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RC-11-1322Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 inspection Number: INSP- 162323 Permit Number: RC -7 -11 -1322 Inspection Date: September 12, 2011 Inspector: Bruhn, Norman Owner: JULMISSE, HARRY Job Address: 24 NW 109 Street Miami Shores, FL 33168 -4315 Project: <NONE> Contractor: SEARS HOME IMPROVEMENT PRODUCTS, INC. Permit Type: Residential Construction Inspection Type: Final Work Classification: Kitchen Cabinets Phone Number Parcel Number 1121360110190 Phone: (305)341 -5663 Building Department Comments KITCHEN REMODELING & COUNTERTOP Passe 9:-/ Inspector Comments No framing, insulation, or drywall was done. NB eC.--- Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 September 14, 2011 Page 1 of 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 r53Nr) Inspection Number: INSP- 162326 Scheduled Inspection Date: September 07, 2011 Inspector: Hernandez, Rafael Owner: JULMISSE, HARRY Job Address: 24 NW 109 Street Miami Shores, FL 33168 -4315 Project: <NONE> Contractor: SKY SERVICE PLUMBING Permit Number: PL -7 -11 -1323 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360110190 Phone: (954)655 -1127 Building Department Comments PLUMBING FOR KITCHEN REMODEL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments September 06, 2011 For Inspections please call: (305)762 -4949 Page 7 of 19 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 24 NW 109 Street Miami Shores, FL 33168 -4315 Owner Information Parcel Number Expiration: 01/24/2012 Applicant Address 1121360110190 Block: Lot: HARRY JULMISSE Phone Cell HARRY JULMISSE 24 NW 109 Street MIAMI SHORES FL 33168 -4315 Contractor(s) SKY SERVICE PLUMBING Phone (954)655 -1127 CeII Phone Type of Work: PLUMBING Type of Piping: KITCHEN REMODEL Additional Info: Bond Retum : Classification: Residential TIiI&g:MUST BE ON JOB AT TIME OF ISPECTION Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Invoice # PL -7 -11 -41526 08/04/2011 Check #: 1097 07/21/2011 Check* 1002 Amt Paid Amt Due $ 58.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Top Out Final Underground 7'9(0 51 q (J -Si Q zj 'cicD,C,OCt -tub (D� q 2 s FLUB r, , Applicant Copy For Inspections, Cali (305) 762 -4949 or Log on at https:// bldg .miamishoresvillage.com /cap /. Requests must be received by 3 pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT the public records of this county. DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. August 04, 2011 2 1 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number sue 1.7121 )�. "residentiai ®� ofll�tlteratian to ...x t F ROVED Expiration: 01/24/2012 Applicant 24 NW 109 Street Miami Shores, FL 33168 -4315 1121360110190 Block: Lot: HARRY JULMISSE Owner Information Address MINE Phone CeII HARRY JULMISSE 24 NW 109 Street MIAMI SHORES FL 33168-4315 Contractor(s) SKY SERVICE PLUMBING Phone (954)655 -1127 Cell Phone Valuation: Total Sq Feet: $ 450.00 0 1 Type of Work: PLUMBING Type of Piping: KITCHEN REMODEL Additional Info: Bond Retum : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Amt Paid Amt Due Invoice # PL -7 -11 -41526 08/04/2011 Check #: 1097 $ 58.60 $ 50.00 07/21/2011 Check #: 1002 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Top Out Final Underground In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated August 04, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date August 04, 2011 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972'; INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No.Pl PERMIT APPLICATION Master Permit No. C,1 -- 13,2•12-- FBC 20 Er, 71 JUL Z 1 2011 Permit Type: PLUMBING 1 p��� OWNER: Name (Fee Simple Titleholder): AO M Esc, I4A""1 1 (A- (N 11 t Phone #3I�5 737 - 6 UOL0 Address:/Zit 1.1 � L� 9 J-I-r L'4- City: ell Ath; State: Zip: c /iet Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 2 y i■-) leg S4 e e-f City: Miami Shores County: Miami Dade Zip: 331 (o 8 Folio/Parcel #: ate) ° Ott 61 q� Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Ky S€rth _k_. 9 L mio Phone #: %I/ 6,57r- 1/Z 7 Address: Ll (C LI CG I r f .r2 City: pal 10 ge State: rf' Zip: JJa le- y Qualifier Name: ,.,� O%)!) 