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RC-13-253Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 185473 Permit Number: RC -2 -13 -253 Scheduled Inspection Date: April 30, 2013 Inspector: Rodriguez, Jorge Owner: SWICK, KATHY ANN & BOB Job Address: 138 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: DAVID HESLER INC Permit Type: Residential Construction Inspection Type: Oripms Work Classification: Addition /Alteration Phone Number Parcel Number 1132060133270 Phone: (786)294 -0954 Building Department Comments INSTALLING NEW KITCHEN CABINETS Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 30, 2013 For Inspections please call: (305)762 -4949 Page 9 of 20 PERMIT # 1 o e4 CONTRACTOR: N 1 SUBMITTAL DATE: - 43 ADDRESS: h ci a_ T NAME: 5 LK, 1 RESUBMITAL DATES: PROJECT TYPE: Gc ZONING FIRE STRUCTURAL IMPACT FEES //, /`) t°� eg, K7 ELECTRICAL HRSIDERM PLUMBING NOC —/ = -_. MECHANICAL te- BLDG 13 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Horida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: JOB ADDRESS: City: Miami Shores cam, t County: Folio/Parcel #: 3 1C `3'^ 3 X)0 Is the Building Historically Designated: Yes OWNER: Name (Fee Simple T' hol er Address: FBC 20C Permit No. Master Permit No. c2—C- 3 ° 5 ROOFING Miami Dade Zip: 3 3 17' Hood Zone: C� Phone#: ?63L?/) City: 1 YVl Ils�t V � �rY State: r zip: ,✓ ` �,`? Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: L ) '(NY \ 6� Address: City: Qualifier Name: State: �7 \n� kk-e Phone: {1, �S. W1/ State Certification or Registration #: Certificate of Competenc Contact Phone #: 11 g --14 1— b Email Address: .14 PS e r 1) to 1 ' _ #c o rk. Phone#:. -Nb1_ 1 i OVy 231‘i DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ ` 0 0 Type of Wprl ; JAdditison CI Iteration Description of Work: --`� I t l \/A1 Square/Linear Footage of Work: q-,60 lew.' NLu) p • /Replace UDemolition Color thru tile: ******** ****+ r**** **** ***** *+ x*** ******** Fees*7+ x********* ***********+x*************x * ** Submittal Fee $ 0 ` Permit Fee $ /C CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ t 1,5 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 pe , In the abs ce of such poste otice, the inspection will y. t be appro ed an? . a reii' spection fee will be charged. Signature The foregoin instrument was acknowledged before me this 7 I2v day of a , 20 6i' by 13 :1 who is personally known to me or who has produced A-1 0 As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: -G7 �un1►tttt��'I, do on• p /0 Signature ___Contractor The foregoing instrument was acknowledged before me this day of & 6 Ptt4v , 20 3, by ✓e, rfti"e -"° who is personally own to me or who has produced pl as identification and who did take an oath. NOTARY_PUBLIC: Sign: Print: My Commissio BARBARA J. BRUNET MY COMMISSION # EE 114698 EXPIRES: August 8, 2015 Bonded Tin Budget Notary serves **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *+ 14 * * *+x�x+x�x *,x,x ****+n***,x,x**** **** x, x*+ x, x*****, x***** *x,* ******* *********+x*** Plans'Examiner Zoning Clerk APPROVED BY Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) 1391" 3n 11" 8 39" 831" B27 BUTT co," B27 BU rd-FY mr- 6 7--7 (.14 X iw I 36REF-2D r, 310" i Miami Shores Vil age APPROVED BY DATE ZONING DEPT PI n(71 117i -T C E WI fl-i ALL FEDERAL ' LES AND REGULATIONS ITY Y co Kathy Swick American Woodmark, Townsend Cherry Cabernet Finish. Standard Non - plywood Construction. No Glass Inserts. Shaker