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EL-12-1156Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NSP- 175086 Permit Number: EL -6 -12 -1156 Scheduled Inspection Date: August 20, 2012 Inspector: Devaney, Michael Owner: ROBBIN, DAN AND JOSEPHINE Job Address: 810 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MOODY ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Generator Phone Number Parcel Number 1132060340060 Phone: (305)758 -2000 Building Department Comments GENERATOR INSTALLATION Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August August 17, 2012 For Inspections please call: (305)762 -4949 Page 9 of 33 ? 11 /tGA�j° D PERMIT APPLICATION FBC 20 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 Permit Type: Electrical 46/4/ OWNER: Name(Fee Simple Titlehollder): j 4 IZP Phone #: 3195 -- 2_9f- 9(� l Address: C 0 other , /el .57--", City: / ; dl svt t° �4c9/1,e75 State: it-" C, Zip: 357.0 Tenant/Lessee Name: Phone #: Email: Permit No. EL 12+ 115 Master Permit No. JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: / Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: �0 60 ° ; et % � �- � 06 � 6 Phone #: 3C/ S-' 7 8 Z O Address: 6 6 q /U 1 10 5 City: / A . / State: zip: /ce) pp r te' Qualifier Name: UA 4 �/ evd'/ Phone #: State Certification or Registration #: o I l ( Certificate of Competency #: Contact Phone #: ,105 75 o c Email A'dadr s: DESIGNER: Architect/Engineer: /� Phone#: 505 Value of Work for this Permit: $ 5#61e, . 0® ° Square/Linear Footage of Work: Type of Work: °Address °Alteration °New ORepair/Replace °Demolition Description of Work: F fell /AWALL .417 t/, Submittal Fee $ 6& OP Permit Fee $ .3.--O' / !' CCF'$ CO /CC $ Scanning Fee $ PitiG Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ �� —1 i 25 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 pe it 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 wil;� t be approved and a reinspection fee will be charged. Signature Owner or Agent r The foregoing instrument was acknowledged before me this (- day of 5 , 201 1--; by VAN' fu._, (k 1 s, , day of V I. 2' - , 201 ; by who is personally known to me or who has produced r(-- I 'J who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: ����`�'sV18 u� / /// /* NOTARY PUBLIC: s. o' * The foregoing instrument was acknowledged before m- this Sign: Print: ®���,\p ) 4i IIIIUi11 My Commission Expires: Sign: Print: My Commissio Sy�s.,=r'_ MY COMMISSION # DD 979267 �s EXPIRES: May 11, 2014 ,titti Bonded Thru Notary Public Underwriters +k+krk�k+k�kKs *N�+k�k+k�k�k�kN �k�k�k�k **** ************** * *********** * ****************** . * *' ******* **** ************ APPROVED BY Plans Examiner /mod% /G Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 175168 Permit Number: PL -6 -12 -1172 Scheduled Inspection Date: August 20, 2012 Inspector: Hernandez, Rafael Owner: ROBBIN, DAN AND JOSEPHINE Job Address: 810 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: SUBURBAN PROPANE Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number Parcel Number 1132060340060 Phone: 305 -891 -8393 Building Department Comments INSTALL 10' OF NATURAL GAS LINE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 17, 2012 For Inspections please call: (305)762 -4949 Page 10 of 33 Ac-/ if CERTIFICATE LIABILITY INSURANCE ..' DATE IMM/DDYYY) 02/17/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certlficete holder Is an ADDITIONAL INSURED, the policy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(!] PRODUCER USA, INC. 445 8011111 STREET MORRISTOWN, NJ 07960.8454 Attn: Morristown.Cefreguect@Morsh.com Fax 212- 948.0979 J08990- ALL-CAS -12.13 CUE NAME: PA tPgtl&N e. EMI: I WC, No): A€ND ARIL. INSURERS) AFFORDING COVERAGE NAIC INSURER A : Liberty Mutual Fire Insurance Company 23035 INSURED - - SUBURBAN PROPANE PARTNERS, L.P. 1 SUBURBAN PLAZA P.O. BOX 206 WHIPPANY, NJ 07981 -0206 ■ INSURER B • Utterly Insurance Corporation 42404 INSURER C : $ 2,000,000 INSURER O ; $ 250,000 INSURER E : PERSONAL & ADV INJURY INSURER F: COVERAGES CERTIFICATE NUMBER: :1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WIIICH 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. INSR TYPE OF INSURANCE ADDL JIISR OUBR WI POLICY NUMBER — POLICY EFT rMMIDUIYYYYI - POLICE Bill' (MMIDDI YY) .LIMITS A A GENERAL X _ , LIABILITY COMMERCIAL GENERAL LIABILITY ICLAIMS -MADE I X I OCCUR TB2- 631507975032 03/01/2012 03/0112013 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES 1Ea oocu MEEpL MED EXP (Any one person) $ 250,000 $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 GENERALAGGREGATE $ 2,000,000 _GEM-AGGREGATE LIMIT APPLIES PER: X 1 P O L I C Y I I ! LOC PRODUCTS - COMP /OP AGO $ 2,000,000 $ AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED HIRED AUTOS X SCHEDULED NON-OWNED AUTOS AS2- 631 - 507975 -042 