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RC-10-383Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: I NS P- 173954 Permit Number: RC -3 -10 -383 Inspection Date: May 21, 2012 Inspector: Bruhn, Norman Owner. LEARY, KIMBERLY Job Address: 72 NE 104 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HUGH A RYAN CONSTRUCTION CO Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number 305 - 759 -1808 Parcel Number 1121360130870 Phone: (305)978 -0983 Building Department Comments KITCHEN REMODEL Pass -�„/� 4C04 Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until May 23, 2012 For Inspections please call: (305)762 -4949 Page 1 of 1 '0110 trt 1 1+4 k" Miami Shores Village: Buildin g Department artment W3n MAR 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAR L 0 2010 N. Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 :" a °,ti „ °,,, • BUILDING PERMIT APPLICATION FBC 20 ems~ Permit No. e Master Permit No. Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) ALAr. Popp i- Kim 102 be)/ Leo /hone # Owner's Address 7 2 MC /c, I 5Y-r- t 11 City #11101 " t S ieN m re S State rt_ Tenant/Lessee Name Email Zip T3! 78 Phone # Job Address (where the work is being done) 7Z /0 /0 y S?'r e t City Miami Shores Village County Miami -Dade Zip 33) 3 8 FOLIO / PARCEL # Is Building Historically Designated YES NO X Flood Zone Contractor's Company Name Hu5L A. Py. Cprs*u c&, C� . Phone # 3D5-77a - O "5 3 Contractor's Address 132o 5 w (3 Ave City 16!1) a rn t State F Zip 3 31 (7.5- Qualifier Name Nvj 1 A- 2y...,. State Certificate or Registration No. C 3G' 0 5-7 o S3 Certificate of Competency No. Phone# 3oS -97e -0973 'Contact Phone 3056 i 7 —o 5 r3 Arehitect/Engirieer'.s Name (if applicable) E -mail R1ar, Ir-60 C a/ • Phone # Value of Work For this Permit $ /C3 1)0 U Square / Linear Footage Of Work: 5 0 '5. f , Type of Work: ['Addition Alteration ❑New ❑ Repair/Replace [1 Demolition Describe Work: OBI- IX.fe- I 2. C��/ ` c� �-e rdles, a ssbc1-41 pk iy cc) tp/L * *, ***** * * *** * * * ** * * * * * ** * * *** *** **** ** Fees ** * *** * * * ** *** * * * * *,r * *,x * * * * * ** * * * * * * * * * * * ** 1k t E Submittal Fee $ Permit Fee $ '�0® CCF $1'_ CO /CC.$ Notary $ Training/Education Fee $ P` Scanning $ ° 0(1 Radon $ 0°40 DPBR $ ° 41 Technology Fee $ Bond $ Double Fee $ Violation date: •e'�. 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 insp tion w iich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will n t be app oved and a reinspection fee will be charged.. ,), Signature 1 O er or Agent The foregoing instrument was acknowledged before me this day o cL , 20 1 Q by /\-141 tJ eot P- who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: sAt �< C My Commission Expires: ,, CHARLENE D. SMEWE , :+� Commission DD 786599 Expires July 19, 2012 Bonded ThtuTro Fait 385.7019 * * * * * * * * * * * * * * * * * * * ** APPROVED BY * * * * * * * * * ** Signature _. , tractor The foregoing instrument was oknowledged before me this day of , 20 t0 , by H1)0 RON who is personally known to me or-who has as identification and Plans Examiner (Revised 07 /10 /07)(Revised 06/10/2009) Engineer NOT Sign: Print: uau,,,n, comet# DD07 My Co ege EXPIres 51112011 o a 9/1 soda W..o.t.a.r'Y u A. s°sn..., a Inn@ snn. .ee441 ' �® Zoning Clerk checked Miami Shores Village MAR o ij 2 g Department De artment i ) 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 APPLICATION FBC 20 Permit No C A0 — M3 Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): Phone #: Address: City: State: Zip: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: /k51, y "'f'`°c' da; Phone #: Address: , f 7 2o 5 f e/ City: fAll 1" a "" ; State: & Qualifier Name: )4151-, i , R, <i^ State Certification or Registration #: 1 ' 05-3. 