Crown Upper Mouldings. Countertop Edge Lower Moulding. Cust. Install Final Design: Date: FS4812 Use Finish Shelf for Valance over sink. fve 3 t3 All dimensions _size designations given are subject to verification on job site and adjustment to fit job conditions. n.y t: � �1 '� This is an original design and must not be released or copied unless applicable fee has been paid or job order placed. Designed: 12/18/2012 Printed: 1/13/2013 c1808866 All I Drawing #: 1 I No Scale. /0100 ga2- Od Alt 5 /46€ &Orli i Owl PRA WACO 4.-J /1/1/A* iv p leaCi LiLA OCATION il,t ei0A 1) ads Pc l Po-VW °Plc D fl 0,0 SrvPPAy MDOsmitC 40 AV 4414) le/IC/NO 138" la 92 41.. .4/i/11" r/710AX ao;//t/4 Ceivi(eger6A-f 7't cl:CD399:57‘ a NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF MIST INSPECTION PERMIT NO.- 1-abill TAX FOUO 0-3Q0106(S432.1t STATE OF FLORIDA: COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby _gives notice that improvements will be made to certain real propen and in acconlance with Chap-W713, Floflda Statutes, the following Information is providiad in this Notice of Commencement 1111111 1111111111 IIU 11111 11111 11111 1111 1111 CFN 2013R0156134 OR 8k 28507 P9 2036; (1139) RECORDED 02/27/2013 11:43:03 HARVEY RUVINe CLERK OF COURT MIAMI-DADE COUNTY, FLORIDA LAST PAGE . - • t/a k Ih t t 4 Space above reserved for use of recording office 1 Leg descri iimPuNstiorattiorawalotaninvie, cription of improvement iumrimiAmta).. - 2. D 3. Owner(s) name and address: Interest In property: Name and address of fee simple titleholder 4. Contractor's nErrne, address and phone number: 47777,141ThrIMMILWAVIM711111111MMOLTIMIC ,a,1""/"MMiSrMatlIIIMMIP5,.. 1051111101111.111.11M1010111110111% a Q A 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number Amount of bond $ 6. Lender's name and addrese: 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 Uenor's Notice as provided in Section 713.13(1X13), 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 e(s) or )' wind Officer/Director/Partner/Manager Prepared Eiy • Prepared By Print Name Print Name Title/Office Title/Office STATE OF FLORIDA COUNTY OF M MI-DADE The fo men BY Di Individually, or as I] Personally known, or 0 produced the following type of identificatlo " • :64" jkla ed before me thlti 5 day of , -Baumnn= for • 1. ; Al Signature of Notary Public: Print Name: (SEAL) rr 1111111ZA 11111111,1K. /IMP A INVISIMMI. ortrottnissem. le WV . ,71•5,1111 11 A g !;1_ '; I AA' 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. Signs By • Owne orized Officer/Director/Partner/Manager who sig rtntk. 123A1-52 PAGE3 CLAUDIA V. CUBILLOS Notary Public - State ot Florida My Comm Expires Sep 23. 2015 Commission # EE 128810 Bonded Through National Notary Assn. BY 0 141 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 190206 Permit Number: EL -2 -13 -254 Scheduled Inspection Date: April 30, 2013 Inspector: Devaney, Michael Owner: SWICK, KATHY ANN & BOB Job Address: 138 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: LS CURTIS INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060133270 Phone: 305 - 892 -0115 Building Department Comments INSTALL GFI OUTLETS IN KITCHEN Infractlo Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments ,g/vr- 2 0 / April 30, 2013 For Inspections please call: (305)762 -4949 Page 15 of 20 02/25/2013 03:57 3059402138 STATE E.MRTMiiin VS thitS REGUA:TION EliNeria • CUMA•c740g$ • BOaRD 19.40. .MORTII: $0. OE • .S.TREET• -.TALLAAAS.SEE: I'M 