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CHANGE OF CONTRACTOR (3) i� i h r s i[I � � u i I i n e p a rt n t }���F� �� €. �t� � �� �. ��.r 10050 N.E.2nd Avenue, Miami Shores, Flarida 33138 ��3 �� �r��:(�as}��5-z2a��ax:(3os�7�s-�g7z �.. ��.�°�'����4�0�.������` I(dSP�CTI�N CtRVE PHONE IVUMBER:{3Q5)762-4944 � �� � F�� 2CI��f� � � � � � ���.� �� � ��5�@C �@Ct11i� �C?. ���`�.' ���F ���.. � PERIVIII' APPLICATIC}N sub P���,Et Na. ���� �,���� ������"m��.x�� P �g�E����� � ��Ec-r��c ❑ ��o���� � �Eves�o� ❑ Ex-r�r�sao� ��E��wa� �]PLUMBING MECNANICAG �PUBLIC WORKS �`��CHA�IGE OF �] CANCEL��1'I�N ❑ SNQP � �CONTRAGTaR DR�aWlNGS � f� JOB I�DDRESS: �� <, �� Citv: Miami Shores Countv: Miami Dade Zip: ����� " ���� FolioJPareei#: Is the�uilding Histaricakly Designated:Yes NQ '�� Occupancy Type: �oad: Constructian Type: Flaod Zone: BFE: FFE; OWNER: Name(Fee Simple Titlehalder}:� ��,�� ��f„, ��� ���� t;:e'� Phone#: Addr�ss: ��. �� �� City: ��� f � f�� State: Zip: �� �� TenantJLesse2 Name: Phone#: Email: CQNTRACT{�R;Company Name: ��,����t���.� Phone#:���_�_�____� Address: �� � �""� �� 7— City: �� E State: Zip: ����� Qualifier Name: 5��� ����`�' Ph€�ne#: State Certification ar Registratian#: � ��� � Certificate of Campetency#: DESIGNER:Arcnit�cY/Engineer: Phane#: Address: City: State: Zip: Value of Wark for this Permit:$ Square/I.inear F�otage of Work: Type of Wark. � Addition [� Alteration ❑ New [� RepairJReplace ❑ Qemolition Description af Wark: �� � �� � �" ��tt5�` �,� � �E �` i� � �� �� �, � � r.��,` ��� �' �" �� ��.�"��,'"� �t , c E r '� a . . . . � �� .� ,. Specify c+�lar of ca/or thrc� tile: Submittal Fee$ Permit Fee$ CCF$ CO/C�$ �canning Fe�$ Radon Fee� DBPR$ Notary$ Technalogy Fee$ Training/Education Fe�$ QoubEe Fee$ Structural Reuiews$ Bond$ TOTAI FEE RIOW DUE$ ���° ��� ' �' (Re��seaa2/za/2o�4) � � �� � N �onding Company's Name{if applicable) Banding Company`s Address City State Zip Mort�age Lender's Name(if applicable) Nlart�a�e Lender`s Addr�ss City Stat� Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that na u`ork or installation has commenced prior ta the issuance of a permit and that all wc�rk will be perfarmed to meet the standards of all laws regulating tonstruction in this jurisdiction. ! understand that a separate permit must be secured for EIECTRIC, PLUM�INCa, SIGNS, POQLS, FEJRNACES, 6UILERS, HEATERS,T�f�KS,�ER CONDITEQNERS, ETC..... OWNER'S AFFIC�AVIT: I certify that all the faregoing information is accurate and that a!I work will be done in compEianee with all applicable laws regulating construction and zoning. "WARNINC TO �WNER: YQUR FAILURE TO RECt?RD A NOTICE 4F CaMMENCEMENT MAY RESULT IN YQUR PAYING TWICE FC)R I�/IPRQVEMENTS TO Y�UR l�RC?PERTY. IF YQU INTEND TQ QBTAIN