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RC-12-2069PERMIT # 1 CONTRACTOR: SUBMITTAL DATE: ADDRESS: Ppirr) CAnniv- lo 31112- 10 NAME: RESUBMITAL DATES: CA\ ZONING FIRE STRUCTURAL IMPACT FEES RS- fro ELECTRICAL HRSIDERM /116 * PLUMBING NOC MECHANICAL BLDG 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 Permit Type: BUILDING JOB ADDRESS: 92/ 0 ACS 2 '' City: Miami Shores County: Miami Dade Zip: 3)/3 g Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): J(d Cir/e Phone#: t8 $V2 £ /c9 Address: A 9 Z / 0 /' Z 41%6— _ �r City: '/ s / / '' %l� S' 't f State: Zip: 3 (� Phone #: Permit No. CT 3 1 2'612 BY: aa000 ® ®__ ®v®0000sm Master Permit No. ROOFING Tenant/Lessee Name: Email: trS yr /ce 04Z--• CONTRACTOR: Company Name: & OW Phone#: %'f.Ji"! Cfrg °0 0% Address: 2/ 0 �G� City: 110"1/ /l / State: Zip: 3 / 3e Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ /...�� C/ 00 Square/Linear Footage of Work: Type of Work: DAddition DAlteration DNew DRepair/Replace DDemolition Description of Work: Color thru tile: + x******** ********* *******+s************ Fees****************** ** ** x*+x ***********+x** **** Submittal Fee $ Permit Fee $ fQ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 4te J l eo 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 FT.RCTRICAL 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, free will be charged. Signature Signature The fo day o er or Agent owledged b who is p onally known to me or who has produced itification and who did take an oath. 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: NOTA Sign: Print: My Commission Expires: Sign: Print My Commission Expires: * * * * ********** ** *** * * ***** ** *********, �x��` x**** �x�xx��x�x *�x�x**** ** *x��x+x+x+s+ + x+ x�x�x+ x�x+ xx��x***** * * * *** * *a� ****** * * * ***�x�x***** �` 24lans Examiner APPROVED BY Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /1012009)(Revised 3/15/09) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: figez- cir/C DATE: ADDRESS: 92i0 7‘-r— 2 i76 R7/ / j/, J 3.3 /38 Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor, I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. 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 new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction 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 supervision and must be employed by you, which means that you 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 understand that state law requires construction to be done by a licensed contractor have applied for an owner - builder permit under an exemption ftom'the law; The exemptions cifies that I as the owner of_ the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial ififi I understand that building permits are ,not required to be signed_ by a property owner unless he, or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. initial S 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that l. may protect myself from potential financial risk by hiring a licensed contractor and having the permit tiled in his or her name instead of my own name. .I also; understand that the contractor is required by law to be licensed in ;Florida and to list his o'r license numbers on permits and contracts. Initial 87-e_s 4. I understand that 1 may build or improve a one family or two - family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially p which violates the exemption.�f improved it for sale or lease, w Initial . 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. initial 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by Jaw and by county or municipal ordinance. 