CHANGE OF CONTRACTOR �
, ,� '�
�
F 4�� • i !t
x"`�� �� I� I � S I I� u�=� a, ��
t� �� }��� �k��r.�� �
'��°�"�� `` ( r�� E�f� f n � �'� �C1 t 3 �_�� � ����s'#�1
��� ��' �' 1OQ50(�.E.2nd Avenue, Mi�mi Shares, Florida 33138 � � �:� �
� �,� Fd ret:{�o�)���-2�oa F�x:(�o�)7ss-���a �����_ � r:� `�� m _,.�_`
�� INSPECTEON ItNE PHOiVE Nl1M�ER:{3Q5}762-4949 .�-'"'�
r ���.
F 4 ��
'L � M�ster Permit No.��` ��� � �� "�
ER IT LI� 1'°I su�ta P�r�it tuo:��'��. �-, � ��� � , �.�
(�BUILDING � ELECTRIC (� ROOFlNG � REVISIQN � EXTENSiQN �RENEWAL
d PLUMBIRIG � MECHANIC,�� ❑PUBLI�We}RKS CH�NGE QF � G�NCELLATIC�N � SHt�P
� ' CQIVTRACTQR DRAWIfVGS
loB a�Q�Ess: _ �`�. ; �.t� �� �T
Citv: Miami Shores Cauntv. Miami Dade Zip• ���'��
FolioJParcel#: ��� ��� �-���`�� Is the Building Historieally Designated:Yes €VQ� �
Qccupancy Type: Laad: Constructiorr Type: F1ood Zane: BFE: FFE:
QWIVER. Name(Fee Simple Tikleholder}: €�� � �f� '�a� � �� Phone#:
Address: �''� � �� ��
City: �C�� ����� State: �'�r�� ��� _�____ ��p � ��,��� ..�_
Tenant/Lessee Rlame: Phane#:
Email:
co�rRacrc��:cam�a�,y�v��,�: �� � �tr�� �� 1���` Pn�n�#: ��� � � �� ����
Address: ���`2e � '��r"� �r�'
c��y: �-� �� s��ce: ---__ __ ����_
Zip:
Qualifier Name: � ���'� Phone#:
State Certificati�n e�r Registration#: �� ����� Certificat�af Competency#:
DESIGNER:Archit�ct/En�ineer: Phone#:
Address: City: State: Zip:
Value of Work far this Permit:� Square/tine�r Foota�e af Work:
Type of Wark: ❑ Addition ❑ Alteration [� New ❑ RepairJReplace ❑ Demoliti�n
Description of We�rk: ���t� ,�� �� � ���°�'��� ��������f. ��
Specify c�lor�f e�l�r thru til�:
su�mE�t��F��� P�r�,Ec Fee S cc�S ' co/ec�
Scanning Fee$ Radon Fee$ D�FR$ Netary$
Technology Fee$ Training/Education Fee$ Dauble Fee$
Structural Reviews$ Bond$
TQTAC FEE NQW DUE$�. � � ���
(Re��seaoa/zalzQl4)
.
�onding Company's Name{if applicable) "
Bonding Cornpany's Address _
City State Zip
Mortgage�ender's Name(if applicable�
Martga�e Lender's Address
City State Zip
Applieation is hereby made to obtain a permit to do the work and insta(lations as indicated. 1 certify that no work or installatian has
eommene�d prior to the issuance of a permit and that all work will be performed to meet the st�ndards caf all laws regu(atirrg
constructian in this jurisdiction. I understand that a separate permit must be seeured for ELECTREC, PLUNIBING, SIGNS, PQOLS,
FURNACES, �C3ILERS, HEATERS,TANKS,AIR C�N[�ITIONERS, ETC.....
4WNER'S� AFFIDAVIT: ! certify that all the foregoing informatian is accurate and that all work will be done in compliance with all
applicable laws regulatin�eonstruction and zaning.
