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REV-12-21-3364 � a��:��"�'. �4. k���,m�,���?'� ������� � 1 � r � S �II� � � �� �uildir�� Q�par�fim�r�t �.C?050 N.E.2nd Avenue,Mi�mi Shc�res,Fl�rida 33138 "��� ,� �.�,��� � �,,���� �°ei:(so�}�ss-z2o�Fax:�3os}7s�-ss�2 INSRE�"f'I�M tINE FFIOME IVUMBER:(30S}T6Z-49A9 �'? �L I M�ster R�rmit No ,����� �� `tte� .A�°�����`� . ■ i �M �■ ..7lAM I'ef iel64 IYV. ��`����""���.�4<, �8.,.r.,,,� ', ��;��`"��..t� ��������� � ���cr��� � �Q����� ��v�s��� � �xr��soc�N �R��Ew�� ��.um���� � r��c����c�� ❑�u��Ecwc���s � c����E �F � �a���L��-��N � s�o� ���-r�ac��� � wi��s �os�����ss: _L`� � � c� ��, � Crty: Miami Shares Countv: Miami Dade Zip� "���`�� FoEiajPareel�:��"� ��l�- °�! !. Is th�Bui#din�H€stor'ccally D�swp,nated:Yes t�� Occupancy Type: Co�d: Construction Type: Flaod Z�ne: BFE: FFE: OWNE�<N�me(Fee Simple Titlehalder�: � Phone#:�a � �a Address.��, °��°, f�� City: ' C°� A State: �C_ Zip: �"�, �- TenanC��essee Name: Phone#: Emaif: Ga a �� t�.�!� f CL�NT�A�'€QR.Cc�mpany Name: ���_;�`.�C'�'_c��s.�_�-*.,���.�� Phon�#:���-�`��'°�,���� Addr�ss:� �� � City: �,�� State� `��:_ Zip: ��\���_e._. QualEfEer Nam�e_� i s� � U`� t'� Phone#e State�erti#Icatlon�r Re�istraticsn#: Certif�cate of C�mpetency##: �ESIGiNER:Archite�jEngin�ee: Phon�#: At�l'�P4SS: CIL�: �t�tt: ZI(a: V�Eue af Wark for this Permit�$ � ��A�Squarejl'an�ar F�atage af UVtork: Type af W�rk: ❑ Additian [� A(teration New ❑ R�pairJR�place ❑ �emolition Descripti�n�f Wark: ��-.��C c� = � � -�,��° Zm �t,� --�� �"" `� f1� �� � -•- �t � - � t�� �� � � � S�r�eify c�lar of ealor thru tile» s��m��c�i F��S �erm�t�e�� cc�S cc�/�c S sc�nn�n�Fee$ ��a�an Fe�$ ��PR$ N�tary S Techt�ology F��$ Teainin�/Educati�n Fee$ Double F�e$ Structural R�views§ �ortd$ TC}TAL FEE Nt�W DUE$ � ��"" �� iR�viseaa��aa/ao��> � �ondin�C�mp�ny's Narrte(if�pplicable� Bondin$C�mpany's Address City State Zip Mor�a��Lend�r's Name(i€applicable) IVE�r�����Lend�r's Addr�ss �ity Stat� Zip �pplic�ti�rr is h�reby made to ok�t�in a permit to dca th�uvark and inst�ll�tic�r�s as indic�t�d. 1 c�rtify that rrca work or inst��Eation h�$ comrn�need prior t� the lssuanc� of a permit and that all wor� �il! be perform�d to m��t t�e st�ndards �f alE la�rs re�ula2ing construc�ie,n in tt�is ju�isdi�tic�n. i understand that a separat� permit must be seeured f�r ELECTRIC, PLUM�INC, SI{�P�S, PCiQ�S, FURP���ES,QC?ILERS,HEATERS,�°ANKS,AIR Cf�NDITI�(�ERS,ETC..... �VIIM1l�R'S AFFIQ��I1T: 1 certify that all the fore�oing informatior� Es ae�urate and that al# wc�rk will b� d�n� in complianc� v�rith all �pplicable laws ee��l�ting construction and zonin�. •`V1/AIRNING T°� �WNER: YOUlt FAILURE TQ RECt�R� A► Nt�T��E Q� +Ct7rl�lItV1EF��CE�tIIEI�fi MAY RES�1l�1' IN Y�t�R PAYIIVG ICE F�R i11lIRFt��✓EMENT� TGl Yt�U� PRQPE� . I� YQU INTEND TQ ��TAIN �I�IAIVCING, CQNSI��T WITH YQUR �EN�tER QR AN A �RNEY �EFORE RE��RDIt�G YC3!!E� IVQTICE C?