FIIVANCING, C�NSULT WITH YaUR LENQER QR AtV ATTQRNEY BEFARE REGARDINta Y�UR NOTICE OF CQMMENCEMENT." Not�ce to ApplicanP: As ca condition to the issuonce caf a building permit with an estimated va/ue exceeding$25€�QF the applieant must promise in g�od faiih that ca copy of the notice of corrrmencement and eonstruction (ien taw broct�ure wiN be delivered to the person whase property ts subject attac(�rrrent. A/so,a eertified eapy af the recordec�notice af commencernent must be posted at the job site for the first inspection,�{vl�ich oecurs seven (7) days ofter the building permit is issued. !n tMe absence vf such posted notice, the inspeetior� wilt noc b�rap raved and a reinspection fee�vilt be eharged, � � f � �� { d g. i ! } f; ( i ��l 1 � / Signafure� � �'"`� Si�nature ��QWNER or AGE(�T �� CQNT ��CT�,` The foregaing instrument was acknowl�d�ed before me this The foregoing instrument was acknowled�ed befare m�this �� � day c�f �����€ 20 �� , bY ���� day of �` �e���� 20 �� , by � �{�� ����`��� ,who is personally known to � ��t�"� ,whca is personally knawn to me or who has pradueed :� as me ar who has praduced as } �� r.�. � identification and who di take an oath, identificatian and who d�ake an oath. �� NOTARY PUBUC; � _� NOTARY PUBtIC: � � �� � '�t� � � �a e ! Sign: -�- ""�� Sign: . "�„� Print: ���� � � Print: a� � 1. � Seal: ��������`{��,� � �� � �� � � � Seal: ��������� �` � � ��`� �� �� ���, 1��20�9 � � � r���5,2f}�9 ��*�����*��**�g�,������� ��* �����* �:**�****,� ����*�*�**��*���*�**� f "����**�������*��*��*���#*����*�� �� APPROVED�Y �`� � � PI ns`E iner Zoning Structural Review Clerk (ReV�se�o2/2�/zo14) 1��x���� � ,�' `��� iam� hores illag� ,�,t � ���r�� L#I' '1 1 R 1 i� t• ' �& �`�'��Rt'U�'`� 10050 N.E.2nd Avenu� Miami She�r�s, Florida 3313� '�'el: {3Q5} T9S.2204 Fa.ac: (305) 756.8972 F �" 7� / � 1 T T P�rmit N. f�wner's Name (Fee Simple Title Holder}: �� � i�a� �r���t� �1���� �� Phone #: C�}wner's Address: x`� �" �� �ity: �� � �r�-� Stat� : Zip Code: �����4 ��b Address {Of where work is being done}: �� �� �� City� Miarni Shares Stat�:�Fbri�a Zip CQde: ���'�� ^ �antraet�r's Company Name: � � r� �� � Phon�#: �� ��� � Address: �� 1"� � �`� � City: � � State: �ip Code: �� �.� Qualifier's Name : '�� �.��t� � I�ic. Number. � �� �� � Architect/ En�ineer e�f Record Nam�: Ph�n�#: Address: City: State: Zip Code: Describe Wor�: t� �� ��1.��C ��1� t���. I h�re y eertify �hat �h� �rk as ��n a �n or�� an /�r t e ��ntr�et��l��+chite�t i� unable or unwilling t+� co pfete the contract. 