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder, may held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner - builder and am aware of the limps of my insurance coverage for injuries to workers on my property. Initial 7 °` 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk, 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govem owner- builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances building odes, and zoning regulatloits. Initial 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. 1 also understand that) may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http://www.rnvfloridalicense.cornklbodoro/cilbiindex.html Initial 177g1 11.1 am aware of, and consent to; an owner- builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial 12. I agree to notify Mad t Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial 1.7� Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court.' It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. ff you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retuned to the local permitting agency responsible for issuing the permit A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this 3 / day of r`-, 20 /2_ who was personally known to me or who has Produced there License or 1 N.Arlas identification. RYJ CLAUDIA V. CUBILLOS 'Notary Public - State of Florida v .= My Comm. Expires Sep 23.2015 Commission # EE 128810 ' Bonded Through Natwai Notary Assn. NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. ' 42I 21X(FITAX FOLIO NO. 1132 ©60 j33 0 go STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made, property, and in accordance with Chapter 713, Florida Statutes, the followi is provided in this Notice of Commencement. 111111111111111111111111111111111111111111111 -Fill 2012RO8 0 6261 OR Bk 28350 F'e 3281:1; (1pa ) RECORDED 11 /08/2012 13 :21 :04 HARVEY RUVI hf r CLERK. OF COURT MIAMI -DADE COUNTY r FLORIDA LAST PAGE is ®.0 Space above reserved for use of recording office 1. Legal description, of property and street/address: 1l.1/4.r9/ S'Mr S, 7 , P3 % ©� S'1f 12' of. Lei 5e GL pF Lr>7 6�! 23 L Ts'f ?t c3 /. ®eo )(.619.-0 ©/ Z./24'9' 38©/ caS©2 f 2. Description of improvement: / Tr / ftt/L./ _`'�" ° A' 3. Owner(s) name and address: /1-474f-'-Y- Stir• L 5 210 /4.r 2 /g1 4J ////'/ J' 1' J f -?3 /3 ig Interest in property: ®c.oez2 i a 9.2/0 '�j 2 %lit =�" /9 ®/?j S /'' T-� s' �/ 3 Name and address of fee simple titleholder. t!(/4d ' 4. c ontract r' am address and one number: id L ` /`�� 92/0 d 'C 9 _ /9'/° 1/ 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number. Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number: 9. Expiration date of this Notice of Commencement: (the 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 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT Signature(s) of Owner(s) or Owner(s)' Auth Prepared By Print Name ,c/V/ / (21V171-1-2- 'rAt i Title/Office 041 ""tf` rC STATE OF FLORIDA COUNTY OF MIAMI -DADE The forkegoing instrument was acknowledged before By ..� an ❑ Individually, or as OU fl c.( for la Personally kno n, or lAilroduced the following type of identification: 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. cer/Direc /Partner /Manager Prepared By Print Name Title/Office me this day of Signatures) o er(s) or Owner( By 123.01-52 PAGE 3 3/10 � Y PUBLIC STATE OF FLORIDA Linda M. Lalani Commission # DD842267 Expires: DEC. 02, 2012 ?NDED THRU ATLANTIC 9CNDinn CO., MIC. s Authorized Officer/Director /Partner /Manager who signed above: By OCT 3 i alz () j., =Zr., -41c- ADD SMOKE/CARBON MONOXIDE DETECTORS. ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS TO BE REPLACED. 