03/01/2012 03101/2013 CO SINGLE LIMIT J.Ea $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROTER1YDAMAGE (Per ecddent) $ -. $ UMBRELLA L IA8 - EXCESS LIAB OCCUR CLAIMS -MADE N I A _ WA7 -63D- 507975.012 (AO$) - 03101/2012 03/01/2013 - EACH OCCURRENCE $ AGGREGATE DED [ J RETENTION$ X WC STATU- I LOTH - NUB L..FB $ $ 1,000,00T B WORMERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? I N I (Mandatory In NH) It pee describe under DESCRIPTION OF OPERATIONS below E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $.. '1,000,000 E.L. DISEASE - POLICY LIMIT 1 000000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space le requtred) EVIDENCE OF COVERAGE. • CERTIFICATE HOLDER MIAMI SHORES VILLAGE ATTN: BUILDING DEPARTMENT 10050 NE 2ND AVENUE NORTH MIAMI BEACH, FL 33138 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Mash USA Inc. Manashi Mukherjee ,.- x"Ca.Ano eotwk i to ®1908 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 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 APPLICATION FBC 200 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): Address: (' dG�• �: City: /67a' 4,j P �✓�! or- S Permit No. Master Permit No 2- -e>e,r.e (// /moo S J/ State: l ;T IVE JUN 262012 Phone #: 3e —Z 7 89/474/ Zip: 337,..3 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: / )00 5 /- City: Miami Shores County: Miami Dade Zip: FoliolParcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Off ' )7AD 4P�46-' Phone #: 303-- '/ �4.3 S 3 Address: /449/ 11167 City: ,A/'/'! /7l' State: 1`=e— Zip: 03« / Qualifier Name: SUa-1 i /47,72".&,,A State Certification or Registration #: Certificate of Competency #: Phone #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ l t— • Square/Linear Footage of Work: \ O cci ( 4 ONew ORepair/Peplace ODemolition Description of Work: (4 X11 / is L. o r\ 1 L, 0! Type of Work: OAddress OAlteration ******+ x******* ******x:****x:x:******m+ nor*** Feesa:********* *+ x******** *****m**:x************* ** Submittal Fee $ Permit Fee $ /5-6 Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ '� I l-• I O Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 . , pproved and a reinspection fee will be charged. Signature / S:. i��, / Pu � Signature Owner or Agent The foregoing instrument was acknowledged before me this day of 20 (2-, by Dar10--- a b 1 t 3� who is personally known to me or who has produced 'd' `- � \ �,/ As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: **+ k***+ h+ k**Na*ak************* ******* APPROVED BY .%`,",'3W.L to .. \gym? q= /tttttl1111110 Plans Examiner Contractor The foregoing instrument was ��acknowledged before me thi saS day of ' rt , 20 by )U1I Jf ? pc' who is personally known to me r who has produced as identification and who did take an oath. My Commission Expire °:»; o ono ?MAIM * MY COMMISSION #EEAI3 EXPIRES: June 15, 2015 FOF �ioA`O BaideAihruli,� H��k�ks k�kNaN�KaN�H�**** ik�kih�k�hsR�k�kH�ikH��k +k�kN�ik�k�k+hH=�hKc+k*** *** * �h *** Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk a! Cony v1 L_ &e paw I 1' Fe_ /z01 eve ,g40114 12°6 116 b �d v. APPROVED ZONING DEPT SUBJECT 10 CCh,�pil ` CE WITH ALL FEDERAL AND Cr ijN I f riLL:ES AND REGULATIONS Suburban Propane 1491 N. E. 130th Street N. Miami, FL 33161 305_ 8 g Qualifier Job Address Longest Run i otui BTU's ,,"041N/2 ,6/4" rece. c,A., rte' #;5' `ozgf g-410 /eic lv 0/0 ' 8 S; 114 ry /AF Ory It OA/ rle rc'C2/(/i2 3/�4 _ -- --,. - to ..L/42CA.,, ,/,,- ,,,e'_ 0'-,ef� /r, ... �r- ! f i. (J $tpL N Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 175088 Permit Number: DS -6 -12 -1157 Scheduled Inspection Date: July 26, 2012 Inspector: Rodriguez, Jorge Owner: ROBBIN, DAN AND JOSEPHINE Job Address: 810 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MOODY ELECTRIC INC Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132060340060 Phone: (305)758 -2000 Building Department Comments SLAB INSTALLATION FOR GENERATOR Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments July 25, 2012 For Inspections please call: (305)762 -4949 Page 6 of 26 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 B IL ING PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: E0 ME 100 jf FBC 2010 Permit No. D5- 12 -1 t$1 Master Permit No. EL- 2.- 1 15 10 ROOFING City: Miami Shores County: Miami Dade Zip: FoliolParcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 'a./° ` et il /11; �--� 64� Phone #: 36. -�'? 