"VUARNING T4 �WNER: Y�UR FAILURE T� RECORD A NQTICE OF COMMENCEMEIVT MAY
RESlJI.T IN YQUR PAYtNC TWIGE FQR IMPRO�VEMENTS TO YOUR PR(3PERTY. tF YC�U INTEND
T� Q�TAI�1 FINANCIIVG, CQNSUGT WITN YQUR I�ENDER QR AN A �RNEY �EFQRE RECORDING
YC?UR NQTICE QF COMMENCEMENT."
fVotice to Applicant: As a condition to the issuanee of a 6uilding permrt with an estimated va(ue exceeding S2St?U, the appticant must
pramise in good faith that o copy of the notice af eornmencement and consPruction tien taw brochure v✓itt be detivered to the person
whose prapert�r is subject tQ attachment. Atsaa, a eertified copy of the recorded notiee of eommencerrtent must be posted crt the job site
fvr the first inspeetion whfeh �ccurs seven (7� dctys after the building permit is issued. fn the absence of such posted no2ice, ti�e
rnspection wilt not be f roved and a reinspection f�e wild be charged.
,/ �, `" ;,� ,�
� �°" �..,.r..��.� � �� ' ,f' �r,�
� r �
Signature� ���� �— Signature �� ��C%��
..�~'" �
� ����CT�'�INER ar AGENT GONTRACTCIR;1 �
The foregoing instrument was acknawledg�d befare me tl�is The foregaing instrument was�cknow�8ged befiore me this
� � day�f �'"�a�� t � ,20 � , by �" day of � ��J 2Q �`� b
� � , Y
�� P� ��� �e � w�ho is personak(y known to ��e;�� �, ����� who is personaily known to
me or wha has produeed as me or wha has produced as
id�ntification and who did tal�a�"°n�ath. �` identification and who did t��Ce' n aath.�r°�'�
�
NOTARY RUBUC: � �� � NOTARY PUBtEC: � ' �'��
f �;, �' �.F �
� .�°
Sign: Sign:
Print: �E��.� � �S Print: ���.t l�`��.� ��� �� �,
���������p �"� � �����d'��f� Y 6
Seal: �^ Seal; > �
�� ��� is�i�n # T71 ' 3T?�
b� �s�� �
�� �� . r� 15,2�19 =°� �� E�p�r�: �5,20�9
"` " t�ru A�t�n a�y
� � � � � �
��'xa��'° daa��� � �I� � � `O�r�(�°FL,ge�''�� �
r*�*��*�x����**��°��NM9�°**����***��*�*a�:�*�mx��*�z�*�m�sz���m�xmm�:�*���*����*��**4t���*�*��**���s��*��ra��a�**�w�*��:*�m�����
�
� F
APRRQVED BY `�''�� �� � P(ans Examir�er Zaning
Structural Review Clerk
tR�V�5�aa21zatzaic�
� �
� � � � �
�. �
�� .�. �
. �� ����� j'- ...-F�. � �P ` � f � � � .. �
� fl �i e; �'" � �/r' ��
f , ai '' ,s�,�
j�.'�IC5�1�"s&3�ff5� , _ d".�.,�.,��'.-�'� .
��� . , �''°"-' '�1 Y�-'�*z
2�"��Y4��Y#r��'r� (ct�+:,m'ta�,�..��d€�a i¢ "����4 � ..
�F'o-.z..�n r.�ht P�.�.zi:r,:,r?} � "�.', '�'
�y-'�+'P,�a� �i�����c`s_;s��,cf � � �.��..�.� '�.
� .
� y,,,,'i f S�i',�iJf�:k�tk'$tTIC{'�Jd S�'".:XfV�'3� � 'd"�C�9'T T.��?
"�ix'3 d}`��i5�'P'.d'AAPk9 t�,.3}X"3#d �..e �„�,,,�a,j x'l i
�F«�,aF>�3?7�,:ure R�st,°���,�L"+e�tvery�..m......,� _�� ���� � �'�"gd
�" S
__
�,� � �
#���' � � 4 � f %�' �1
_r _ �
� ��i��������� �..>�.�,��am..� _.
°^°� i� "." ��'+.� �-., t ��� ��,�
� ��:� ��_i F 7 8�� � �_�-��. r,a' ,. ____
���' # �',t'�£3 CYP'�'' �X''dCJ {` . i} "`f"p 9
__ e „
� ������ ,4�� . � �.�W*�e„'e� ..__ _ _=__gde__`�-�....._ __ n �
��:f$,�;�'`�kPt#9.ZI�i� �__ ,p__� � „> __m ?�" �b__a,�
:5 s ��A a -e3.