30 3jJq g LtlitYodvx CO Miamighores Village APPROVED BY BATE -- ZONING DEPT_ . BLDG DEPT ,2/.4.. poi • SUBJECT TO COMPUANCE IMTH ALL FEDERAL STATE AND COLINTY RULES AND REGULATIONS f-Ate)- edYz._. Si il -- CO • ■ ';A Q 1 Li `:.3 ' o t-11 A#1 •X''‘ NO POINT ALONG COUNTER TO BE MORE THAN 2 FEET FROM G.E1 PROTECTED RECEPTACLE. PUT DIW RECEPTACLE UNDER SINK. ALL FIXED APPLIANCES ON DEDICATED CKTS, 1921" If 24" 30" 36" 54" 103+" ff 224" 1" 2941"—/12;14" 28+" 434" ft " 1 24" / 24" / 44,StialifigiTZADM:34161,11:411101.1%:YfiN &JON 30-RANG 1) B21L 4DISHVV 0 ATTalIV-7:V"igifRWIMEtt...1° 0 RW3612 h,,,4d-'AlftlitfROt; 11-15 BEP BEPO1 E!!!!!!!!!!!!!!!!!E 13424lRII. B24 CC 830 W3030-GL rlorTimor 4 ' " 1 18" 1, 24" 261r" 30" 1 All dimensions _size designations given are subject to verification -41 job site ; ia II justment to fit j.. conditio TT TAW STOTT. 1CITC:RFINT 20 TECHNOL GI S This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. Designed: 9/24/2012 Printed: 9/25/2012 All I Drawing #: 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 APPLICATION Permit Type: PLUMBING JOB ADDRESS: 92 /0 /11/&"-- 2 11 OCT 3 1 2012 BY: o -- v........e FBC 20 Permit No. pLJ 2 - 2c57 Master Permit No. 1 � 061 City: Miami Shores County: Miami Dade Zip: J.3 a Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 1,72* .71?Z` %, /e- Phone #: % 6 —S93— 6109 Address: ?2 /0 A/6°- 2 _ City: Y �(��/ $ /To'(� f State: F Z Tenant/Lessee Name: Email: Zip: Phone #: if5'c '7 /L L, L. . CONTRACTOR: Company Name: 7E/P'4 6 %J /492-7r!i/ /1,7701A' ' '6Phone #: Address: /3/ 9/ Ce1 c City: Ot l/4'/`4/ State: �' Zip: 3 3 /1.� Qualifier Name: 774A/C'(1-0 12 (c am G Phone #: 162° � - 2�3 State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: 715'6- Value of Work for this Permit: $ Type of Work: Address OAlteration Description of Work: k`C'U1 i \ 6 : tJ Square/Linear Footage of Work: ONew ORepair/Replace UDemolition SOU C.-el t�s n (1.) e4- Submittal Fee $ Permit Fee $ /o 0 CCF $ CO /CC $ Scanning Fee $ Radon Fee $- DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ )0 (Qi.") 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 reinspectis fee will be charged Signature wner or Agent The foregoing instrument was acknowledged before me this day of ®L-`] , 20 (2, by SA-A) (/ C , i(3 who is personally known to me or who has produced As identification wliiiiiIttitdij4 take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this day of l ®\\4 , 20 lam", by 11. 600 2,60sC.ce, who is personally known to me or who has produced 7 — . as identification and who did take an oath. NOTARY PUBLIC: Sign: l /' Print: edottg.) My Commission Ex "'kf, KARINA P. RODRIGIUEZ MY COMMISSION # DDSM3651 '4,tapsfir EXPIRES: March28, 2014 1400.3.NoTARY FL Notary Dimon Assoc. Co. *************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** % 2 Plans Examiner Structural Review (Revised3 /12/2012)(Revised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09) Zoning Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 GONZALEZ, FRANCISCO JAVIER TERRA GROUP INTERNATIONAL INC 1310 S GREENWAY DR MIAMI FL 33134 -4767 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE STATE OF FLORIDA AC# 26&q2., DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CFC1426856 08/21/12 128047151 CERTIFIED PLUMBING CONTRACTOR GONZALEZ, FRANCISCO JAVIER TERRA GROUP INTERNATIONAL INC IS CER7J.e.LED under the provisions of Ch.489 ES Exp£rat£on date: ATIC 31, 2014 L12052101773 Offrgero AC #6286947 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD BATCH NUMBER SEC# L12082101773 LICENSE NBR 08/21/2012 128047151 CFC1426856 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 GONZALEZ, FRANCISCO JAVIER TERRA GROUP INTERNATIONAL INC 1310 S GREENWAY DR MIAMI FL 33134 -4767 RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER St 1st FLOOR MIAMI, FL 33130 241842 -4 euE6brERNATIONAL INC 3191 CORAL WAY 33145 MIAMI 2012 