0 $ 3 Certificate of Competency #: Contact Phone #: 3 uS^ " J' _1)5 Sr 7 Email Address: DESIGNER: Architect/Engineer: Phone #: Zip: 3-779 S Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition OAlteration ONew ORepair/Replace ODemolition Description of Work: ******** ** ****+x **** * * ***** ** *** **** *** Fees **+x*,x** ********* **** ** ***** *** * * *** x * **** Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Tecbnology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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 AFFU)AVIT: 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property i subjec to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first ins. 'ction hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will n, t be a proved and a reinspection fee will be charged. Signature The day wh < Signature wner or Agent C - tractor is9__ The foreg4i ins iment w: ackn' ledg bef� e m :„ isday I by l )f to me or who has produce produced t T� o egg g in'.� ment was ac 01 ,.by identification and who did take an oath. o is rso all own to me or who h.' 9 N Sign: Print: My Commission Exp Exp #�E12 �= MY Commission # E.E x81 Nob Assn. Bonded Through N OTAR Sign: Print: My Co entification and who did take an oath. LIC: • •, Notary ' u ' t •, trfftAy Comm. Expires Sep 23, 2015 Commission # EE 128810 ' o ' got' Bonded Through National Notary Assn. * * * * * * * * * * * * * * * * * ** APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Zoning Clerk Wily Va. 0031221 Pap /nil Bebling Sketch (Page 1) MgmtgLZIEEKLIIRMARY. 044ERLY PaggtathgL2 he VIP Lender CHP MORTGAGE tamW MIMI-DADE State Ft. lb Codt 34138 33.0' 39.0. wood Deck 10.( 14.0' Rath 16.0' Living Pining Foyer vac Sailt Kitchen 23,0. 5A" Porch 1.1.0 MA 13Y:- TEWM)ii 0 2010 ill ee wied"11 410/10 obk- 84.0k ,C P!$ ',A IT #: iRcip_ Miami Shores Village- APPROVED BY DATE ZONING DEPT BLDG DEPT SUBJECT tO COMPLIANCE WITH kI 1 FEDERAL REGULATIONS STATE AND CGUN CY rIULES AND 41 z 14.0 X 10.0 . A2 26.0* 5.0 - A3 t 53.0* 28.0 . A4 I_ 14.0 z 11.0 Attacked Garage rat neer Total Liviag &yea - 40/1",692-1, 144.0 -206.0 1502.0 1592.6 AS 14.0 X 19.0 . 266.0 AttactomICIAxage 70582 ftwago Arms 266.0 Rim SICTAISI =TOTAL for Windom* eppialsal strItsme by a lo Rat 14090UNCIDE .9Yeevr- -266.0 4,74.0".." Moy,c27-4rp A2 p 67C.Pc7"A5 , Aloy fr 461,14e-4- 1044Y441- g-e"Atitticter/2.4- 're /7e e,I.6c /..400cf, V itirrityie,„J 1 'bett Ces.NArt> e57 t 9 z#6, eAs Ai a re/ A-4 at7i-", e, reA- g e_ Neva e ty e,te avir72 > ,,7yte44 A vc-Aer '7,1Lci e, ?/747\0e- A/7/v ii0-14--eo c,fr_ P t c4 /fa Ar‘P'e- 9 Ai, /4 e S i-775 ‘K, 4.2 rzokw-,A, 3AV k ft Permit No: 10. ?y Job Name ,2010 Miami Shores Village Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 ADE CO THERM ENSEP'r STATE OF FLORIDA SEE OTHER SIDE DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 02/19/2010 EXPIRATION DATE: 02/19/2012 DO NOT FORWARD HUGH A RYAN CONSTRUCTION CO HUGH A RYAN PRES 1320 SW 13 AVE MIAMI FL 33145 1.11.,11,,,,ILI „I,I,1 ,,,,11,11,,,1.,111,,,,,1,111.,, 9811 PERSON: HUGH A RYAN FEIN: 562312507 BUSINESS NAME AND ADDRESS: HUGH A RYAN CONSTRUCTION CO 1320 SW 13TH AVE MIAMI, FL 33145 SCOPE OF BUSINESS OR TRADE: 1- CERTIFIED BUILDING CONTRACTOR IMPORTANT OPursuant to Chapter 440.05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of electior L under this section may not recover benefits or compensation under ti D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt... apply only within the scope of the business or trade listed E the