32349-, 01.8• CURTIS , LEWIS. ..STEVEN L.. s, :CURTIS. .:131C... 20341. NE 3.0TH. AVE A. .I:Q.8 • AV.ENTURA . . • Confetylotionst with: th i§. tirxionq(.1 ycAJ berAgrie.010.0 the .neerty:orge:Million Jans cens b Rid D.Odrimp. nt of Si.kinggis: aiiii*ProtesiOnai uIat10 . Cur pre •••r41:liEonstitsesi0g1 isY6.11.brOiliactq:1.6 sfic txpx.Oz:to•01.1?psque..r6.qaOrtiral,.41:4 fly FJoilM!aii. • toty Ating . Evi*.y:day sircofcle.r.1.0 $orws.youstieupr; . . • Ftg Intprfliatian alp.01 our sorvices,phomm 1.p9 Onto•WW:W..triytwiitii.4411049...cail.t. : Y•06:00.6:id frIer4 irg*PrniMibi‘,•(.4004tpi.lf-0j*6*.ina. the ri.vgillOtiont,t4t.. • • .inpact.yeLi • tobarlibe.Videviiitinent nOii4tettesrs.efnel learn 'more atiout.ii1P, 60111610 . . . . #6461 P.001 /001 ....... • • • :6,614: . -.• . :*: . . :CisuromE4gsail at thb :CkippilrEgergt. I 'C. Lice,ns0 Effibie,a;iy...9:espliotio NI illy; WO ..... Cf.giSkintjy $.1ilv.e:td sO.gve.. you botor.t4that. so.4ork.orwo i(our:.0411.10.0Drik.. INnk Yeu•lotnsi tiUt:Ithets:lh:*Fitirldia, dn . ..':* • ..'.0.0.#.7400.:•magitio:......t congratulavons. on your. riOtre'himr01 •,. ......!" .. . .... • • • D H HRE EfAtE ...... . ..... MARMSITZWmRfatilifOo"", ff394151410tWa;gavaoriF104;1'41644"fiR400:,r0Ortm.""fitt .. IKTitilfinoffgaroymw677, • • :14;051800561.• ' .. .. . .. • . . • . ..• . . • .. • :.: : . . : • ..,....s..).:.....:'.....:-.:...". :. .-: . • .•.... : . ... . . '.': •i: . . . . . . • :''. ... •.. • -'. :.........,.....: .. ....,............... , *•*:::..'. ..... ....'.' .. ' ... • • .... ' ::: ........" : ... • ... .. i .. •:-...: ';:-.... '• : .....• . ; . : • ..t......., : ..... '.....?*: : : .. ..... .. ..... . ...... . .... ... . ....•.• . . .• ..... .. .. .. • : : • : : . •• ..• •.• . . ...... ... • nallingSerf-k fgatatawatt ,,,of.a.textfommt.mawmxii& . . 51i:8 cm-:41 • : • ::THIO 4-.S.:01017:•A ...... • • . • ..... itiSittekS• NAVE} Lk:CA*541' • • " • • ..... • ' • • • • 1.•-• CUR • • • • • • • :.P:ria 2•0341: -NE • *.3.0- AVE"" • • • • • * 3.3.1.40: :CITY: OF :Atigtillif/A L: .-..1-1*:Busutolia. • * :196.ELECTRICAL NaA : *LOW. otON&A$1:A4C rawn %MA MI* gateiT • OV4Z43,4 ':tiftWATe 41+' lital!ilineaLaxwor,RiFt rs fat *P. Tifg .1E.Riktri .1:6,=14/3 seP •r: STA tiiiija:A"VallUnlik.: " • U.. WrAtigr3;141•40 kluktsmV.ZE amairrr.Vit .. • 04:1.1•2/.20.2 0015Aa. . . . coN TRAtT —1004 : EC0003115 • • 44.60 e • VOINOVFOOMAR stlic LE:W1S•:•S -CURTIS: 1F.'-RE$ 204:1* tE •:3Q-•AVe.- 100 AVOTORA 3•31110 1.•ait•istti 5,144.04 11 £TOZ /5Z /Z0 02/25/2013 03:54 3059402138 #6460 P.001 /002 / 10 ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE IMM DD•YYYY1 04 -17 -2012 THIS CERTIFICATE'S 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 certificate holder is an ADDITIONALINSURED, the policy(les) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statementon this certificate does not confer rights to the certificate holder in lieu of such endorsement(a). PROOUCER AUTOMATIC DATA PROCESSING INS AGCY 250717 P: (877)287 -1316 F: (888)443 -6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: PHONE FAX °"E`a' (877)287-1316 tAC.NoI: (888)443-6112 EI.d1 ADDRESS: PRODUCER CUSTOMER ID 1: INSURERS) AFFORDING COVERAGE I NAIC 0 INSURED L. S. CURTIS INC. 20341 NE 30TH AVE APT 108 AVENTURA FL 33180 INSURERA: TVAn City Fire Ins Co INSURER B : INSURER C INSURER D : INSURER E : INSURER F ; CERTIFICATE NUMBER: nnr rurraaQCO• 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 