��������;������������������������a������������M
�A rec�i�t t�s,��r�;Fs€ �fr�C�rts'r(Uci Pf€![�.€�!}. �nn�s���c`�;enss�e€�m r�u�ip;,s���rz�tadl
��C�;�€s���€�:�s,:t r,f�ry��r.��,ri�i��. 2ssc�.��res�r,��iznna..ft=y,cPsua�c�3,�I�.a'�
��?�fr�rntv��sf�zf�.w�:c��Ii�;ry r,r�`��:n;�fe� r�tEsrr¢��e u�?cr a�����3tf��<3(E�c�v;�s�i�z�
?3K',iYlC4"u. ` E1•'��_rjry,�,§r;E�"kFSfi�(p!`i4�€t P�.iits S"uU�?�Qc2€iL��.
��i e tr,��rs�arFi r�,itt ic�r�����€�r�� st" �'i�� rr�t.
�'t?es''�,�if�f�1`"t� C�"'.£a'�.£t3��`3f 4��4°z�.�"}:.?s#;z+f('i:i;",.: �.<.".;#��,��:I{'4:Y$f £:(u[{".Jv,V'ili.'eC, (5 s`l:°c�a;;2".
g:,a�;,s�-i�,zEe.�,r.r,u1. ��.i3°��tr r;a�i�re r�cs,sv;i4t�z k�rrs�,�s,c�r
f.3 r1�k".�ad � x�c.a S`Psi r�t�;"c�''i�-t`f
f7�4�E£'tp"€�t'e�E�i�'�"af6#C€�{;�; .n�r`ii3€f ,�t,;��;:.�x E G�:h;�tt;a a,�, �.:3#,�� �
�Ya��,r;xy�>���ase�;��rtr���u��.�€€sesu��ari'#� r;,e„.41 a�:�Eeas��,���ar�:.`:�,U tr��=
�:r;�'a: a,��,r� �r.>z .a�ss..E��cd�oc 5f�v,r�, a+r�ii�,�a> ���;;;
:��?r�uri� P�:'�' �c^:,�i:�t;. �
� _ii��s'(t� �s�E'tfG:u�:� tr(��3REi't'�fC';a E�i'f€CE,.;.'n.�:`L{
�C��rs�ieti n�a .ur€;..<,.�r t f a���,�r�fe f:�r a.,��re i°� ��,�<f� n<i z�=sr 2�y�tr3:�����
��rrr€�t�Mr,�i€n�:S. �,ti y nrE,��u r�:.�r<��t�`�r�r!�� ��s�+�xi�f�
�rr..,�:�.�z¢ce�.rna r�r�r:f=�rrft�v<=,.c�s,.a a,rs�rr,�:�r.;�. ."3y nz r .rx tn f'r,:� :�r.�.>�r..�,�s�as.i�t�r,���;����4
'd'Ql=4#�`r(.`'��E�ti��,.li.`-',�`£"�LG4.,tt�'r`�7'.:f�e,''J,?.;�SxU�3�:sc i{S£,'%�7,d2st�uiEu.E�'�`�s"c.E6j.
i C�ti�,�z'Px¢r'�et��ic���s n�#;i�c�G th� �t'��€�s}�Ye E��y<s�.�crir r r�,i�r�,�s�y%�
�.s��ctrcc€rr�rr3�ai,s�.�n+�,a1S��r,,,¢€�u�,rr�i1 �;cc,��c�i a �t�ai�;r�f c;#m�[iinc$,Et�iict,l��trf�
ur�`�€�'rrt y P?a.i4�r;��,. isS'r'FS?r��;3arrc.if{va vr�a(J li+�:t��it„tc�;�Cx c:t
�s�tr hrE ets�c���a!=c�;:�°��u�;�a��as�;�r Eiiis t;'wru�F,�firtei6��rc€€�,€,S�<�.:.>i.�7*n�{�sr
�rx���.er��r:r ur�t`rkr ra�,�a��:c�f,Y�.s rn�s�n�F.,? C,�¢Y�(i���t��sE,,�ia�v���r,si�;ziic.;"..`c,s
�;e k«fi(��r r� r,rines: €a��[rro.€`�in�.�f yr�,ct�n E,,ess u�^>trm�rk,r,�n th"t�
Pe��;�r�r��¢i�s u�nt€r r�ri c�s;€;�d�a a ra,�„�r�" Ge�fific#i�ai�r�ca"s�ir tS�E?r-z iE��;r�rcr��.�x€tx:�¢rs
c�i�ia:.v�p#.s�z�.�ar.;the r¢c�t�ieaf�s.�s�.�4 f�!rei. �y��,is�3��E a r=,x€Y tc=.h�r��s�+lec�,r f�l�
�su;;�.a r��,�r>�ai haru,c��;+r��¢r�<r�z;cs�,t or�,�e ��Rra��a r a�sv��,=�,n.A€;€;�,rv.;s.s��r;��i:ts€ry�e.