� CQ ENCE � ENT.,, Matrce to Appiicgnt: As a eondttiarr to the issuance of ca building permif wrfh ar��stimoted vatue exeeeding�2.5tX1, the appfr`cant musr prvmise in gaod faith that a copy of the notice of comrnencemenY and construction Pien laru brc�chure arritf b�d�livered ta iire�person whase praperty is subj�ct t�attachment. Also,a certi�ed c�py�f the r�cc�rd�d natice�f amm�ncement must be poste�#at the jcab site for che frrst ins,�ection which occurs seven (7) days after the bull�ing permit is issu� . In the absenc� of such pt�st�d notie�, the inspectfan wif/not be apqroved and a reinspectic�n fe�wifl be charged. �,`, �� �� ,� � —�� � . � a,� � : � � Si�natur� �-''"�� Sign�tur� � `� �.� � ', � � �.___. .�---_.---�61�lt�t�a GAe ENT �QF�1�Fi�CTt�R Th�f�regcain�instrument was acknowledged before me this The for�gcaing instrument was acknvwi�d��d bef�re me this �'� day of �� � 20 �-'� ,by '�`� day�f ��C� 20 ��..� ,by � �:e.,�-,�� .�n`��,v�F�o is persanally known Eo ��"`������ .. �who is pers�n�lly kn�wn to me ar wha has pr�duc�d � � �s m�e�r wh�h�s pr4duc�d �.������ �s id�ntificatic�r��nd who did take an oa . fd�ntifi�atiran�nd who did t�k�an�ath, 4cs�:�ilre\ .S�fituai�,.ti4 `it01 '.^,l",1m�kSa Y1raS' 1 aSii�tCt.k�i �St � �2. � iit �� ,i.� S Nt?T` Y Pt1BL� : � pPrt� ��� R1C?TARY PU�1.lC: � ��1E,�'`��g1gi� � � � ' 't , ' �, � ��yl�e�'�, � �ea�� ���a0 ,�� ti,���� � t _ ° � �� ��� �,��,2� � �\ � � ._.. � t C S4 � .., . , �'1 � Q 4 � �,Z P f ` � �� Sign: �,•.. � �am � �;�ca . Si�n; � �` �"�.� " � � . �:;� 1 ; -�. � _��. � m ��� . „, ..ti � � , �� , �. ,�, 1,. �� , . � ���� �. �� � �� � � .'. Print: .P¢, � � Print: S�al. -�" � Seal: ��*�e���*�*�������s��a�*�,��*�a���*�a��*��*�*��*���s��*�«*���*a�*�*��«��a����������*�����a���s�*����*���**a�a�*a���a�«��a� APPR�V��BY Plans Examiner Zoning Structural R�view Clerk (R€�visedQ2/24f 2014} � ��,���,�,� IaCi'll hQC@� I��age ��r� �a��� �� � �,�`'� 1005Q N.E.Zt1d AVetIU� ��I� �° Miam� �hores, Fl�rid� 3313� � T�1: (305} 795.2204 Fax: (3Q5} 756.�972 ti� t r — r r ' ti In r c ti .;e\ �..�, 5 , ,,.. , .�, .:..� 1 �... ,..,� . .,,. .\. ' .�.. � ;..'�. �. . �'.-�.' t 1 ..4 � 1 �- C �. A `l Z \.. t1k. �� �.t� \ s. �� \�-- .-� � t.� �l -l' .\ \. .\" .\� c i� ..l \�ti. .t '�:c �, ..� � �.:i. �, .c� .�. 3 ti�, :.��� � .\ „ r`-...� „x .����. 1 .�. .` �,. �.l�.*, .,..::.. .,. ti� .�. s \„1 `.�\. .\r 1 t.. � 1 � .5 �. . t', � 1 ; ti \ .`, \. �.. .� �.. � 1...� ,,. , :�.�. � \ ..:�\ \. ..i \. s .. :�. � \ �� S 1. � , t. 1 \ £ � �� ,....,,�., s..., �.ti �, `,�.,,.. � � ,:,. . „ ,�,.. ...�.���\ L:..;t ,.�.t. v .t � \ 2 \�...; � \<. � ti \�t � i � l. � . \ 3\ t � \�ti ,` ti s 1 � �ti` i .,.,.,ti s .'i� .� .�.. ! t� .�. 1 � ,;,z.,... t:.t�.t„ .tt. .� �.� �Z �� ..\ \t:�A .t.u�, ,�,�,�.,,,1�+.�v �, ��„ .�.<„�1\a� �„�,�`)� ra,E� �.�.<�,<�� �� ,y� �. ,s'�., t,, o�� ��� t �;� �t � ���� 1��.;�� ;� � ��tt �1� ��, v�E.