LOCAL BUSINESS TAX RECEIPT 2013 MIAMI -DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2013 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A ART. 9 & 10 THIS IS NOT A BILL — DO NOT PAY °IEWRA GROUP INTERNATIONAL INC snlrgal0111,13 CONTRACTOR TIES IS ONLY A LOCAL BUSU ESS TAX RECEIPT. IT DOES NOT ITT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CRIES. NOR DOES IT EXIT THE HOLDEFI PERMIT OR AN U OTHER LICENSE REQUIRE) BY LAW. THIS IS CERTIFICATION A-F E HOLDER'S GUAUPCA- TM PAYMENT RECEIVED IDAMI -DADE COUNTY TAX COLLECTOR: 8 /21 /2012 09010015004 000045.00 SEE OTHER SIDE FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 cTREENEWAL STATES Cfl 26856 614308 -5 648 WORKER /S 2 DO NOT FORWARD TERRA GROUP INTERNATIONAL INC FRANCISCO J GONZALEZ 3191 CORAL WAY 648 MIAMI FL 33145 11111, 1111,, IIII, lR, I11, 11, 1I1,, RIR11111 ,1,Ri11,RI1RR11,il1isio8 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 9210 NE 2 Avenue Miami Shores, FL 33138- 1132060133080 Block: Lot: JUAN SUTIL Owner Information Address Phone Cell JUAN SUTIL 9210 NE 2 Avenue MIAMI SHORES FL 33138- (786)543 -6707 19141 N BAY Road SUNNY ISLES BEACH FL 33160- Contractor(s) Phone TERRA GROUP INTERNATIONAL INC 305 - 774 -9405 Cell Phone Valuation: Total Sq Feet: $ 750.00 0 1 Type of Work: PLUMBING Type of Piping: KITCHEN REMODEL Additional Info: Bond Retum : Classification: Residential ,i i, ing J03 AT TIME ILUPETIO 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 -10 -12 -45804 11/09/2012 Credit Card $ 108.60 $ 0.00 Available Inspections: Inspection Type: Top Out Final Underground , 1 Applicant Copy For Inspections, Call (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. November 09, 2012 2 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 9210 NE 2 Avenue Miami Shores, FL 33138- 1132060133080 Block: Lot: JUAN SUTIL Owner Information Address Phone CeII JUAN SUTIL 9210 NE 2 Avenue MIAMI SHORES FL 33138- (786)543 -6707 19141 N BAY Road SUNNY ISLES BEACH FL 33160- Contractor(s) Phone TERRA GROUP INTERNATIONAL INC 305 - 774 -9405 CeII Phone Valuation: Total Sq Feet: $ 750.00 0 1 Type of Work: ELECTRICAL Additional Info: KITCHEN REMODEL Classification: Residential Scanning: 3 FS MJST E pia gip AT TIME. OF !NSPUTION Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $150.00 $9.00 $0.80 $165.10 Pay Date Pay Type Amt Paid Amt Due Invoice # EL -10 -12 -45803 11/09/2012 Credit Card $ 165.10 $ 0.00 Available Inspections: 1 Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground W. W. Applicant Copy For Inspections, Call (305) 762 -4949 or Log on at https: // bldg .miamishoresvillage.comlcap /. 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. November 09, 2012 2 ti Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 inspection Number: INSP- 188604 Permit Number: EL -10 -12 -2070 Inspection Date: April 08, 2013 Inspector: Devaney, Michael Owner: SUTIL, JUAN Job Address: 9210 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: TERRA GROUP INTERNATIONAL INC Permit Type: Electrical - Residential Inspection Type: Rough Work Classification: Addition /Alteration Phone Number (786)543 -6707 Parcel Number 1132060133080 Phone: 305 - 774 -9405 Building Department Comments ELECTRICAL WORK FOR KITCHEN REMODEL Infractio Passed Comments INSPECTOR COMMENTS False QG 1 G /`° � Passed Inspector Comments CREATED AS REINSPECTION REINSPECTION �r FOR INSP- 187461. CREATED AS FOR ► -- 87332. z5( 42-17A 2 a c; 7:3 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until April 08, 2013 For Inspections please call: (305)762 -4949 Page 1 of 1 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 APPLICATION p©ME\MI Et OCT, 3 i 2091 g B Y: FBC 20 Permit No. -} c! 2 2-:(37 Master Permit No. �-K ) a- 2,11k 09' Permit Type: Electrical JOB ADDRESS: '22 /o A/ 2 /1 k- City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 1TVA /V ?4 M &L S ci y7 L Phone#: 766 `s y.3 ° 6,709 Address: 9210 A/c 2 �9tvG City: State: Zip: 33718 3 Tenant/Lessee Name: Phone#: Email: Cr/ a e L / z4 Z. eiX CONTRACTOR: Company Name:.. 