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DS-06-2288qIIqUr6 Miami Shores Village !tato cuT Will Building Department tr TOO, cant %e' wed ( Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 10 416 PERMIT APPLICATION FBC 2004 Permit Type (circle Owner's Name (Fee Simple Ti Owner's Address City m 2l -iortS State FL Zip 3 3 1 3? Tenant/Lessee Name Phone # 25 E 17 OCT 1 7 2006 7. Permit No. Imo% Master Permit No. Electrical Plumbing Mechanical Roofing Al &Yule A Silld eVhone # 3QS- 75t4 -71 g S IVE 101 st Job Address (where the work is being done) 2s-1F WC /01 St. City Miami Shores Village County Miami -Dade Zip 3 3 (3 g FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name t\-k7 jy1L0 WVi'P s Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: DAddition ['Alteration Describe Work: T PP iztou Phone # Square / Linear Footage Of Work: ❑New ❑ Repair/Replace ❑ Demolition Submittal Fee $ Permit Fee $ °-� /V -"CCF $ CO /CC Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ Technology Fee $ Zoning $ Structural Review. $ Total Fee Now Due $ See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS. and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature l/A11'' Signature Owner or Agent Contractor The fore oin instrument was ackno ledged eefaore me is / The foregoing instrument was acknowledged before me this day of , 20 by Ci i UI c 1a . day of , 20 , by who is personally known to me or who has produced who is personally known to me or who has produced s identification and who did take an oath. as identification and who did take an oath. NOTARY P :v NOTARY PUBLIC: ,poOBipppp Sign: � fo, v�`f Sign: Print : Print: My Commis on Expires: 1.71'ti�g °dam '� �"8l My Commission Expires: olio hp� 200? Y xP APPLICATION APPROVED BY: (Revised 02/08/06) /604, Plans Examiner Engineer Zoning °I\ I 5106, • yrnJ {�v V Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax: (305) 756.8972 BUILDING O M C IE E'V M Permit No. `' Z PERMIT APPLICATION b G� aster Permit No. FBC 2004 SEA 0 6 200 BY. Permit Type (circle): Building Electrical Plumbing Mechanical Roofmg Owner's Name (Fee Simple Titleholder) kit( '; _ rl, NStral c;, Phone # '5 7 5 4 - 7 7 f' Owner's Address 2-i3-44 ' -E- Ci ,S t 3::.„5.- „L.- 47,33 City NU tark -t ,c kru State FL, Zip 2,, 73i, 3 &. Tenant/Lessee Name Phone # Job Address (where the work is being done) 25 4 NE '1 01 'a t f* City Miami Shores Village County Miami -Dade Zip 3 i 3 �j FOLIO / PARCEL # Is Building Historically Designated YES ' NO fly` Contractor's Company Name i — y' Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Architect/Engineer's Name (if applicable) Certificate of Competency No. Value of Work For this Permit $ 2.000 Type of Work: ['Addition Describe Work: LIT R ['Alteration rL, u u 't7t Phone # Square / Linear Footage Of Work: ❑New k -zpoo 95' [21 Repair/Replace r?i" 1, X ❑ Demolition ash �L LK -Q.Go A Otw i .s *, ** * * * *, , * * ** * ** ** * ** *,x,r*** *** * * * ***F * ****** **.** * * * * ** * * * *! ** * * * * * * * ** * *** * ** * ** Submittal Fee $ Notary $ S'CO Scanning $ Permit Fee $ Training/Education Fee $ Radon $ Bond $ .a .t Code Enforcement $ Structural Review. $ DPBR $ CCF$ 1 Technology Fee $ Double Fee $ CO /CC Zoning $ Total Fee Now Due $ <1:2 See TOM Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS.and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certafied copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature LU-1 iosit, ,, „. c� Signature Owner or Agent Contractor The foregoing instrument was octal, before me this . `r The foregoing instrument was acknowledged before me this day of 200L, �by9 Y., )k” \-0 Pik +' '(? day of ,20 , by ' who is personally known to me or who has produced as identification and who did take an oath. who is personally known to me or who has produced TO