„ � ��,� �`lorida L,aw requires Warkers' �ornpensatie�� insu�-anee ceaver��� cander Chapt�r 44E} af the Flc�rida Stat�ates. Pla. Stat. § 440.05 allows cc�z�pc�rate of�'icers in the ccans ccion industry tc�exernpt th�mselves from thi�requirem�nt for az�y constructican proj�ct prior ta obtainin�a bui�din�pertnit. I'ursuant to the Florida Division of�orkers' Compensation Employer�acts Brachur�: An employ�r in the canstructian industr}� who cmplaya one or more part-time or fizll�time emplayees,including the owner,must obtain workez�s'compensatian coverage. �orporate officers or m�mbers of a limited li�bility co�pany (LL.C} in the constrztction industry may elect to be exe�rtpt af: l. The offic�r owns at lease 20 percent of th�stack c�f the corpor�tio�x or in the case o�' an L,LC,a st�tement att�sting to the minimum 10 percent awn�rship; 2. The officer is list�d as an affieer af the corparation in the reeorcls af th� Florida Dep�ent af Stat�,Division of Corparatzons;and 3. Th� corporatic�n zs registered d tist�d as active with the Fiorida I?ep ent af �i�Eee,L}ivisic�n of�orporations. No mc�re thazz thr�e corporate o#�ieers per cc�rporation ar limited liability campany z�embers are allc�wed to be �xempt. Gonstruction exemptians axe valid far a period of two years or uritil a voluntary r�vocatian is filed or the exemption is revoked by t�te Iaivision. Your ec�n ctar is requesti�z�a permit under t1�is workers'coznpensation exemptic�rt��zd h�s acknowl�d�e that he or sh�wiil n�t us� day Iabor,p��t-tizne employe�s�r subcontractars for your praject.Ti�e�ontract€�r has pgovided af�idavit statin�that h�or s�e u�il be the only per�c�n allowed to work an your praject.In these czrcta�ns ces,Miamx Shc�res Viiiage does nat require verifiGatio�a of r�orkers'compensatis�n insur ce covera�e frotn th�contractor's coznpany for d�y labor,part�Cime ea�zptoye�s ar subeontractors. BY SIGNING BELC?W YOU ACKNQWL�DGE T T YC}U HAVE �D THIS NC}TICE UNI)ERSTAND ITS CC}NTENTS. � � Si�nature: C?wn�r State of Florida �ounty of Miami-Dade The fare�cain�was acknowted�e before me this �� day of ,20 \. By t �.,.t� _ c wha is personally known to m�or has produced as idezatific�tioz�. � :Q;r�Y'��;, i���A�A�taR��;a?ATO ;?'.»..�.;� Notary?ub;ic-StaEe af pi�r��a Notary; '`�� �c":� Comm9sslon��tH rt923aQ � �'�c�°�' tay Comm.Expfres 9ct 2E.Z025 SEAL: ` r�.���..��°�°"�` 3and�Q through r��tfar�e;Norary�,ssn, � � � a � x � � ��� C}ecemb�r 1C�, 2021 State af Florida Caunty�f Mi�mi [��de Be�ore me this day p�rs�n�lly app�ar�d �4nteani� �uvara whc�, being d�ly s�carn, depos�s�nd says: That he II b��he only persan warkin��n the pr�aject located �t 123 NE 99 S�T. � �w� �` Contr�ctor Signatur� Sworn t� ar�d subscribed before me this 10 d�y af D�eember 2021 by Antonic� Luvara. �` P�rsonally knaw �� C�r Produe� fd�r�t�#ic�tic�n Typ�af Od�ntifi�ation Produc�d ��>... 3� x� � �...�E,� t,. � �� �� �� ' .. � �r._�� �.��-.�..�._—�'.�-� � � � , a � � � �°'� b ,,, ��r. .. ��,.�� >, ��,:�� �� �.� � ,�.,z,t..��,..� Print, Typ�or Stamp R�ame c�f N�taey