at�c�`c;��c v<=�'.r;�;,n.�xr a P:ae�ic,r�,f eet�r:s�ce�;€[<
er�rrsr+Ic2�°��,�a=�rs;#t f i,G�r�rrestr��#�Purri
l����f{� �fr r'ic I'�i=�i�rr€3�;i?Yc�y€u�r�rz�r,�€s��, 4 a t�,�:��u�3Ya�,F z��r� r ,
;�T' �rxrY�:;����.�,jsu;u au(fi,�vrxrscr.>r� Y 7"r`-:�J�:`fi.n,Gr.�47 .� .
. ���R�� �
�,
� ��,,,� iami hores illage
..� ��� ����..� �u i Id i n C}e a.rt�m�nt
� _ � � P
����R'�`� I QQ5Q N.E.2nd Avenue
M�ami Shor�s, Fl�rida 3313�
Tel: (305} 795.22�4
F : (305} 756.8972
� F � T / L� T
Perr�it N.
�
C�wner's Name (Fee Simple T°icle Holder): ���� ���.���� ���� Phane #:
Qwner's Address; ��., ��, °� �"°[�
City: ��c a � ��� State : ����t i�c�y Zip Cade: �"��'��
,��b Address (Of w�here wark is beirrg done}: ��, �� ��` ��
�ity: M�arr�� SM�re� State:�Floric�a Z€p Code: ���`�$
Contractar's �ampany Name. �,� d��- ��- . ��� Ph�ne#: � ��� � �
Address: ��a �� �� �� �� ���
�ity: ���i Stat�: Zip �cade:
Qu�lifier's Name : � � `� b � " Lie. Number: �""' � {� �--�`�� 7.
Architectl Engine�r c�f R�eord Name: Phc�ne#:
Atddr�ss:
City. State: Zip Ccsde:
Rescribe ark: � � ��- �� t� ���r� �.�t �
1 h�r� y certify that t � ��k has ��r� �. an one an la�� the �ontra�tor/�.r°� itect
i� Unable or ur�willing to eo pl+�te the cvntr�aet. 1 hol th� uilding 1�ial and �h�
Mi�mi Shores har�r�nless c�f all legal ir�vc�lv�nn�nt,
�� �
ai�nature � ignature
Qwner or Agent Cancraetor or Architeet
The foregaing instrument was aknowiedged befare me The foregoing instrument was aknowledged b�fore me
this day af � 2Q� ,by �� � � this day�f , 20 by
Who es personally knc�wn t��e or who has_produced who is personally known to me or who has produc�d
' \ �"`1
�` � �=as indentific�tiQn. as indenEificatian.
; �
Notary �'ub[ic: ` ���� ; ��. Notary Public:
� € �'` 3' ��
aign: Sign:
Seal: .*��� �f� Y Seal:
:���... �� ���ssl�� � 37�1
�� �� . � ��, �9
, � �
�� a>,
(� t��
���`8d4��t6Y5 � .
1,��QRE,g� �� Miami Shor�s Yifla�e
'��► uildir�� �p�r°t ent
� 1 Q050 .�. 2►�� Avenue
g �s
••,• ••,•�� i� i �hc�res, Fl�rida 33138
i 'Tel: (30S} T95.2204
�'��a=�s���°�'� Fax. (3Q5} 756.8972
"��ORLD�
�hang,e af ContractorlArch�tect ar En ineer
A chan�e of eontractor, architect or eng�neer must be done under a permit r�umber. �T"here is a $7S.OQ charg�
far a chang� of contractor. The owner will submit a Chan,�� of Contraetor Form completed with notariz�d
signatures. If the sEgnature of th� previous contractor cannat be obtained the awner must send a certified
letterlreturn receipt notifyin� th� pr�v�ous contractar, architect or engineer the reason for the change. The
owner mus� allow 10 business days for the contractor, archit�ct or engineer tQ respe�rtd. A permit applieatian
must aecompany the change �f ca�ntraetor form, with th� infQrmatiQn and si�nature of the new
co��ractear. The new c�ntractQr must be registered with the Vi(la�e or rnust stabmit tk�e required doeurnents
to register wi�h the Village.
