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PL-13-1425Miami 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 JUN 2 4 2901,3 FBC 2U/ 11 Permit No. / Master Permit No. JOB ADDRESS: _&� 9 S 'S 7 City: Miami Shores County. Miami Dade Zip: 3 -Sal 9 Folio/Parcel#: toCtjo Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Address: *2150-4- G 9S Tk(j_1- J City: 1" ,\ t°CLyiitt 7E1t'lcoC State: T-'LM1Zip: Tenant4,essee Name: Phone#: Email: CONTRACTOR: Company Name: Phone#: Dos 8 q6 _4 9 61 Address: %05 AIW 3f SPrCe+ W /`¢• City: H / State • � Zip; �,�� Qualifier Name: C c Cf ywo -7 ,a,0- Phone#: 7A% -g IA- .3 3 at6 State Certification or Registration M 4--re-14-12, 7-4f Certificate of Competency #: Contact Phone#: Email Address: _P e'5;/MQ rpe'lole'- DESIGNER: 3la-33-),(" WO. stn ,cv(-6'�6 Value of Work for this Permit: $ A-50vae Square/Linear Footage of Work: Type of Work: DAddress OAlteration ONew C�epair/Replace ODemolition Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ pet TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip 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 approveknd a reinspection fee will be charged. Signature �,°I1�.11`l..e �,'""� Signature Owner or Agent The foregoing instrument was acknowledged before me this day of, 201 by Ark v" w ersona�9&e or 4Eohas produced t` As identification and who did take an oath. NOTARY Sign: Print: My Commission Expires: APPROVED BY Contractor The foregoing instrument was acknowledged before me thisalL day of J i)� ,10 , by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: \\►►►►un a Nihi�i Si THER VALDES 06 '; Prin �' i �ct��i/s� �B�j`,• ? My —Via 0 Sian Ex iieS+An 1 P (j lays Examiner Zoning Structural Review (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk �r c.h (-c r e -- CHICAGO BRICK TO BE PAID IN RUNNING BOND PATTERN NOTTO EXCEED 35" IN WIDTH ALONG EAST SIDE OF HOUSE s r {� • " war - SFE ATTACHED R DETAILS r A r Y .- 1 1 ► / - 'VYSJ pig Alc �. T! FINE SALT FINISH I�i 1 r � SF, ATTACHED - Cwas5 U F DETAILS r a ....�, GRASS PLANTED AROUND SLABS � N �T . NOTICE OF COMMENCEMENT A RECORDED COPY MW BE POSTED ON THE JOB SITE At TIME OFFWT 0jBpWWN PERMIT NO?L' - �/�-.714X FOLIO NQS 0/) STATE OF FLORIDA: COUNTY OF MIAMI-DADE: THE UNDERSIGNEb -hereby gives notice that Impyovements will be made toft -00 n real property; and In accordance with Chapter 713, Florida Statutes, the following Wonyallon Is provided In this Notice of Commencement, CFN 2013RO502826 OR Bk 28694 Ps 1910; Qps) RECORDED 06/25/2013 10:06:17 HARVEY RUVINY CLERK OF COURT MIAMI-DADE COUNTY? FLORIDA LAST PAGE Space above reserved for use of recortling office 1. Legal -description of property and street/address: 7 /V f All 4 Ar" _Zewle 'S 2. Description of -improvement: j 3. Owner(s) name and address, _-Aiadrv' srlgP �A,4 f :Zo interest Proo In property; .3 '5. a5 W Name and address, of fee. simple titleholde.r. 4. C�oj"ctoes name, ;'*4�ss,anc�phope n4nper. 1)&s V 7et51,.1Z_t 5- Surety-_ (Payment bond required by owner from contractor, ff. any) Name, addressand phone pumber_ Amount of bond 6. Lenders name and adilrew. 7. Persons within theState ;of Florida designated by owner Upon Whom notices or other documents may be served as provided by . Section 711313(1)(q)1., Florida Stejutes Name, address and phone number. TE OF pjQRIl �, COUNTY OF WDF- QW 8. in oddMbn to'himieff, own 71313(1)(b), Florida Statutes. Name, address -and 'p­h-one*hL designat6i the following M 9. Expiration date of this' Notice of Commencement. (ft 00"in C14 is I yew from the date of recording untess a different date is specified) WARNING TO OWNER: ANY! PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION,OF THE NOTICE OF QQMMENCEMENTARECPNSIDERED IMPROPER- PAYMENTS -UNDER CHAPTER 713; PART 1,SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT YOUR PAYING , *TWICE FOR IMPRQV�EMENTS10 YOUR -PROPERTY. A NOTICE. OF, COMMENCEMENT 'MUST I§E-,hEWRbEb AND POSTED ON THE j0B,SrrE5ttPOAE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCINOVORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. " '-Authorkod Officor/Ditector/Partner/Manager Prepared By.,, Prepared Print Name A rQ Print. Name Title/Oifife Title/Office-. b -Wt OF FLORIDA: I.r OF COU MIAMI-&AIJE The fo oing Instrument was aeknow . ledged before me this V-/ day -of U In`dM,du'Wly, or for E875185 i la'PerSCtially known, :1_jD1r11t1piodU0e 'f, 17 d the dlIdW1hgty06 6 'Identification: -Signature of Notary 9" Publi ' c: Must 11mume; or 0 X. EVY-MOL AMC 92!AK VERIFICATION MMSUMT TOSECTIONA DA STATUTES Under penalties of p I bdiky, I deb 14ii th it I ' "Ave regoing and that the facts stated In it are true, to the best of my knowledge and belief. Signeture(s) of Owneqs) or Owner(s).'s Authorized Officer/Director/Partner/Manager who signed above: By 1230-62 PAGES 3MO By