9 ' r( i, Address: / 0i /VL , f, _�- City: Ai; 4,/ I 51' � it S State: �� Zip: Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company' INI Name: + (-/I Uv�ru G In Address: /►6 q lV td QO S City: 1 1, l� f i1 / State: Pt/ Zip: 33/5-0 �® Qualifier Name: Ot /-/ls 'J A 00 /r Phone #: State Certification or Registration #: �61 /f q Certificate of Competency #: Contact Phone #: 7 Xg6:70 Email dress: Phone #: '7Jg"Z:ZO DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ g ®0 ` 0 Square/Linear Footage of Work: Type of Work: ❑Addition DAlteration UNew ORepair/Replace ODemolition Description of Work: . L, B /4 ATP"LL 6 °P./h .4 ctitei Color thru tile: ************ ****** ***+ x**** **+ x**m ******* Fees** **** *+ x***+ x* *******+ x+ x*+x*********** ********* Submittal Fee $ Sb .00 Permit Fee $ / X> oa CCF $ CO /CC $ Scanning Fee $ pR/D 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 i' Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State / Zip Application is hereby made to obtain a permit to d6 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 no a approved and a reinspection fee will be charged. Signature // Owner or Agent A The foregoing instrument was acknowledged before me this T The forgoing instrument wasacknow geed before me this day of p�Z _ , 20 _ -by \J IC_ (1 t3 , day of who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: P who is personally known to me or who has produced 11I t1I ury,�� As identification and ‘\‘111 ,+ takes S v 0*: NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY ie ld' Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Sign: Print: My Commis ,,' MARY PAT BRIGGS 4. MY COMMISSION # DO 979267 :9 EXPIRES: May 11, 2014 Bonded Thru Notary Public Underwriters * * ** Zoning Clerk Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit NO. DS -6 -12 -1157 Issue Date: Not Issued Expires:Not Issued Folio Number:1132060340060 Owner's Name: DAN AND JOSEPHINE ROBBIN Job Address: 810 100 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: Total Job Valuation: 0 $ 800.00 Contractor(s) MOODY ELECTRIC INC Phone (305)758 -2000 Primary Contractor Yes i Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 6/28/2012 : Yes Comments: 06/26/2012 12:02 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES @001 ********************* *** TX REPORT lc** ********************* TRANSMISSION OK TX/RX NO 2689 RECIPIENT ADDRESS 93057541333 DESTINATION ID ST. TIME 06/26 12:01 TIME USE 00'42 PAGES SENT 1 RESULT OK Permit 11 o: 'c2-1156 Job Name: June 26, 2012 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet 1) The generator must be a minimum of 10 from side lot line and 5' from rear. 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 305-762-4859 RA ) 5 - -75 (4e4 II: l'-'1A0 Permit o: 12 -1156 Job Name: June 26, 2012 Miami Shores Viiiage 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 1) The generator must be a minimum of 10 from side lot line and 5' from rear. 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 - 762 -4859 FAX — /59f1333 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. I /-32() -03-/-0066 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. 111111111111111111111111111111111111111111111 CFt4 2012R0489383 OR I .k 28184 Ps 4422; (1 p s ) RECORDED 07/12/2012 10 :36 :31 HARVEY MIN? CLERK OF COURT MIAMI -GAGE COUNTY? FLORIDA LAST PAGE Space above reee for use of reco office 1. Legal description of property and street/address: '3/1.S8 2. Description of improvement: /-1 oae-- op - eL.�c =%%C' I e.4 L. 3. Owner(s) name and address: >/� �� ' f A / Interest in property: Name and address of fee simple titleholder: /U/Pc 4. Contractor's name, address and phone number: �� i GTh. //JC' 64 VIA) fii ft/.4i4/ PC, 3 /s-,0 5. Surety: (Payment bond required by owner from idiftractor, if any) Name, address and phone numb : A) Amount of bond $ i 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon who Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: A- STATE OF FLORIDA, COUNTY OF DADE I HCRCBY CERTIFY that Uiisisa tam copy of the odgi >1 e 9 ,s' - on day of • __ may . e served C 8. In addition to himself, Owners designates the following person(s) to receive a co 713.13(1)(b), Florida Statutes. I, tt� n Name, address and phone number: /U 4 the Lienor's Notice as provide.' in Section 9. Expiration date of this Notice of Commencement: t /r expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER Al- 1 ER 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) orb: or O r ' Au/Zize cer /Director /Partner /Manage Prepared By �i��:b , �__y Prepared By Print Name pAmtEL Apr A.1 Print Name D A) /gL 1et)A &Ai Title /Office Title /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The foreRoing instrument was acknowledged before me this AIJIEL R(kb/ J3° r dividually, or ❑ as for d Personally known, or ❑ produced the following type of identifi Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. /1 day of -V-061-1 . a/ 2- Signs By Owner ner(s)' th• Officer /Director/Partnr /Mana 123.0 =t' PAGE3 12/11 By PERMIT #: Ds- t2--I1S1 Miami Shores Village APPROVE BY ZQMINO EISPT MARY PAT BRIGGS f4„ MY COMMISSION # Dt) 979267 EXPIRES: May 11, 2014 Ws Bonded Thru Notary Pole Unftwriters 2o KW 4E4E4A-root