Cr�c��r��c� r�� c�r�nc�a �as ��`"`f �` ��`` � - Prc�duced�h�r� �icer�se c�r�t� ��-� -� � � �s ici�r��ific�tic�r�, t .�.. � ���..�� ����.��....�_�.�� _ c�v���� n���-��� �.�[....�,. . ^cF,�.VP, a3dii61�4 P4b.Y . � . . '� �` t�4Y�� ESS#fJN#�23�Z79 :�; .�� ��4 �e' IR�9e S�pT�m 3,2022 ``a?�o��Qe;r x� A ��� � ����9'!'1��E"��g ���.$ ��. �� !� �,� � ���€� � A�tT�le�i�j�f ��rr�i Sh�r�s ��������-{���.w�� _r_� m�_�_ ....������,����� RE: ��qt����F�r C?�r��r�aai�d�r��st�r P�rrr�it Prc�pert��ddr���;91 (�1� 1�`�v�, �i�rr�i S�or��, F�.33�.5C? �����;� � � �> � �� Pr�ap�rt�{C)�r��r�; �r6�ci10��r�d��rm�r� R�y�� FtaE�t��11-31t}2-�lfi- �t� . 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Ins ecti�n Re ue5ts � Descreption: REMODELIN{a F�QORING 2 BATHRQOMS RND � Valuation: $ 25,OQ0.04 ��,�`�����\�1�������\`�� \4�,,���,�� � KITCHENREPIACIN6CABENETSANDAFPLEANCES � ���,���a,'„�`��y�?��.����t��`���'����`��`Z���\��� ve�� ���� j Total St#Feet: 1,5$2.OQ \�����`,�,����n���i��z���������i\`�����\� ���,z��:;� � Fees Amaunt Paym�nts ��te Paid Amt Faid Applicatian Fee-Other $50.00 Total Fees $49$.50 CCF $9.0o Credit Card 12J26j2Q18 ��p,pp D6PR Fee `��•�S Ceedit Card C73/25J2019 �qq�,�p DCA Fee $4.50 Edueatian Surcharge ��.�p AmOutlt Du�: $p.00 Notary Fee $S.OQ Permit Fee $40Q.OQ Seanning Fee $9.OQ Technalogy Fee $11.25 Totaf: $49�.50 Ui� It1 � GCt� Q y In consideration of the issu�nce to me of this p�rmit, I agree t� perfc�rm th� work co�er�d her�under in eompfianc�wi4h aEi ordi�anr�s and e�gul�tions pertaining th�reta and in strict conformity with the plan�, dr�wings, statem�nts or specificatior�s submitt�d to the prop�r authorities of Miami Shares Vi#I�ge. in aecepting fhis permit E assum� respansibiiity fcar all work d�ne by�ither myself, my agent, servant�, or�mployes. I understand that s�p�rate permi#s are r�quired fc,r EL�CTRI�AL, P�.EJt�BING,MEGNANICA�,WIN[�{�WS, DOORS, ROf��lNG and itNIMMIN�PC?OE work. QWN�F2S A�IDAVIT: I certiiy th all the faregaing information is accurat� and that all work will be d�ne in compiianc� with aIl appficabi� laws reguEating #ructivn ning F thermore, I authorize the�bave narned contractor t�do th�work stated. � , Rutho zed Signatue�:Owner 1 Applieant! Gontractor / Agent Date � IVlarch 2S,2d19 Pa�e 2 of 2