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RC-13-901 Ml mi Shores Village JUN 12 2013 Building Department �o ao °000000 o4�a44a�o 90050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(306)762A949 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No O Permit Type: BUILDING ROOFING I JOB ADDRESS:_3� I�Jt✓ G'1 .r+ City: Miami Shores County: Miami Dade Zip: 331 Folio/Parcel#: a Is the Building Historically Designated:Yes NO ✓ Flood Zone: r OWNER:Name(Fee Simple Titleholder): L EG H:=)I G w�'�c�S Phone�#:� O S 'j 1 Cj- (o CY(o Address: 3�f o 0. fVW - 0 e . City: "- T i State: gip; 331;;:Lj Tenaot&,essee Name: phone#; P Email: f CONTRACTOR:Company Name: 44,A, C� -A ' ° ne : �-I Address: l t7-1�-'-� SW 55 �'e✓r•' r"7 ) 1� L z ! City: State• 7ip; Qualifier Name: e S L-ewy i Lx-( Phone#-. - 441? State Certification or Registration#: Certificate of Competency#. Contact Phone#: Email Address: DESIGNER:Architect/B : Al aQ GAme-I 1V-- Phone#: 18 G, - 5-,43 Value of Work for this Permit:$ 350 Square/Linear Footage of Work: Type of Work: DAddition DAlteration DNew DRepair/Replace 0bemolition Description of Work: �',Cnr��. rJn✓-!� of -f�,r 1G i�-G�-�P�.-� WG 1 I Color thru tile: Submittal Fee$ Permit Fee CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ Banding 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which oVrprs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be appro a reinspection fee will be charged. Signature Signature Owu1hr or Agent Contractor The foregoin instrument was acknowledged before me this 11:� The fore Ding instrument was acknowledged before me thisx� day of ,20t,by lrn 1 RYVI y of 20.�Z by &l"yl eeJ 1.&Y)L.Lr wh perso 0 o me or who has produced who is rsonally kn to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: A BLANK Print: acon Print: i �➢ K,_. My Commission Ex .f p'„ l October 01,2014 My Commis Via_ � ®MMISSBOfV1=000573 rnce.com P�. E'XPIRES October 01 2014 pir '-� z _�- n �;9 l�Y�.3:,-^ 1 NOridatdo4aryServicc:,wm APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3n2/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3115/09) 54'-2" ij r rn off�, ,�',-;;f' �" f�✓'fr N f fi N • ii J Q(�fvt - CE DRV J } f r�Jf/ iJ rf,ri f•f_f/ C' :�"'f f-_'rr i KITCHEN fY°.,.. d✓ f�r'f .' o!+. rr•�`f:.'r�+� J,, _f ✓s: � > TCHEN �fFAMILY' BA 421 f ROOM / >. 00 I } EATN #I� f/j/ r / if BATH` D NN NG/- .,AUNDRY BOOM-.yr ! J• 's/"'' ,-' - r / r , KI HE�lf f/ UVING,r dM� E OF V' /,AREA EA$ I , No M 4 am STA. -F OR LAN y q G f' dSCALE. N.T.S. o Im em OF w Immalm 7fm PLva, Ptl~ 97 'ST : KiIIAMI S ORBS` FLORIDA ` 138 Drawn Issued F'rEi jct No. M:Y 06-,20"13 Cross Ref. Ievistons u>avuu+are tau. R l 2 PROMDE (3)-2x10 WD. HEADER BEAM °°°° ��� ° °• ®• p� FAST W/16D NAILS O W O.G. © ® ®• ®, STAGGERED EA. SIDE OF WD. BEAM all .� I:O ffi ,� ® � PROVIDE*NU-VUE•NVRT-24 6 a ® • f7 �'� STRAPS FAST. W/TOTAL PRUDE 2x4 O 16°O.C. MAX. =z- - 24 m:M m (6)-10D x 1W NAILS NOA VERT. STUD WALL • �Y : �m PI7 o #13-0206.17(TYP.) �!