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. itsr TYPE OP INSURANCE SOUR STSR WO POLICY NUMBER POLICY EFF POLLI�CY E►iP IAAMIDONYYYI IMM /GOIYYYYI LIMITS • GENERAL LIABILITY ----- j i • EACH OCCURRENCE $ • I COMMERCIAL GENERAL LIABILITY DANAGt ID MENTEO PREMISES IEe =offence/ 9 CLAIMS•MADE I OCCUR I I 1 MED EXP IAny one person, 8 ' I PERSONAL & AOV INJURY 9 GENERAL AGGREGATE 8 ;Salt AGGREG UMIT APPLIES PER: POLICY ' PRO• LOC . PRODUCTS • COMROP AGO 9 • AUTOMOWLE LIABILITY ' COMBINED SINGLE LIMIT 8 IEa eeeulen) 1 ANY AUTO 1 I • ALL OWNED AUTOS • I • BODILY INJURY IRe. person) 9 I SCHEDULED AUTOS I • BODILY INJURY IPer eccalentl 8 ; HIRED AUTOS PROPERTY DAMAGE I IPer ecctdertl $ NON•OWNED AUTOS $ �I $ • UMBRELLA LLAO OCCUR • i : EACH OCCURRENCE S , __ EXCESS LIMB CLAIMS•MAOEi AGGREGATE 8 DEDUCTIBLE i $ _ I RETENTION 9 I • 8 WORKERS COMPENSATION I i AND EMPLOYERS' LIABWTY YIN ` I ANY PROPRIETORlPARTNEgrfXECUT� j1 A OMFFFICEER*M pER) EXCLUDED, !NIA' I 76 WEG TR4954 I ! 05/01/201205/01 /2013 WC 37ATU OTH X I TORY LIMITS I 1 Efl E.G EACH ACCIDENT 8 , 000,000 If yes, deornbeunder I OESCRIPIION OF OPERATIONS bets* E.L. DISEASE • EA EMPLOYEE 9 1 , 0 0 0 , 0 0 0 E.L. DISEASE • POLICY LIMIT $ 1 , 0 0 0 , 0 00 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES Winch ACORD 101. Addilionta Remark. Schodulo. It enaro apace Is ru ndred) Those usual to the Insured's Operations. r!CRTICIrATC unI nen - Miami Shores Village Building Department 10050 N.B. 2nd Ave. Miami Shores, FL 33138 Vn•MV,.,.V.•',. p. uV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIE EBENTATIVE 42_ "7aile^\--•'' ACORD 26 (2009/09) -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 02/25/2013 03:51 3059402138 RTI. FtC D AS A MAT YOrt:t1,t,t.A10XIm *0 WO ABILITY :. INS Ui #6459 P.001 /001 • • • 14.P4.4fri I: • --$44 —Amish .. ; T 41141441 41475032' ov 4'4 110WWWW4NWS, .... Tomo sm.Arei'tio AO4 :OF PY4 ,w144i .. • • ■44444..44.44 ■.1.•:,6.4444.44 • • sma.snwl aowsrismi *ORO • lif.:OL•Alt. ii0i.""TI.A WW • 4i.tA • . • 40.11110g ZT94e61/Ert 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 4V40//.3--07 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: i 3cY we City: Miami Shores County: FBC 20 CD Permit No. ELI 3 Master Permit No. 12_,C- Miami Dade Zip: I3 Folio/Parcel #: Is the Building Historically Designated: Yes OWNER: Name (Fee �SA� 1 Simple Titleholder): VU Address: le31c dO tik City: 01 (. : \hd'e$$ Flood Zone: Vw State: Phone/4: ( ` 3.9 ( 03 Zip: 33 VU Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: COst Phone #: 3 OS(T -0, �J Address:- ,746 y °%d S _j j Pry lJs State: Qualifier Name: Phone #: State Certification or Registration #: �j �� �C`ei ificate o omp�teno}� #: u C� l 75 Contact Phone #: 7 e </ /'d /7(( Email Address: Aft crate C dy® z. DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 'LC) v a Square/Linear Footage of Work: Scti Type of Work: DAddress CIAlteration UNew ORepair/R-,,lace Description of Work: G i\ 0 U ` k eA1/41/4 ‘L.eS�� V UDemolition ear ******* * * * * * * * **** * * * * ** ** ** ** * * ****** *Fees * *** ****** ***** * * *** * **** *** **x* * * * * ** *** Submittal Fee 63' Permit Fee $ /-00',0 P CCF $ fVfID Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ CO /CC $ TOTAL FEE NOW DUE $ 11 0 ' 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 AN'N'IDAVIT: 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 approv ., and a einspection fee will be charged. Signature Own or Agent The foregoing instrument was