7 ref Aner' Phone #: '(09.a2% -1 State Certification or Registration #: CFO. i Z 7. $J Certificate of Competency #: Contact Phone #: 1Pja (1C( C1 S--7 Email Address: FLIA C C"LJ 8 Q-,LS© ` nil .-4 DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 4f 50 Square/Linear Footage of Work: Type of Work: Address Gilt Iteration New ORepair/Replace ❑Demolition Description of Work: 16 QYlfl -. `r' * * * * ** ***** ** ***** * * * *+ ** * * * *** * * *** Fees** * * *:x****** ********+ x***** ************ * ***** Submittal Fee $ Permit Fee $ /.161 - CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip �A. 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 spection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection il; not be approved and a r'''spection fee will be charged. r Signatur Owner or Agent The foregoing instrument was acknowledged before me this( day of , 20 by 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 Exp' AMP wok 11 97+-6_ 1111141railtaikk44040Pf Cornmissico # DD 921629 Bonded T F. ''atic' I Notary Arsn _t Signature Contractor The foregoing instrument was acknowledged before me this 1 day of ,20 0 (,by who is nersso j known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: My Commission _ � � F�ut3ERT0 L. GUTIEP.' EZ _} � Notary Public - State o' Florida �y Comm . Expires Dv' x*+ x, x+ x*, xx�, xx�m, x,, xx,* x�+ x, x, aa�**,+ xx�*,>« m° x+ xx°, xx�, xx°, x, x, xx�, xFia ,x°xu°,xFxa�,x,ts *,x,x,x,x,�,x x ,k,x1629 �, .ice ff , t1r Through P � � ie ;Zo sn. k; lam` APPROVED BY 1 )--2--0i/ Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk ,AC RO asp CERTIFICATE OF LI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITU' REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate Bolder la an ADDITIONAL INSURED, the the terms and conditions of the policy, certain policies may require an a certificate holder In lieu of such endoraement(s). PRODUCER Aon Risk Services Central, MC- Chicago IL Office 200 East Randolph Chicago IL 60601 USA IN2UREb Sears Holdings COrporatioh dba Sears Home improvement Products, xnC Attn: Risk Management E3 -219A HoffmanvEstatesaIL 60179 USA COVERAGES CERTIFICATE NUMBER: 5700431 B THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 6EEN ISSUED TO THE INSU ED NAMED ABOVE FOR THE POLICY PERI00 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R ADD SUB Limits shown are as re uq sated LT • annex I. LIABILITY X COMMERCIAL GENERAL LIAR/LITY - CLAIMS -MADE OCCUR B I L I E iINSURANCE I Da o7/D7na1 rrrm Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS , EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES rE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED policy(lea) mint be endorsed. If SUBROGATION IS WAIVED, Subject to ndorsement, A statement on thla certificate dose not confer rights to the CONTACT NAME (AIC (866) 289 -7122 (Fan'., Nat: CB47) 953 -5390 INSURERIS) AFFORDING COVERAGE NAIC Il INSURER A: Indemnity xnsurante Co of North Mari ca 22667 43575 INSURERS: ACE American Insurance Company INSURER C: INSURER 41 INSURER E: INSURER FI 88 REVISION 111 ER' TYPE OF INSURANCE a BEN'L AGGREGATE PL IT APPLIES PER; POLer I IJFer ' lLOG AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS HGOm POLICYNUM9ER LIMITS EACH OCCURRENCE $5,000,000 DAMAGt IO H61Q(g6 $5, 000, 000 PRaLSES_(Ee !rcwnrmce) LIED PXP (Any ohs person) Exel uded PERSONAL & AOV INJURY GENERAL AGGREGATE $5,000,000 $5,000.000 PROOUCTa - COMP/OP AGG 55,000,000 - SCHEDULED AUTOS X NON•OWNE0 — AUTOS B UMURELUA LIAR EXCESS LUIS DED RETENTION IMMINIOL OCCUR ISAH.: ti49 Y5AH08896637 CLAIMS•MADE WORHERE LOMPENNSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE N OFFICERf �MgEP EXCLUDEDV (Myaendatary In NH) DESCRIIPTION OF OPERATIONS below NIA U1 2011 08/01/2011 0a 01 :+ COMSINEO SINGLE IJMIT $5,000.000 08/01/2012 TEA aeddenlL _ -_ . BODILY INJURY ( Per panon) BODILY INJURY (Per =Veep FROPERT(DAMAGE (Per accident) WLRC b452803 CA MA SCFC46482527 WI 08/01/2011 D8 /01 /2011 EACH OCCURRENCE AGGREGATE 08/W2-517 08/01/2012 DESCRIPTIGN OF OPERATIONS/ LOCATIONS! MOLES (A1heh ACORD 107. Additional Remark' Se04o4e, if more ewe la repuhmel x 1 TORT LIM 1 IE• E.L. EACH ACCIDENT E.L_ DISEASE.EA EMPLOYEE B.L DISEAS&POLICY UMIT $2,000,000 32,000,000 52,000,000 Holder lde