°•°" * ® PROVIDE 2x4 VERT. WD. PROMDE 'US'' R77 ROOF °r ON:0 o Sal co STUD5 TO EXIST. (2r2x8 5 • t (� EXIST 2)-2x4 WD. ANCHOR FAST. W/(5)-8D NAILS �i� �°• ••° � �� NAK B" 4.0 T. W/16d PLATE TO REMAIN) TYP�i®hfEW NOA FL 81D7.55 �. '-• 'r I I A F i [ PROVIDE AWL 44 f a WD. MEMBER TO f ° EXIST CONG BEAM NEW 2X4 WD STUD FAST W/14° ' (TQ REMAIN) 0 A325 TNRU-BOLTS O EXIST. MASIRY 1Y O.0 STAGERED y er PRZ95jIDE ADD'L 4x4 WD. MEMB WALL(�REMAIN) ' (TYp,) TO Q4ST. 2X4 WD. STUD FAST PROVDE 2x4 WD \ W/W 0 k325 THRUO CO STA®1 - ` & BLOCKING(TYP. AS I SHOWN) FAST ti W/(2)-16o NAILS O f; _ STRP5E F T.�Wr/NVIK- / == PROVE 2x4 VERT. WD.STUDS TO EXIST Q EA {XXVN \ (6)-10D x IW NAILS NOA MASONRY WALL FAST. ') #13-0206.17 (TYP.) 2ka STUD r o 0 TAPtONS O A PRUDE 2x4 O MALL O r O.G (TO 6'O.0 REMAIN SHOWN i m _- - VERT. STUD WALL ` / (TYP' PRUDE 2x4 WD. m / PRQYIOE(22x4\ FO G�TYP.I AS to _ W. TOP PLATE F J EXIST. (2)^2x6 STUD 1 \ 11 r V WALL O 16° O.C. (TO f \ REMAIN AS MOWN (lYP I ^ .r f •S Vw 0) i EXIST. 2x4 %4 WD. BASE PLATE O (TO REMAIN) x. rn f r W to � - rf r'. - t. r 7 77 V J 22 EXIST. 2x4 STUD EXLSV METAL STRAPS PROMDE "USP° RT7 ROOF WALL O 16a Q.C. (TO (TQ ') ANCHOR FAST. W/45)-SD MAIN AS SHOWN NAILS EA, CONN.W!45)--SD FL. (TYP, 617.55 (TYP. O NEW WO. STUD LOCATION) w oa WD a. ERAMING DETAIL R� SCALE: A= 1 —0 r i CITY AloftL AMPM cuply Miami Shores Village APPROVED By ®ATE 70NING DEPT BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COl1NTY RULES AND REGULATIONS Miami shores Village `SCRs Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 June 18, 2013 Permit No: RC1_*901 Building Critique Review 1. The detail submitted changes the scope of work. The alteration is changed from a level 1 to a level 2. Provide plans signed and sealed by a licensed architect or engineer for the renovation. FAX 786-472-5790 i Norman Bruhn CBO 305-762-4859 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. 08/19/2013 14:27 FAX 1 800 685 7330 DATA SCAN FIELD SERVICES 16001 ********************* *** TX REPORT *** TRANSMISSION OK TX/RX NO 3718 RECIPIENT ADDRESS 97864725790 DESTINATION ID ST. TIME 06/18 14:26 TIME USE 00'47 PAGES SENT 1 RESULT OK ai Ohores Village � 10050 N.E.2nd Avcr:u e _ 11 i irni Shores, Florida 33138 M�o�e• Tel: (30;b) 79b..1204 ORiv� Fax: 4205) 75(3.8972 Jane 18, 2018 Permit No, RC1•A-901 Building Critique Review 1. The detail submitted changes the scope of work. The alteration is changed from a level 1 to a level 2. Provide plans signed and sealed by a licensed architect or Engineer for the renovation. FAX 78C)-472,.5790 t � Miami Shores Village Rin V, Building Department A ,� 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 By---- oeoo®oo®oe INSPECTION'S PHONE NUMBER:(305)762.4949 - FBC 2010 BUILDING r� \ Permit No. ?J�90 I- PERMIT APPLIC TION �Maste Permit No. Permit Type:!4x B !