(. �hang� of Contractor form compfeted, signed and notariz�d.
2e P�rmit application by new contractor.
3. Required feesm
4, Cc�py �f c�ri�in�l letter s�nt via ��rtified mail along wi�h th� returned reeeipt.
In a�ddition to the requirements abov� the architect or engineer c�f record must auth�riz�d the new arc�itect
or en�in�er tc� r�produce his docum�nts. Th� auth�rizat��n must be in writing and must b� signed and s��led.
�
�'��,����� ���(��t �..��
�/liarv�i, E��r�h 9,201�
Sirs
�ESMAR PC I�C
ATT: EDUARD�A�l�E�
6405 NW 36ST# 224
MI�MI
Dear S�r
1"his letter is tca inf�rrr} yc�u that I am r�mavin�yo� ar�d yc�ur eampany �s sub�can�r�ctvr fe�r th�
ee�nstru�tion c�f rr�y haus� �t ME�rni Shores 1270NE 97 ST. ! ar� r�pl��in�you by�noth�r
�ar�pany.
Sinc�rely
��� "� { ��� , w.
VICTC�RIA�6LLECaA;S
IJSPS.cc�n�G � US�'S `1 rackin�C� R�su11s �'a�� � c�f 8
Pnces(httpstlwww.usps.comlbusii�esslpness-htm}
5earoh or Enter a Tracking Number
(ntema6onai(https-thuww.usgs.comfinternaftanailweic:xme,I�tm)
Tools
Galculate Inte€naflo€�a(Rnces{https:ttircalc.usps-coml�
Pnr�t int�rz�ationel Labels(https�Ucnsusps-cam!}
��� ��C������
�����������
t���� �
����������"'�
������������"��`���a�,,
��n
„� s�
. . {https�.flwww.usPs.comrn4eniaHonaifgo-npw.ntn�}
�eam at�out
Rdnt(ng&Shipping IntemaYfcanai{httpslMnvw.usps.e:�mfinternalfonalfint�matianai-how-to.hhr)
intemat{onal Maii Serv(ces(httPs./Mnvw_usps-cximt�r�temattonaltmaii-sh(�ap(ng-servlceshtm)..�
GVoba(E�.tcess Guaranteed t�ttps ihvww.usps.comhnternatianaligxg.t�tm)
Rnaelty Ma€i Expresa En4ern�t9ona!{https:ltwww.usps_caminteee,ationallpnoniy-maii-er,press-inEemationalhtml
Prionty Mafi Internatianal(Mtps:t/www-usps.camfnteniational/pnanty-matl-internatianaLFrtm)
First-Glass h9aii intemattanai{httpa.Ilww4v.usps.UromFintema.3onalfflrst-cl�sS-maii-int�mationc�Lh�m?
inEernstionai insueance&EMra Sorviaes(https7twww-usps-eom(ntemationaihnsuranca-extra-se[vleas.hin7}
Pre�aanng Intemation�l ShEpmenEs(https:tlwwv.�.usps-�omtntematlonaltprepan[ig-in€amabanai-sh[pments.html
Gompleting Gusfams Foor�s(httpa:tNrww.usps.comfintemationalleusf�ms-forms.htm)
Military&plplametic Maii(https7lwww-usps.oam(sh(ptapa-fpadpo-htm?pov�Intemationai)
Send�ig Mo�tey Abrasd(httPs.ltmkur.usps.comftnternatia�tsUmoney-tra�afees.h€m)
Passports(https-thvww.uspa.comTntematianaltpasspo€4s.html
Search or Enter a Tracking Number
Heip{https_Ihvww.usps-comfheiptw�lpoma.;:tm)
Find t�lssing Maii(httR�:ttwww-usps-oam(help(rnisstrlq-matLhtml
FBe a C(aim{https:If4vww.us�s-canllhelptclalms.htm}
Raquest a Refund(htt.pslhwrw.usps.comfhetpleefundshtm�
Contact Us{htfps-llv�xw.uaps.camlheiptcontant-us.htm}
FAQs{http.lfFaq-usps-comt)
Saarch USPS.com
Search or Enter a Tr�cking Number
TaPSaarches w _ ...�.�.�, �,..V....m, ��...�..... _...�......�...�.,....�.