As identification and who did take an oath. NOTAR '''TBLIC: Sign: Print My Commission Expires: NOTARY PUBLIC: Sign: Print: My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) Plans Examiner Engineer Zoning NAME: ADDRESS: VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT DATE: r /Cc Do hereby petition the Village of Miami Shores to act.as my own c.ontraetor pursuant to the laws of State of Florida, F.S 489.1403(7). And [have read and understood the following disclosure statement, which entitles rrie to work as my own contractor; I further understand that I as the owner must appear in person to complete all a'pplieations. State Law requires construction to be done by a licensedicontractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for.yolar own.uae and.oecupaiicy. IIt may' not be built for sale or lease.: If you sell or lease a building you have built yourself within one year after the.constructlon is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any .person working on your building who is not licensed must work under:your su. perVision and must be employed by you, which means.thatyou must deduct F.I.C.A and with - holdings tax and • provide workers' compensation for that employee,, all, as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and -initial each paragraph. 1. I hold title to the above property and I am planning on doing this construction Initial ')yt 2. I understand that as an owner- builder I must abide by all zoning ordinances and building regulations in effect at the time of permit application Initial 1l1;- 1 .I have an understanding of the 2004 FBC & FRC and understand that this department and its inspectors are there to help enforce and interpret the code. There is a copy of the code in this office for review. 4. I' understand that the building official alter or give advice on how to meet minimum code. Initial )11. and inspectors ate not there to design, code —. only if the structure meets the Initial /I tr.) 5. I understand that as an owner- builder, that any contractor disputes with sub- contractors. and myself must be handled in a civil court with the advice of an attorney. The department will not mitigate'a,ny contract disputes. Initial 6. I understand that if I compensate any person or company for work performed they are required to have a business license in the county. If for any reason they do not ,posses a business license I will be responsible and liable for any wrong doing from this unlicensed company-or person. , Initial 7. l understat'id that if any.person.gets injured on my construction project —they are entitled to wdrkrtien's compensation. And if they do not posses a workmen's policy I could be held liable for all doctor and related cost which could include loss of wages during recovery from injury.` Initial 8; I. understand that under state and focal laws I can not do any Electrical, Plumbing, Heating, Air & Roof work on my property with out first .obtaining the proper permits by licensed contractors. Was acknowledged before 'me this B y r6ddC:( 'k"Cf [Li day of Initial 20 o _: who was personally known to me or who has Produced there License or as identification. xpives: Jtt 3, 4,, Eioncli4g Co 7.!' Legal Description: Lot 6 and the West 4 of Lot 5, Block 34, of AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, according to the plat thereof as recorded in Plat Book 10, at Page 70, of the Public Records of Miami - Dade, FlGtida. Certified To: IVAN AND MARCELA ASTRALAGA; LAW OFFICE OF MARK D. BALZLI; ATTORNEYS' TITLE INSURANCE FUND, INC.; HOMEBANC MORTGAGE,its successors and/or assigns. Community Number: 120635 Panel Number: 0093 Suffix:J Data of Firm Index: 3/2/94 Flood Zone: X Date of Completion: 08/14/01 •06.59.1 Notes: Property has access to Public Right of way and No existing above ground