1 hald th� uilding fificiai �.nd tMe ia i h�res har less �f all fe�al inva►Ive �n�. � � S�gnatur � �" "� -'Signature Qwner oe Agent Gontraetor or Arehitect The foregoing instrument was aknowledged befare The foregaing instrument was aknowledg,ed before m� this�day of ,2(��,by �� �D� ��, �..5 this day of , 20 by Who is personally known to me or wh�as��roduced wha is p�rsonally knc�wn to m� �ar wh� has produced <�;, as indentificatian. as �ndentification. Notary �u�tic: �� i`� Notary Public. Is, . Sig�� � �' _. ,.�..;,' Sign: S�ak �� �������� �� � � � Seal: , •�� �[ss�on � 771 �� � E �; t 15� 19 � 1 �Y '�ar�c��� � �5►`��c��� ��, ME�I7tf SF11C?M'�S YIII1�� � �r�` Bitii�t,�ICl� Q�pa.YtPt��'ltt �,C� ��Q�Q .�. �N� �Y@C1tJ� �•�E• ••��•� Miarr�i �hores, Florida 33 t 38 ..aA... � Tel: (3QSj 745.2204 �'���,r�����°``� Fax: (305) 756.l�972 �'�,�R A' Chan,�e of ContractarlArchitect or En �neer A chan�e of contractor, architeet or engine�r must be done under a per�mit number. Ther� is a $75.00 ehar�e for a change of contractor. The owner will submit a Chan�� of Contractor Form eompleted with natariz�d signatures. If the signature of the previous cantraetor cannat be obtaEned the ewner must send a certified (etter/return receipt notifiying the pr�vious cantraetar, archit�ct or engineer the reason for the change. The own�r must allc�w 10 business days fcar the contractor, arehit�et ar en�ineer ta r�sp�nd. A permit applicatian must accompany the chan�e �f cantraetor form, with the information and si�nature af the new cantractor. The nevv cc�ntractor must be re�ister°ed w�th the ViHage ar must subm►t the required documents to r€�gister with the Villag�. I, Change af Cantraetar farm cc�mpleted, signed and notariz�d. 2. Perrr�it applic�twan by new contraetor. 3. Required fees. 4, Copy af original lett�r sent via �ertified mail along�vith th� return�d receipt. In additi�n ta the req�airements abave the architect or engineer of record must �uthorized the new ar�hit�et or en�in�er to r�praduc� his dact�ments. `fh� autharization must be in writin� and must b� sign�d and sealed. � � � � � �-� � � �� � � ��� ��� � -�� - , ,� � � � �����a� ��""� ��`�� � ��,- � ; � `t�� 'ti �, 5 � � e�„� � � �t �.� u��a �,�s �„ �Yt�i F�4za31 F� � 5� ���' �°' ��irs�'�rric�s�E����u� �� �a��,�sc �`� ��+�e.,R&c��ai��€�pv? � �.�-. �' "„� � �;�i�rr F;�acai�tev�i�,cs,°� �...�....n .._�F�Q��it?Ftrit � �ic:,����n������rr,� c���y ��' � °�,t #��r� � ,�t,���n s±�;�,s„���3,� ����� �. � � � j��;�r s��n��ta� s�a�+i as���� � �S�i ������� ��;.,.. ��� � , .w� � _� � C� � t~� ��"� ��������: � . r� ��"a��F :��sz�� �.; �____�.. � _�+�� � �%, ������ . v� � _ _� � � t�•+ �. .. s:<� . � �m ��e t, � ����'�x „,� � _m_. �. � ����.�� .�� � _:v``���rw...sa n �"r��� a��tt� �. M2� .�a�a m_v��, b.,�.�_ � � � � � ��� s � ��.. ���������1�� "s���.c������������1�������r��fi���� �,.•3 r�cz,ix$�(iP� �„��n�.f th�.G,rtiiie��R�i}I�3l�t.1}. �i�r�r�ef �rei��i rtt �r�c�;��z,s�e�ra#�?