7t e, 4 6 •atli° w c4'4"t 0/11 °% %(Phone#: 306 -7-8-c-1 Address: 3(91 twaVie-6 C157 City: /4((//74-1( _ State: f �Z-- Zip: .3.? / T-5- j Qualifier Name: F C'tfC) t/ 6264/ 24 Ye 2 Phone#: 7 ©O - �' iCJ -C---? State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ ?50 Square/Linear Footage of Work: Type of Work: ❑Address Alteration j UNew DRepair/Replace ODemolition Description of Work: tC ol) I * **x *** ************* :+x ****** * * ******* ** Fees************* ***** * *** ** ** ** * **** ******** *** Submittal Fee $ Permit Fee $ 4" 4,9 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ '^ C n TOTAL FEE NOW DUE $ 1(0 .10 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 noti of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit . 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 e; day of 1 , 2011-, by SArNr J7 i who is personally known to me or who has produced /mil As identification and who did take an oath. NOTARY PUBLIC: Sign - L ��� ► ►►uii�ttii,,,i Print: .� ,s _•. ��' �' / � � iOA 1R}�1is E�ne� APPROVED BY �7% /ofiU,/ niii Examiner My Commission Expires: Sign Contractor The foregoing instrument was acknowledged before me this day of (C 1 l , 20 \E ; by t ) 14- who is personally known to me or who has produced D. L. as identification and who did take an oath. NOTARY PUBLIC: Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Commission Expir KARINA P. RODIUGUEZ MY COMMISSION # DO 07.56S1 EXPIRES: March 28, 2014 1 3.*JrARY FR Notary Dial M800. Co. Zoning Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 GONZALEZ, FRANCISCO JAVIER TERRA GROUP INTERNATIONAL INC 1310 S GREENWAY DR MIAMI FL 33134 -4767 Congratulations! With this License you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you bette For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE STATE OF FLORIDA AC# 6 213 7 7 3 3 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION EC0001218 08/21/12 128047151 CERTIFIED ELECTRICAL CONTRACTOR GONZALEZ, FRANCISCO JAVIER TERRA GROUP INTERNATIONAL INC IS CERTIFIED under the provisions of ch.489 Fs Expiration dates AUG 31, 2014 L12082102559 AC #6287733 TRT DOCUMENT' MMI5CipREp. GKGRDONE :Iv CI RO` RfNTgrAtiNEMA; TED"P�APER STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ# L12082102559 DATE BATCH NUMBER LICENSE NBR 08/21/2012 128047151 EC0001218 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489:FS. Expiration date: AUG 31, 2014 GONZALEZ, FRANCISCO JAVIER TERRA GROUP INTERNATIONAL INC 3191 CORAL WAY SUITE 648 MIAMI FL 33145 RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 241842 -4 BuilittniaffilWIERNATIONAL 3191 CORAL WAY 33145 MIAMI 2012 LOCAL BUSINESS TAX RECEIPT 2013 MIAMI -DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2013 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER BA - ART. 9 & 10 THIS IS NOT A BILL — DO NOT PAY RENEWAL FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 INC STATETn1218 614307 -7 648 ® ERRA GROUP INTERNATIONAL INC ine 'OEM CAL CONTRACTOR Ties IS ONLY A LOCAL 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 PERMIT BYLAW. YIDS 1/3 NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA- TIONS. PAYMENT RECEIVED MIAMNADE COUNTY TAX COLE`T008/21/2012 09010015002 000045.00 SEE OTHER SIDE WORKER /S 2 DO NOT FORWARD TERRA GROUP INTERNATIONAL INC FRANCISCO J GONZALEZ 3191 CORAL WAY 648 MIAMI FL 33145 11111) 1111:TNN111i1Ti1IT11IN11NNT111) 1111NN1111TTN1NTIiNTiTI111 0