notice of election to be exempt. E Pursuant to Chapter 440.05113), F.S., Notices of election to be exemi and certificates of election to be exempt shall be subject to revocat if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1 STATE OF FLORIDA AC #3912338 DEPARTMENT OF BUS INESS AND PROFESSIONAL REGULATION CBC059083 08/13/08 080090015 CERTIFIED BUILDING CONTRACTOR RYAN, HUGH ALBERT HUGH A RYAN CONSTRUCTION CO IS CERTIFIED under the provisions of Ch.489 'FS Expiration date: AUG -31 , 2010 L08081301757 03/0512010 14:43 9549560555 COVER ALL INSURANCE. 1'/4 Ul /W ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER COVER ALL INSURANCE 6800 W. ATLANTIC BLVD. MARGATE, FL 33063 DATE (MWDONYYY) 030612010 THIS CERTIFICATE IS ISSUED AS A MATTER OR INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ALTER HOLDER. OVERAGE AFFORDED BY THE POI. CIBELOW. INSURERS AFFORDING COVERAGE NAIL tY INsuRs0 HUGH A. RYAN CONSTRUCTION COMPANY 1320 5.W. 13 TH AVE MIAMI, FL 33149 FAX# 3054158-1992 INBURERA. AMERICAN VEHICLE INSURANCE WAWA It INSURER C: NEWER D: INSURER e: THE POUCIES OF 'NBURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION CP 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 I5 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE UNITE SHOWN MAY HAYS SEEN REDUCED BY PAID CLAIMS, INSR AWL DATE THE , THE Il3$UIN0 NSUR ENDEAVOR TO TAIL 10 DATE WRITTEN 10050 NE 2ND AVE P- .,uOYEXPIRATION LIMITS A REP(IESENTASi �f MCRALLIACIUTY C NIERCiAL GENERA GL -0504000073.00 0210112010 3210112011 , EACH OCCURRENCE (1,000,000 * 130 X 6 TQ Rg Y NT&D ,yA81L1rf I CLAMS MACE X OCCUR MED EXP t4jw one more s NO PERSONAL 3 APV NJuRY $ 1,000,000 OEN 1 N_F.RAL AGGREGATE $ 2,000,000 $ 2000,000 I ArGR GAZE LIMIT APPLIES PER PRODUCTS • CQMwOP Arc POLCY Ti LUC AUTOMOB LR LIABILITY ANY AUTO ALL ODD AUTD6 SCHEDULED AVMs HIRED AUTOS NON -OWNED AUTOS �Q1if� (! R . INID SINGLE LIMIT $ BODI Y INJURY {P°' P°` ) SPOO Lam} Y PROPERTY DAMAGE f • (Pa/accident) ARAOE UAMLPr'Y ANY AUTO AUTO ONLY -EA ACCIDENT .¢ $ THAN °A ACC OTFEW AUTO ONLY: AG O S ESSlUIt�R Ty OCCUR CLAIM8 MADE —1 Ce0UCTIBLE ' RETENTION A EACH QCCURRENDE S AGGREGATE S E WORKERS L OEPENSAnQN AND EMPLOYER, LIASIUTY ANY PROPRETORIPARTNeRIEXECUTNE Dr FFaICER/MEMBEREXCLUDED? SPECIAL PROOVIEIOMS balaw 41 111114 1114 RR G,t„ GACri ACCIDEIJT E.L. DISEAS3- EA EMPLOYE E s___ E.L. DISEASE • POLICY UMIT 3 OTHER DESCRIPTION OP OPERATIONS / LOCATIONS I VSH1CL6t i EXCLUSIONS AMMO BY ENDORSEMENT t SPECIAL PROVISIONS REMODELING CERTIFICATE HOLDER CANCELLATION ACDRD 25 (2031108) 0►ACORD CORPORATION 1986 SHOULD THE ABOVE DESCRIBED POUCIESSECANGELLEDHEFCRETNEEXPIRATION VILLAGE OF MIAMI SHORES DATE THE , THE Il3$UIN0 NSUR ENDEAVOR TO TAIL 10 DATE WRITTEN 10050 NE 2ND AVE NOTICE TO RnhCATE HOLDER IRt PC THE LEFT, BUTPAILURE TO 0030 SHALL WANG SHORES, FL 33138 BAPO�St'E'.N6 L LIABILITY KIND THE INSURER, ITS MEETS OR REP(IESENTASi �f AUTIA RFJ IESSNTA ACDRD 25 (2031108) 0►ACORD CORPORATION 1986 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE. UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1111111111111111111111111111111 1111111111111 CFN 201080509.661 OR Bk 27369 Ps 21931 (1pa) RECORDED 07/29/2010 14:02 :37 HARVEY RUVIH, CLERK OF COURT 11IANI -DARE COUNTY, FLORIDA LAST PAGE 1. Legal description of property and street/address: 77- pt /0'f . Slf /Gd- pi l kW/ -S� re-5; 144. S.71.Yr 2. Description of improvement: b< '1+4•4, a Q,2 o' 3. Owner(s) name and address: Maw �o P p 4 �' / w.60✓ i t / . 2cvy 7 2 N 6 /0 Y SA -rd. s�.breri FL 331 P Interest in. property: Name and address of fee simple titleholder -4. Contractor's name and address : Ont. f 1� y ay. Cy,.