Pq BOXES(hftp:ttsearah_usps.comfsearoh?
dient=responsive_ecom&output=xmi_[t� dtdSpraxyetyieshaet=responsiva_ecocr�&aort=date�.D�.�.d1&vde=2Q6&v,•e_rnc-1&oesUTF-�&ie=U?t=-t3&ud=1&axclude_apps.�1&site=usps_co�nh7i
7Gabout�27Cposta!_axplorer8ulang=en&access=p&efltqr=3&�ntqm�=0&itter�0&�=P4 ta2G�o�s�
PASSPORTS(htlp:ftsearch.usp&-com/se�rch2
Gient=responsive._r�e:om&autput=xml_n�a_dtd&proxysEyl�sheei=respor�alve_ecc�m&sprt=date:D:�-d18wG-2QQ&we_mc=l8ac�=lliF-8&ie=[;TF-8&ud=1&exdude_apps=l&site=uspa_e.om ab?C
7C about°�7C postal_exR��rer&ulanc�=en8access=p&entqr-3&entqrm=Q&fi tter-0&q=Passports)
FREE BC)XES{http:llsearch.usps-eomtsearch?
oltenh-rasponsive_eeam&output=xmi_no_dEtl&proxystyiesh�et=responsive_ecem&sort=data:Q�.L:d 1&wc=20P�3wc_me=t&ae=UTF-8&is=UTF-8&ud=7&exclud�_apps=l&slt�-usps_com l 7e
7C�hoot°�7Cposfaf_e�lor�rr&uiang-en&acoess=p$antqr3&entqern-C&filte�0�q=�ree%F06oxes}
USP� Tracking� F�Q� > fhtt�:ilfac�.usp�.c�m/?artic(e1d=2�09A0}
Track Anrather Packa�� -�-
�"rackingl Number; 7Q1710QQOQ0045995169 Rerr,ove x
Your item was delivered to an individuai at th�address at 12=41 pm on Mar�h 13, 2Q18 in MIAMI, �L
33166.
H�w��n 1 help y�u?
{�� �ItVet"GC�
htt�s.11taals.usps.cc�ml�or'TrackC�nfi�•m�ctic�n:�iR��=ful�pag�&t�,c-2�text�8777=�tI�a�e... 3,12812Q 18
USPS.cc�m:�� R IJSP� Tra�iLin���1 R�sul�s I'a�� � of�
T'�xt&�mai[U�eiat�s �
'Trackin� Ni�tc�ry ,''�
marcn��,Za1a,�z:a7 pm
Delivered, Left with Individu�l
MIf�E�I, F�33166
Your item was delivered fo an individual at fhe address at 12:41 pm an March 13,2Q18 in MIAMf, F�.33166.
M�eeh 12,201�,1:E32 pm
C7elivery Rttempted-Na Acc�ss fo I�elivery Location
MIAMI, F�33166
March 12,2018
In Transit to Next Faci6ty
IVlarch 11,2018, 1:3?pm
Departed USPS Regionaf Faeility
MIAtUt!FL DISTF2I�UTION CENTER
Nfarch 9Q,2018,9:58 pm
Arrived af USPS R�gional Facility
MIAMI F�QISTRI�UTION GENTER
March 14,�01&,6:1�pm
Departed Past Office
MIEAMI,FL 33133
M�rch 10a 201�,11:46 arn
UBPS in possession caf item
PVIIAMI,FL 33133
Produ�t inform�t€on �
See�ess .^
�n't find hat y�u'r� lo+akin for?
Go to our FAQs s�ctian�a find answers to your tracking questions.
How can t het�you?
l�ttps:l�toc��s.usps.carn/gol`I'rackGonfi�-7�zActio��`?�R�f—f�.�llpagec�tLc—?&text`?8777=&tLabe... 312�12�18