acknowledged before me this day of , 2d5 , by 7 who is personally known to me or who has produced L. t As identification and who did take an oath. NOTARY PUBLIC: -' NunuiUi� Sign: Print: My Commission Expires: Contractor The foregoin instrument was acknowledged before me this 7 day of , 20 / ; , by t� /j (2/-.A./0, who i or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co CASSANDRA N NEBBIA %AAMISSION 8 EE219418 WIRES ►25,2016 (407)3884153 RorideNoterjeente.com APPROVED BY , /1 e',0 Plans Examiner Zoning Structural Review Clerk (Revised 3 /12 /2012)(Revised 07 /10 /07XRevised 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- 185496 Permit Number: PL -2 -13 -255 Scheduled Inspection Date: April 24, 2013 Inspector: Hernandez, Rafael Owner: SWICK, KATHY ANN & BOB Job Address: 138 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ALL COUNTY PLUMBING Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060133270 Phone: 305 - 796 -6124 Building Department Comments KTICHEN REMODEL INSTALL SINK AND DISHWASHER Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments April 23, 2013 For Inspections please call: (305)762 -4949 Page 8 of 43 i 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: �3 8 Kt- FBC 20 L`D Permit No. FL 13 -2,s-5 Master Permit No. , 0 3 s. City: Miami Shores , County: Miami Dade Folio/Parcel #: 11-- SW Cie) -.3270 Is the Building Historically Designated: Yes zip: 3713/ Flood Zone: OWNER: Name (Fee Simple Titleholder): (2pt.kp k3 6 ci, Address: City: Tenant/Lessee Name: Phone#: State: Phone#: 7d14:-46713 - f 03 Zip:. ), 7 (vS) Email: CONTRACT : Company Name: A-11 GY) it/' v b'MN hone#: Address: 0 0,4?? /i 1' 5a J City: OC :V rafe4,4e08ti/C State: �,ti Qualifier Name: (2J/ �.( /-1 � y�(�®� /�!'�J.� State Certification or Registration #: C_C'.,,3 � C(& 1C� Certificate Contact Contact Phone#: 9T7 _ i /Z'z--- Email Address: /A't afi1 DESIGNER: Architect/Engineer: Zi JJ ? Phone#: �S"-V --324r- Z Z of Competency #: Gth (5)Vif1 ezi 4-/h , CO Ai Phone #: e� Value of Work for this Permit: $ (DM 1 Square/Linear Footage of Work: (� Type of Work: DAd ss� UAlteration 1 "` ew ORepair pla ODemolition Descripton'`of ' ork \� W t� l� ��� � 9 eA • QrAkC *** **** *+ x**** ****** **** ******* **x:****** Fees ************ * ******* ** :****** *************** Submittal Fee Scanning Fee $ Notary $ Double Fee $ Permit Fee $ r ®�� CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology 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 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 th ence of such posted notice, the inspection, ill not be ap rove. ' a reinspection fee will be charged. Signature � �-�' �1 � � � � ®/ Signature Contractor The foregoing instrument was acknowledged before me this ( The forego' g instrum nt was acknowl ed before me this day of '� "(CLG) , 2013, by - CS"Ah� , day of �' k, 11-x\ 20 13 , by 1 \11 P1-0\ L?J rS i\ C r who is personally known to me or who has produced -1 C) o is $ersonally known to me or who has produced P I-44 . As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: E• :CO:‘ .4■••••, �'-• o' C,70- o) :: fp °•,3 !i `�� /4Allrrp n i I1N���� APPROVED BY / P-I'L) Plans Examiner as identification and who did take an oath. Structural Review (Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) NOTARY PUBLIC• Sign: Print: My Co L_`v0) xp�fliry Public State of Florida David P Hester gs My Commission EE1109$19 Oi �` Expires 0111512014 * * * * ** * *** Zoning Clerk