$41ve r.. Co, 1320 Si,.% !3 Ave. w+• �4 I' 5. Surety: (Payment bond required by owner from cont.' Name and address: Amount of bond $ 6. Lender's name and address: 4— 4, ,.. rep:• anytIPY thetthis Is e office r: i41a .�lfi.'.'rj---\i �N�i. -p� .•.'t' { -♦ 7. Persons within the state of Florida designated by Owner • •- whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)0), Florida Statutes. Name and address: 9. pirati ' n.date of this Notice of Commencement: the expiration date is 1 year from the :date of recording unless a dill: ent •' =te is specified) Pn ; Print Own = r' . Name 144 /W 713 1 Prepared by Sworn to and subscribed before me this S? 14 %!�¢ , 2010. Address:` / . Z 0 fL' 1 3 > Notary Public �t..A -e. (�. r ; l"'11 a^i ft_ 7 3% .° tq��,"� Print Notary's Name C�T1 11C Ski /C- My commission expires: 123.01 -52 ,PACSEE 4 W02 MIAMUDADE COUNTY TAX COLLECTOR 140 W ;FLAGLRR ST. 1st FLOOR NANO, FL 33130 2010 LOCAL BUSINESS TAX RECEIPT' 2011`. MIAMI -DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2011 MUST DE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 423124-7 BUSINESS NAME / LOCATION HUGH A RYAN CONSTRUCTION CO 1320 SW 13 AVE 33145 MIAMI THIS IS NOT A BILL — DO NOT PAY RENEWAL RECEIPT NO. 441839 -8 STATE# CBC059083 OWNER HUGH A RYAN CONSTRUCTION CO Sec. Type of Business This csu2Y6A - GENERAL BLDG CONTRACTOR BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY. EXISTING REGULATORY OR. ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PEnxtrr OR LICENSE REQUIRED BY LAW, THIS 1S NOT "A CERTIFICATION OF THE HOLDER'S 'QUALIFICA- TIONS... PAYIdENT RECEIVED MIAMI -DADS COUNTY TAX COLLECTOR:. 07/27/2010 60050000367 000045.00 SEE OTHER SIDE ATEtiOktiFil3A DEPARTMENT OF FINANCIAL SERVI DIVISION C? WORKERS' COMPENSA ? °;1 CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE WORKERS' COMPENSATION LAW FIRST -CLASS U.S. POSTAGE j PAID MIAMI, FL PERMIT NO. 231 WORKER /S 1 DO NOT FORWARD ' HUGH A RYAN CONSTRUCTION CO HUGH A RYAN PRES 1320 SW 13 AVE MIAMI FL 33145 1i11111.s � }T 1411�t 111h 3 lTt,11111�T t! }sll� }ttli tlll�It TrT,�,T„1�' MPT FROM FLORIDA EFFECTIVE: 02/19/2010 IEDCP IRATION DATE: PERSON: HUGH A RYAN FEIN: 562312507 BUSINESS NAME AND ADDRE A RYAN CONSTRUCTION CO 1320 SW 13TH AVE MIAMI, FL 33145 SCOPE OF BUSINESS OR T CERTIFIED BUILDING CONTRACTOR 02/19/2012, a?) IMPORTANT OPursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed on the notice of election to be exempt. E ;R E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 1 Protect Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 72 NE 104 Street Miami Shores, FL 33138- 1121360130870 Block: Lot: KIMBERLY LEARY Owner Information Address Phone CeII KIMBERLY LEARY 72 NE 104 Street MIAMI SHORES FL 33138 -0000 305 - 759 -1808 Contractor(s) Phone HUGH A RYAN CONSTRUCTION CO (305)978 -0983 CeII Phone Valuation: Total Sq Feet: $ 10,000.00 80 1 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN REMODEL Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee Radon Surcharge Scanning Fee Submittal Fee Technology Fee Total: Amount $8.00 $0.40 $2.00 $300.00 $0.40 $9.00 $50.00 $8.00 $375.80 Pay Date Pay Type Invoice # RC -3 -10 -37251 08/11/2010 Credit Card 03/10/2010 Credit Card Amt Paid Amt Due $ 325.80 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final PE Certification Shutter Final Window Door Attachment Tie Beam Slab Termite Letter Framing Insulation Drywall Screw Shutter Attachment Window and Door Buck Ceiling Grid FiII Cells Columns Declaration of Use 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 11, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date August 11, 2010 1