Millar :2287931 Certificate No f 570043198488 Alfred w. Nyman, r. License # CnC1249510, 000012538, CCC132$316 located 4 1024 Florida central Parkway, 32750. .F� Dell R. Hoyt License 0GGC1517994, CRcOi7383 located S 1024 Florida Central Parkway, Longwood, PL 32750. CERTIFICATE HOLDER CANCELLATION City of Metal shores 10050 NE 2nd Avenue Miami Shores FL 33138 USA ACORD 25 (2010105) SHOULD ANY OF THE ASOVE =SCRIBED POLICES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELVER: lb IN ACCORDANCE VAN THE POLn9Y PROVISIONS. AuTHORRED REPRESENTATIVE Jae. irk t S W e.l;Q ®1988 -2010 ACORD CORPORATION. All tights reserved. The ACORD name and logo are registered marks of ACORD 1 Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 [dl Construction to chen Cabinets, nit Vii : APPROVED Expiration: 01/24/2012 Project Address Parcel Number Applicant 24 NW 109 Street Miami Shores, FL 33168 -4315 1121360110190 Block: Lot: HARRY JULMISSE Owner Information Address Phone Cell HARRY JULMISSE 24 NW 109 Street MIAMI SHORES FL 33168 -4315 Contractor(s) Phone SEARS HOME IMPROVEMENT PROM (305)341 -5663 Cell Phone Valuation: Total Sq Feet: $ 19,363.00 0 1 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN REMODEL Stones: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Bond Retum : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $12.00 $8.72 $8.72 $4.00 $580.89 $9.00 $16.00 $639.33 Pay Date Pay Type Invoice # RC -7 -11 -41525 07/21/2011 Check #: 1002 08/04/2011 Check #: 1097 Amt Paid Amt Due $ 50.00 $ 589.33 $ 589.33 $ 0.00 1 Available Inspections: Inspection Type: Drywall Final Framing Insulation In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. August 04, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date August 04, 2011 1 wa eu1 rc te` iami Shores Village i Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 TT- JUL 2 1 2011 a....................... BUILDING Permit No. g'C' I I 13adN PERMIT APPLICATION Master Permit No. FBC 20 07 Permit Type: BUILDING e, Q 1 �Q --_ OWNER: Name (Fee Simple Titleholder): �i X451 1" �-J ` Phone #a63 7f / o 4 imp Address: i j 69 ii-re( / City: M■'911 i State: FL Zip: /42, Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 33/41 Folio/Parcel #: 1` —c2- j 31,® O 11-0 1 9 3 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name:D \bfirtit., _A-IrY1f)Y JL- •f Phone #: 951A -3-"D 79479 Address:WZ` f Fi.->ticliN Os .i pA .111_,-- k ,oA-1 City: n _ State: �k Zip: 3-2_7s- Qualifier Name: t �\ .. e ___ minrs Phone #: -19`Q (4 (04 cl'25 LI State Certification or Registration #: C., 6 r2-&-,3 r Certificate of Competency #: Contact Phone#: Q ?S S -1 Email Address: R_ �L `u 4-' DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 1 q 1 31123 Square/Linear Footage of Work: I/O GJ Type of Work: ❑Address \ Alteration,/ �_ New ❑Repair/Replace ❑Demolition Description of Work: % - c�J\ed a Tl l N l LA-rt r COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *Fees* ******,***** * * * * * * * * *•* * * ** * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $C) g'ck CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City Nit State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip State CK 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 wi of be approved and a reins 'Q tion fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this p c�The foregoing instru day of03_1-1_, 20 \,by 0%,- (2_ 3 u ` emu'" 7lay of rt who is personallv�o ae -or who has produced As identification and who did take an oath. NOTARY '_ _ : LIC: Signature Con actor ent was acknowledged before me this ICI 20 [, by k ■I 11/4.4,01. t • 1 who is persona ll known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Sign: Print: ��' : +�a° j �! . 's.