�ING ROOFING JOB ADDRESS: 3 97 Street City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3206-013-5800 Is the Building Historically Designated:Yes NO X Flood Zone: OWNER:Name(Fee Simple Titleholder):B&L Realty Holdings, LLC Phone#:305-519-6968 Address:3900 NW 2nd Ave City: Miami State: FL zip: 33127 Tenant/Lessce Name: n/a ' ne#: Email: CONTRACTOR:Company Name: �G P` 't �"� �-^ l ' = Phone#: 305-219-3448 Address: City: Miami State. FL Zip: i Qualifier Name: �C)+�'�°� "�`'� ! Phone#: 305-219-3448 State Certification or Registration#:.GG' -i l l—] Certificate of Competency#: Contact Phone#: 305-219-3448 Email Address: manedtAir4ei@aol.com DESIGNER:Architect/Engineer: n/a Phone#: Value of Work for this Permit:$15000 Square/Linear Footage of Work: Type of Work: UAddition DAlteration Cir Kew R<epair/Replace ODemo!�,;` Description of Work:6'-e+' 'ex�,+� tte i ter-) chsj ry1Cr$ci wl-11n one vv "Me 41, i °P rQrxje,, A 19 i°.,woj hee-r ecim ce t 4 S r ntc, C hh anae X71 i vtit yW^GIG�v�o G t'�4�L}C .Jt ,�C'' C GC%Y"r C 4•'�Ca�c: 3-�1� ��•s Gl r^ao�j 'WJ.in 'tt7 i'���!� l�t:�C a.�'+ :,t 3 -vc ,v�s c.mne4-+cj.�- rr+,o'�A�_,,e,.�.r�- �crac vci�� y , i� -sti:.S i�c�t1 - ;; t.i(�c�l�xiel�--e�►GcC. t'A t C' r') W i► Y1t' -Golw hmk4ik: y9 x 4' e'-3 6 ,—% `r, .i tx+it fiG- t�l eJ l �dG 1 ��Cth2✓. �1- c°xi��r���' C>� h�,�r- Gea OIr;�Ci n �e1�i�t b�r;te yGq-C,�. ees�` cfcaoe 5e ei�.►-1 00-t Submittal Fee$ Permit Fee$ CCF$ CO/C $' Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ Bonding Company's Name(if applicable) Bonding Company's Address City State zip 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." r 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 fee will be charged. t _ Signature Signature O er or gent _ Contractor The fore oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of by I day of ;20 ,by who's gersonall o me or who has produced who is rsonal y kno to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: f� L Sign: U Signerr-L, Print: R.QfW77NI (26 l Y-- Print: e 1 G^ a My Commission Expires: ®� My Commission Expires: 4# MY COMMISSION#EE000573 RONNI BLANK 1 14 MY COMM18SION f:000673 F1a0deNotery8evice.co n a EXPIRES October 01,2014 k_°" `s-U153__ FWddeNotary9ervicemm APPROVED BY Plans Examiner — - Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) to auk— r1 , _ a a °s <2, 6' a I O PENT 91 W e n BEDROOM 9 � 13 ` w° CLOSET 3'-7' a, !2 ,� 14 01N C N CL CLOSET a A BEDROOM ..2. FAMILY ROOM � I� t W 1 �j STORAGE EXISTING Cl PLANTER CLOSET �° 6 WI W CLOSET 41 IN LAUN� a DINNING ROOM IN O J I O O 15 BEDROOM ;'22 > EXISTING KITCHEN �^ LIVING ROOM WOOD J I FENCE E)MING PLANTER OF 3 W W OFFICE ?� g AREA 4' 2 2" EXISTING, PLANTER 7 q_b s EXISTING tz EXISTING 4' 13' 2' PLANER a f^ $ METAL GATE Rw 25-42' FIELD VERIFICATION PLANKEMNM' « •, • ° °FIELD ON: _ _ �LWBTOR 1111111 EXISTNG COMPILED FROM VARIOUS SOURCES A T@IV �PRO.rlCf LOUVER AND DEEMED AS RELASM CONDITIONS DMMYAFFB=rM4GTNE O MODIFY WRMIO TO ALLOW ALLATION PRODUCT OR ITS NgALLATION MUST BE FED V�SYTI¢ NEWW PARTRION TO ALLOW FORQ4SIAUATIONOF 11 CONTRACTOR OR ACONTRACTOR APFCtMREPRBSJi`MAM4 PRIOR NEW WP DDW. BIDDING. O WPIDOW NUMBER 1 • EXISTING -- r-a GARAGE �- .