encroachments. VCR A. V M H h Property Address; 254 N.E. 101 STREET MIAMI, FL 33138 Survey: M5507 scale: 1"/ 20 ' 2) 3) 4) 5) 6) 7) 8) 9) 10) F.1 /2.P /N0 /ID 115.00' 19.10 15.55' b' ri LEGAL DESCRIPTION PROVIDED BY OTHERS T7fE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR OTHER RECORDED ENCUMBRANCES NOT SHOWN ONTHE PLAT. UNDERGROUND PORTIONS OF FOOTINGS, FOUNDATIONS OR OTHER IMPROVEMENTS WERE NOT LOCATED. ONLY VISIBLE ENCROACHMENTS LOCATED. WALL TIES ARE 70 THE FACE OF THE WALL. BEARINGSREFERRNCED TO LINE NOTED ASB:R NOIDENTIFICATIONFOUND ON PROPERTY CORRNERS UNLESS NOTED. NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYORS EMBOSSRn SEAL DIMENSIONS SHOWN ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN. ELEVATIONS IF SHOWN ARE BASED UPONN.G.V.D. 1929 UNLESS OTHERWISE NOTED. THIS ISA %OUNDARYSURVE .SSOTHERWISENOTED. I HEREBY C E R 7 7FY THAT THIS B O a R VEY IS A TRUE UE A ND CORRECT REPRESENTATION 'FA SURVEY UNDER MY DIRECTION. SIGNED l C L 1 NGUEL ESPIN6 A I.S.AiL NO. 5101 TATEOFFLO" DA FOR THE FIRM THIS SURVEY ISINTENDEDFFORT(OR'l'EGEEOR REFINANCEPURPOSEONLY, EXCL(ISIi LYFpR! THIS USE 13Y THOSE 70 WHOM ITIS CERTIFIED. THISSURVEYISNOTTO BE USED FOR - CONSTRUCTION, PERMITTING, DESIGN OR ANY OTHER USE.WITJIOUT WRITTEN CONSE NT OF • .. MIGUEL ESPJJIOSA. • 39.75' 24.05' 30.10' Concrete MZG t/ L. ESPINOSA LANb sup:vEvINa; zwa 6494 S. W. 24 STREET MIAMI, FLORIDA 33155 F.1/2. W /N0 /ID F..1 /2.P PHONE: (305) 740 -3319 Legal Description: Lot 6 and the West Y2 of Lot 5, Block 34, of AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, according to the plat thereof as recorded in Plat Book 10, at Page 70, of the Public Records of Miami - Dade, Florida. Certified To: IVAN AND MARCELA ASTRALAGA; LAW OFFICE OF MARK D. BALZLI; ATTORNEYS' TITLE INSURANCE FUND, INC.; HOMEBANC MORTGAGE,its successors and/or assigns. Community Number: 120635 Panel Number: 0093 Suffix: J Data of Firm Index: 3/2/94 Flood Zone: X Date of Completion: 08/14/01 Property Address: 254 N.E. 101 STREET MIAMI, FL 33138 Survey: M5507 Block Corner O N ra‘ Notes: Property has access to Public Right of way and No existing above ground encroachments. scale: 1'y 20 F.1 /2.P W /N0 /ID F.1 /2.P W /NO/ 11 0 1 e ajtj:p: Q- - - -A `. M gN L ge INC I r to 6Y9 .L r; Ee, • nn f MID Lre • '1 h. I H— - -. - • baI Aia �6n n, L �I • • - AAAp.I :• • . -•=-. ., 4—m1 MM a-.-rvi, - elf:' A .6"5",-37A .MG`_A GENERAL OTES: I) LEGAL DESCRiPTIONPROVIDED BY OTHERS 2) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASFIJIEN7' OR OTHER RECORDED ENCUMBRANCES NOT SHOWN ONTHE PLAT. 3) UNDERGROUND PORTJONS OF FOOTINGS, FOUNDATIONS OR OTHER IMPROVEMENTS WERE NOT LOCATED. 4) ONLY VISIBLEENCROACHMENTSLOCATED. 5) WALL TIES ARE TO THE FACE OF THE WALL. 6) BEARINGS REFERENCED 70 LINE NOTED AS BE. 7) NO IDENTIF7CATIONFOUND ON PROPERTY CORRNERS UNLESS NOTED. 8) NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYORS EMBOSSED SEAL. 9) DIMENSIONS SHOWN ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN. 10) ELEVATIONS IF SHOWN ARE BASED UPON N.G.V..D.1929 UNLESS OTHERWISE NOTED. 11) THIS IS ,BOUNDARY ;CURVE • . OTHERWISE NOTED. I HEREBY CERTIFY THAT THIS BO ' ` VEYISA TRUE AND CORRECT REPRESENTATION .lF SURVEY P' ' - ' r,{ UNDER MY DIRECTION. SIGNED GUEL ESPIN Sill NO: 510 ATE OFFLO A FOR THE FIRM THIS SURVEY ISINTENDED'FOR1AORMAGE OR REFINANCEPURPOSE ONLY, EXCLUSIVELY FOR: THIS USE BY THOSE 70 WHOM ITISCERTIFIED. THIS SURVEY IS NOT TO BE USED FOR CONSTRUCTION, PERMI7TJNG, DESIGN OR ANY OTHER USE WITHOUT WRI7TEN CONSENT OF MIGUEL ESPINOSA :.. -..:., �.. I. t M461(JEL ESPINOSA . LAND 51. RV&YI. N6, INC. 6494.5. W. 24 STREET MIAMI, FLORIDA 33155 PHONE: L�F3O5) 740 -3319 —LB 0`64.63 .:..... j Legal Description: Lot 6 and the West 1%z of Lot 5, Block 34, of AMENDED P MIAMI SHORES SECTION NO.1, according to the