� �{�,E�n€c;ta�E�e,�,t�,e�r��s�os„�2�il�,ieu�. 1�,�c�3t �r a�;st a���,T+�r�4si��a��tiaali,^=:�t: � �.4^�nA�±e�#sf«3tia��t e�e:wE���ar�aN�.s?�.�( reYu�reCa�{�t�:�r n�s ca��hcu��i��a.�r�se^t?�`tL ��iiurtry. .I�P�b;�-�us.ns�r�:w�i=ertif�ecf�'si?rt�ce��rt ta Ul� �r�rax.��i r�`�c�s r}i€-i�a�fn�t�`�t�,pt�n�� r��9i�ss���f�<. �+�r��4�uc,ih t :���s���y t`r��� 3�,e r;=[�'" Ft,�,r���c�a��ve[y se���e,�'��G���4=�e ���s�t�.i��s�r��;. �i�.;�r��,�re'�ir�s�s t s�cri���!i r�adn�,�; F� #Y`�.�;P sJ�' SS„v� t�}tl�3t,a G 7�. . ir7���t�Fd�i�f F��ttte��ez�s: �e°,I?4���a�vre��r�+i ��-r,h r�;�s;r�s i13� �Y"�ss maY 3�carc��sr i;e��#t�c!��ai sc tiz:e��S#h slc,��e ta ks��,i�;<.� ;p�aa.�r3f�rie{nc?t �-c�i't.t�s��S�;t",F4rs�{��ss�P�mK,uu Sc��v��ak�, ,�w��,i[,P e�t rtt iii. arF'�'��i}t�1���.er�°i�c n�.,Ys ,�'s,� �s��,�y�fc+:r��r� �r�^���,u���t �f�;;�,i�o���a�n,c�,�.a�a�av�ita��r;� r�„i 4 .,,,���u x��atr ir�<rs3 . +��rs.�� �� #r71F.r:�a.i�a��ai°�t�'sE. 3ia;�E�€cFk=ieS�s�+�Ei�c=�§'i�th��;��:�s;�r�:��e�.=tiec! �ss�ra��n e,.utk�r��a§a s�t�v�i��zi���r��;�I�:�� �'��°�,�e,x�r i�.��..��s,�c>^��F,u,.n��,r�s�ar� �v;:"i.a..�'�a:I��€�,t r�.c a.hsx�e+e P'z�};trcY,ar� t,?,at��a,sE,t�i�a�s�£�i�}. {'.}{,+C,3gifi L�'�i�i a`.j;At?Eti`iGG' {3uS R£?i.".�:k'�^ut�h�v. � F ��>i,ut�tyx�ar,��i�a ��€is���aas�t� E uE��c c�s��xvt�a F[om:�t,c��`i.z,iu�.��xri�� �-c��t� � .�x���c�f o�€�a�is��tY�,t aul���a;� �r��ia;,,,F r�un,:i�il s.�r�c. t�cn�;�s�f$. r±�.iF�c��s�,��=�i iik� a�s�n}t r���r �Fnr�r���:;,t��r�a!:�z�,��E�9 w�?t���r�E�r t,�:��e�r fi,��1r^i�rWr#�t >Ieze�; ,sea,t��.ur et2U�?sexrur7#��,it;.m�.c,�c :v��is�r���iey�,est C��i�3e.���,ii�[�3.�,.�3 Pc��t�:liFice`"��r ti��fallt�;� 2� Etii�:c:�: k���r�raskl�z�.ifi ytu t���'���evu�2����3�����n�th€x -���i,.:r�z,�z e�?i sa=�vac�:,�v�.t��,c�t+�t�e��€�,���� 4.,3tfi�3 M9�l e�.Qi,�$�;,�S�c;�tl��^�r�ta{f,��€xa,�,�rr� u;�ia,�'tvcry+in�#.f�irq£hc.rc�cj�ie,n���,r��t�>rt�?. �at t1,rr,d�1�a�,;�*1�z iB ta th��<ilpir;c�,���.�) Yta�.�,a,r��#+.��st�h�r9c€�,�t+r�tum re€�}�t�az a,� a;.�ar`���r�;�te p���;a��a�t��1e�x?sa�the r��il��;cc@. �x�;rtst:nic ve€s;rxr�.F�,p,#aar�c�z��s�;t���€�r��i�ir ui}�i7�.liCtNx���'��fYi�J��E�:t��£'iSd�t�°l�}1��,�i�i tah".t`i'jF.P'432'£itN�1 F}�hC1I'£el�vt''s�1 l)t�tdC Cl`3�3Ii}}Iui'ns x 'a���3�SA,s�,'�'..�� $�¥3�A' .�.�$�}C,� .� 9F..• �S i a?z2�a'����,.�c:i#l.^(ti�E;a;���=,�;�:t)F.:kd Yn�t�.aa'a'-€�t�t}�:k:}i`i� � � . � �IaF'Tllp ��C`C�1 �, �Q�.$ $It"S METRQPC�LET�f� A/C INC ATT RIC��ERT�3 C�CIN�AE�EZ 6917 RIW 50 S1" MIAMi Dear Sir This I�fit�r is tc� infarr� y�u th�t I am r�r�ovin�ya� arrd yc�ur c€�mp�ny as subc�ntractors fc�r th� c�nstr�action �f my hc�t�se a� Mi�mi Sh�ar�� 1270 �IE 97 51�. I am repl�cfr��yvu by an�th�r c�ntrac��r. Sinc�r�ly ,� �,., � . �� � . �,.... VICTC? IA�11LLECaI�S