°). °, Print: My Commission Expirl : '' -1171 Commission # " . Assn «,. gor,ded Throe h National Notary •.rd My Commissio -E p ', My Comm. Expires Dec 27, 2013 Commission # DD 921629 Burled Through National Notary Assn. *** * *** * *** *, ter * * * **** * ** *** * ****, ************ �ra****** ** * ** * * *a * ** * * *a * * **** * * * * * * * ** ** *** * **** * *** * * ** * * *** * * ** APPROVED BY L= li�K/ ��6f/ (Revised 07 /10 /07XRevised 06 /10/2009)(Revised 3/15/09)(rev6/4/1 0) Plans Examiner Structural Review Zoning Clerk 111111111111111111111111111111111111111111111 This Ins tt t Pre ared by: Name: SEARS HOME IMPROVEMENT PRODUCTS, INC. 1024 Florida Central Parkway Longwood, FL 32750 Phone: 407 -551 -6000 NOTICE OF COMMENCEMENT CFN 2011R051$271 OR Bk 27778 Pc 4521; (1ag) RECORDED 08/03/2011 14:26:0.9 HARVEY RUVII'1v CLERK OF COURT MIAMI -DADE COUNTYt FLORIDA LAST PAGE Permit No. Tax Folio No. J/ j.i(o -(% // f O% 9 THE UNDERSIGNED hereby gives, informs you that the improvement will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1. Description of property (legal description:) 1 /1 044 5 jL ,q11 „Moro Lib a) Street Address: 2. General description of improvements: 3. Owner Information a) Name and address: i +rJ1 -2d r, b) Name and address of fee simple titleholder (if other than owner) c) Interest in property: 61- 00-r 4. Contractor Information: a) Name and address: Z m: ; p/ J7i0.1 SEARS HOME IMPROVEMENT PRODUCTS,, INC. 1024 FLORIDA CEIVTRAL PArucwAY. LQNC9}rpo FT, 42750 b) Telephone No: 407 -551 -6 �_,_.,,��Qp Fax No. (Opt.) 407 - 767 -8536 5. Surety Information: a) Name and address: b) Amount of Bond: c) Telephone No.: r Y Fax No. (Opt.) 6. Lender )44. a) Name and address: Phone No.: 7. Identity of person within the State of Florida designated by osYner upon who notices or other documents may be served: a) Name and address: b) Telephone No.: 8. In addition to himself, owner designates the following person to receive a copy of the Lien or's Notice as provided in Section 713.13 (1) (b), Florida Statutes: a) Name and address: b) Telephone No.: Fax No. (Opt.) ' 9. Expiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is specified) 1��� WARNING TO OW ER ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF !� c C d'►i:4'.,'L',• ANDREW STEVENS 4 in t /L4�.A)LA 4-4 � ~ MY COMMISSION # EE075339 ignature o wner or Owner's Autho ' ed Officer/Director/Partner/Manager •?y. ��• EXPIRES March 17, 2015 FloxtdallotarySe�vae.cwn C L.K... 1.GB .. I°°rl3sao�ss — PRI� NAME The foregoing instrument was acknowledged before me this r)":" day of `UUi , 20 ) ( , by nee Lk. �iyj 1,s.3.0 -- as /5 t...r- - J (type . of authority, e.g. o cer, trustee, attorney m fact) for (name of party on behalf of whom instrument was executed). Personally Known OR.Produced Identification Notary Signature - - Type of Identification Produced Name (print) tLAA-4r..., Sr-COCA-6' AND Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that . : ve read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. FORMS/NOCNER2007 ignature o Natural Person Signing Above STATE OF FLORIDA, COUNTY OF DADE i HEREBY CER17FYthat this is a true copyof he original tii�o e2 vU dayo/ WITNESS h C• 20` HARVEY d and Official Seal. UVLI *C 'O HI rc iliVittMOIKIrd rtittdittiS IV- 004 DrA • P•412421. tj.l.141 55.e Customer approval of layout and design X • All dimensions size designations given are subject to verification on job site and adjustments to fit job conditions. • p hp 671 2� t,j v t 9q s tnie - I-AkG.t k /FL- , 3 C ccf • •.•e• • • • • •• • • • Ines* • .•• • • •.• cam' • • coo > 111111111111111 • • • 1 • .1 3d /$ Gv.M Dwayfl,R 2 • h .2 Lena sit /46c YZ X4 -4La. G►3 o /S'f3 VOL 'VA Qg9 Aga yZl lfie -BC L' h' h .3 522- a Av:gyL- L A Miami Shores Village BY fi I DATE i APPROVED ZONING DEPT BLDG DEPT 9,' SUBJECT TO COMPUANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS i • I Iut tM4t �+o• C0ow10 SEARS HOME IMPROVEMENT PRODUCTS GRANITE VENDOR: 52b Date needed: / / Date ordered: / / PO number: /e9otl496'1`q 0 Job Name: J'iri, oisst- CounterTop Color: .770.w joex.. Splash Height (from deck up): id. Address: ON MW. /D7 4 sm/mr o Aida/ ch"orr Home Phone #:3of 7o- 0404, ADDITIONAL CUT OUTS Cook Top: ❑ YES ®No Range: ❑ YES ®No # of Electrical Boxes: Edge Profile: 071,,et, Work Phone #: 3 CM THICK Alternate Phone #: Sink Model - //s? /.b n %o8 Sink Color - rs TEMPORARY SINK IYEs 0 N V N 45 r---;f40 / ft e If •• ••• • • • • • • • • • • •• • • • , • • • • • • • •• ••• •• • • • •• •• • • • • • • • • • • • • • • • • • • • • • • • • ••• • EW CABINETS YES II. NO❑ =FACE YES C3 NOEr NOTES: ••. • • • • • • • • ••• • • • • • • • • • • • • ••• • • • • • • • • • • • •• •• • • • •• •• 000 • • • ••• • •