plat recorded in Plat Book 10, at Page 70, of the Public Records o Dade, Floti.da. Certified To: WAN AND MARCELA ASTRALAGA; LAW OFFICE OF BALZLI; ATTORNEYS' TITLE INSURANCE FUND, INC.; HOMEBANC MORTGAGE,its successors and/or assigns. Notes: Property .s access to Public Right of way an nd encroac Community Number: 1a963 • Panel Number: 0093 75 ® Suffix: J Data of Firm Index: 3/494 Flood Zone: X Date of Completion: 0 ::0`:41 1,3 Property Address; 254 N.E. 101 STREET ` MIAMI, FL33138' w S Block orner • DATE 1 II Pli 1/) 4 f $UBZEGT TO COMp&JAP WITH ALL FEDERAL •••• • • • I` ST 'llC•iND COCNTY T 1jLES AND FII 'CA J1 ATIONS • - •, 17iro gm APPROVED ZONING DEPT- BLDG DEPT •. - •• • • • •• • =_M ;_a a mItlINIM eau .n.5=.4.i. 0100..--.W Aft101111‘11.131170011111 -- . s�ii� 01110eeeai..1.r a.r.e.. -- -u- _ __._ ___ *run .... ' me roam .� -.roam ammo 001101M,MOIN MN 1100011,091111010N101 WI -_ :-...tylig .e � Mosio sss m' ms e ea�ci ► �e � t , i t f r , . . MIK7 4111P•filal 1111111141111 i ,-tl> - - . :� a `°_° as ----,e � �.:—.. 110.7 111111:111/ ."rr 00111211 ftgre k' . ime.' I�.TAC1af l•p— ' f- f7 - • 3•• n aric ..ma1.RmR. GENERAL NOTES: A b M gig iv I •; e 14 e• h. 1 H- d- 'fa'1r.7'i ••• d•s:nv e • 1. 1,' 0 .ry- I.A .f:w51 1) LEGAL DESCRIP777ON PROVIDED BYO7HERS 2) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR HAM? ENT OR OTHER RECORDED ENCUMBRANCES NOT SHOWN ON THE PLAT. 3) UNDERGROUND PORTIONS OF FOOTINGS, FOUNDATIONS OR OTHER IMPROVEMENTS WERE NOT LOCATED. 4) ONLY VISIBLE ENCROACIDIIENTSLOCATED. 5) WALL TIESARE 70 771E FACE OF THE WALL.. 6) BEARINGS REFERENCED 70 LINE NOTED AS B:R. 7) NO IDEN77FICA.770N F O UND ON P R O P E R 7 Y C O R R NE R S UNLESS NOTED. 8) NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYORS EMBOSSED SEAL. 9) DIMENSIONS SHOWN ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN. 10) ELEVA77ONSIFSHOWN ARE BASED UPONN.G.V.D. 1929 UNLESS OTHERWISE NOTED. 11) THIS IS A,BOUNDARYSURVE, .. OTHERWISE NOTED. 115.00' HEREBY CER77FY THAT 77HSBO ^ D - RVEY IS A TRUE AND CORRECT SIGNED I�I:� GUEL ESPINQS .4 (' S.M. NO., 510 TATE OFFLO '' DA REPRESENTATION FA SURVEYP UNDER MYDIRECTION. ONE STORY Residence • # 254 FOR 771E FIRM THIS SURVEYISIN7ENDED FOR7f%iOR"!l9GE.OR REFINANCEPURPOSEONLY, EXCLUSIVE_LI FOR THIS USE BY THOSE TO WHOM ITISCER77F7ED. THIS SURVEY IS NOT TO BE USED FOR CONSTRUCTION. PERMI77YNG, DESIGN. OR ANY OTHER USE .WITHOUT WRITTEN CONSENT OF .. MIGUEL ESPINOSA. .. . 6.80' or,,r 24.05' 00 30.10' Concrete F.1 /2.P W /N0 /ID 115.00' F.1 /2.P W /N0/ .6494- W' 24'5TREET ••• • Mr4s4,L FLORIDA 33155 •• • • • • • • .•.• • • •• • • • • • • • .•.. • • • • • •• • • • • • • • •• • • • • • • • • • • •• (.60) 740 -3319 Lg` 64b • • i •.. • • • ••• • • • • • •loo ,:• • • •• • •• Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795:4' -p. 56.8972 Teo BUILDING PERMIT APPLICATION Master Permit No. FBC 2004 - ______0e ® ®® Permit No. BY :- Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 1 (IV UX 01 9 ( ������ �C�� Phone # , ��. c) "75(-1 '- 1 CI 'S 5 Owner's Address City State Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Vill. e County . Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name C) \i Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: �S L J C_U f Q Square / Linear Footage Of Work: ******** * * * * * * * * * * * * * * * * * * ** * * * * * * * * * ** Fees************* * * * * * * * * * * * * ** * * * * * * * * * * * ** * *** Submittal Fee $ Permit Fee $ Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ CCF $ CO /CC Technology Fee $ Zoning $ Structural Review. $ Total Fee Now Due $ See Reverse side -* Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 , by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 , by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: ©(et e Plans Examiner Engineer Zoning f,