�F. - if DOOR • 22'9° u J rI EXISTING B « l { PLANTER 10 Code I KIN 1 12 6' 19 BEDROOM s �� CLOSET T-2" a P�� s CL CLOSET 01 BEDROOM 50'-102" ��1G f 1 S'1o'ti a.�CQ,��Q✓ C'�y"°s �I i�°�d31C,J J FAMILY ROOM Z q' 2 LA- p � ,. - - e a STORAGE EXSTI>G � � +� �- O Q Be PLANTER �-_"' _ -J CLOSET �`�� + �°^r t✓' i �C, � ,t O v 6 �..JJ CLOSET ® ' '� rte. L"� �-�° t--.a` 1L� i^ s"►�, � Za� z a LAUNDRY y1 f+-C C� �,•�P iGtC� �� t 'j' 1L 1-}-Z j—I °—Z S` � S DINNING ROOM '' m %:E 142 55-8 z 5 12 BEDROOM 2 EXWM KITCHEN 1 WING ROOM WOOD FB�OE EXISTING PLANTER 3' 2 23'2 54. 3 ag c �a nc- TE OFFICE s AREA 4' �' ExISTNC s .° °a 0 ED' PLANTER I , ST f L R P N i � 9-6" ExLtrNG ! t 1 1.. PLANTER �U" J�C TO CC2-11 LIANG�'dV1Th� -EDERA� EXISTING J! n DRAWN BY.JA Y G I� 04101.13 GATE T� F AN �'.0:IQTY r S ANn RF rULATl()ldS� ZDWC. .1 N2 PLANTER G 25-42' FIELD VERIFICATION PLMlMMNOTE. EXISTING Fl0.D THESE DRAWINGS WCORF'ORATEBUA.DING WFOMWION 7� —W--- LOUVER COMPILEDFROM VARiOUSSOURCESASSOCWEDWBHiH6FROACi O p(ISfING WNDOW AND FRAMETO BER@AOVE0. AND DEEMED AS RELIABLE.CONDRIONS DIRECTI.YAFFECTWGTHE MODIFY PARTITION TO ALLOW F-0RlMAVATDN OF II PRODUCTOR BSMALLATIONMUST SEM.DVER�BYTHE �yTB�DOW CONTRACTOR OR A CONTRACTOR APPOINMREPRESBWIVEFR OR t BIDDING. O W-NUMBER x EXISTING - GARAGE 22'-9 DOOR —1 7 WINGLANE 1 3 10 i 12 13 BEDROOM 9 CLOSET 3'-2 2 2 cl enRA 1°L°p i C, v t(g v-, k-Nc-4+x to 0 p 1 ce ce- - 2 CL CLOSET ° 3 BEDROOM 2 50'-102 J FAMILY ROOM pp 93 Z z ►-�� l� C C C-+ 0 < o L, STORAGE EXISTING ® �1�, C i°1 - O pw p U. PLANTER 2 QQ .7j-� CLOSET } N G a' 1 i --j 7- O w O 6 Q uj V` CLOSET ® 2 �� °'e �G���� - h=1 3_°i� III Z a O § LAUNDRY a� t1 GsQ� y.-�Pa i�G� cm f 1S° 7°°> m J Q Z 1 LU G� DINNING ROOM ca 0 Tn Ln g 5� 55'-6' b 2 Ib a 2 BEDROOM 2 EXISTING (] KITCHEN I LIVING ROOM WOOD FENCE EXISTING PLANTER 3' r ° 23'-Z' 6-6' 3 APPRO�9E® ® DA OFFICE 2 AREA 4' 2" EXISTING z 70MING DEPT N PLANTER 2-0 SLAG LOOR PLA EXISTING J NUR SUBJECT TO COMPLI NCE WITH ALL FEDERAL METAL METING 4' 13 2 . DRAW GATE ULES AND REUI_ATIONS O4A.13 NBr.LB CO NTY DWG. No. e A-2 1 EXISTING PLANTER 2 si- low Yy I ni 4!-4to ►i`DiFZ1:I�ui L7 OFFICE AREA L 21 1 BEDROOM CL I CLOSET I FAMILY ROOM STORAG�%. CLOSET CLOSET STORA>�' DINNING ROOM BEDROOM LIVING ROOM 51-el 6 E)=Nr, PLANTER EXISTING PLANTER 721 4C SET 132- I ni 4!-4to ►i`DiFZ1:I�ui L7 OFFICE AREA L 21 1 BEDROOM CL I CLOSET I FAMILY ROOM STORAG�%. CLOSET CLOSET STORA>�' DINNING ROOM BEDROOM LIVING ROOM 51-el 6 E)=Nr, PLANTER EXISTING PLANTER Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-199214 Permit Number: RC-4-13-901 Scheduled Inspection Date: September 17,2013 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Final Owner: , B&L REALTY HOLDINGS LLC Work Classification: Addition/Alteration Job Address:395 NE 97 Street Miami Shores, FL 33138-2405 Phone Number Parcel Number 1132060135800 Project: <NONE> Contractor: ACA CONSTRUCTION INC Phone: (305)788-8914 Building Department Comments INTERIOR REMODEL FOR KITCHEN AND BATHROOMS. Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-199143. No access, no one home Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 17,2013 For Inspections please call: (305)762-4949 Page 34 of 39 C7 Miami Shores Village SAY 1.6 2013 Building Department h- y: 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 _ Tel: (305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.949 FBC 20 CC) BUILDING Permit No. j PERMIT APPLICATION Master Permit No` Q 3 ®cl Permit Type: B ILDING ROOFING JOB ADDRESS: �� �`I J-4-_ City: Miami Shores County: Miami Dade Zip: ::�Z Folio/Parcel#: I I-3 �k-- CX,-Q I `5 5?>0 Q Is the Building Historically Designated:Yes NO ✓ Flood Zone: OWNER:Name(Fee Simple Titleholder): �- � "-e 1 C�11�' ,1PhLne `" �� - S lam'( - 69&Z Address: Kbin City:_ /^� �'�-,r� d State: (_ Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:_ - �"�l" .�C �°'� Phone#: Address: S'VV 15!S '-T City: Ct I State: r' L Zip: 3 1 Qualifier Name: 64-­%e':.-r°SC L-df_r-Y­�...t X. Phone#: State Certification or Registration#: C- CA C- i 'S I i I—I°";�- Certificate of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: / Phone#: L� C)C13 Value of Work for this Permit:IS Square/Linear 7epairlReplace e of Work: Type of Work: DAddition !]Alteration ONew ❑Demolition Description of Work: b) 7:0 >=),Cx+je,mt S Color thru tile: xxxx�xxa��sxxxxx�xxx+x�x��x�x�xxx��x����xF�x��x�x�x�xx�xx�xa��xxxx�xxxxxx�xxxxxx�xxxxxx Submittal Fee$ Permit Fee$ G CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ ctt!�_��Structural Review$ TOTAL FEE NOW DUE$ vo 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 einspection fee will be charged. Signature Signature O or A ent Contractor The foregoing ins nt was acknowledged before me this 2ND The foregoing instrument was acknowledged before me this day of MAY Zp by MICHAEL BROMLEY day of MAY 20 L(35,by ANDRES LEMUS , who is �- a ly 1F Town me or who has produced who is pl•soly�kno to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: z NOTARY LIC: Si Sign: prin. RONNI BLA NI A no Print: R N i W°•°si, W f'4 CNN My Commission Expire :_ 0 my'(;i'���MISSI06�#EE000573 My Commissio s� �Y COPaItViISSIOhB ik EE000573 Oct EXPIRES 09,2014 C°.:`DIRES O ;op�o EXPIRES October 01,2014 jjt° �IondallotarySacvice.com °j N°° (407)398-0�`' (407)3 398-0753 FlondaRlofsryService.cbm skIs:k°k°kskak-hak�ikikskskakksk��ak $a XsuaakskiksIask��kkkIssksisik°XskskkXk:k�Is akak°ksk�k�F+akBaikiksIags�°kakihslaikskskskaksk�sk=kkkknkksksk°kIssis$aik°Isakakikskskskak�kkskik�°kkakkis APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)