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Building Department
1W50 N.E.2nd Avenue, Miami Shores; Florida 33138
Tel: (305) 795:2204 Fax: (305) 756.8972 ���. _- —
INSPECTION'S NE NUMBER: (305) 762.4949
Pertrtit Nd. 1 % 1
114
tWATION Master Per Wt No.
JOB ADDRESS: 99M NE 4 Ave. Rd.
City: Miami Shores
Folio/Parc, 11-3206-017w1230
j
Is the Building Historically Designated:
OWNER: Name (Fee Simple
Address: 9969 NE 4 Ave R
City; Miami Shores
Tenant[Lessee Name:
Email:
County:
Yes
Y'
NO Flood Zone:
Joel Minsk! /Andrea Minski
CONTRACTOR: Company lame: Regency Fool and Spa of Florida, Inc. Phone#95 -583-7373
Address: 6507 NW 13 Coup
City: Plantation State: FL Zip: 33313
Qualifier Name: Rafael A. Imbert 305-684-3804
State Certification or Registration #: CPC056811 Certificate of Competency #:
Contact Phone#: 954-583=7373Email address: midam@regencypool.com
DESIGNER: Architect/Engineer.
Value of Work For this Permit0-1
; $ ioo- $gwwe&hwar Footage of Work:
Type of Work: ®Addition,; UfAl4ation ®New ❑RepairMeplace ®Demtotition
Description of Work: _ &l �g` ~
�
t2 e-1 771,00
i. Color tr '
i
Submittal Fee $ Permit Fee $ `7 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ TrainhWMaeation Fee $ Technology Fee $
Double Fee $ 1 Structural Review
TOTAL FEE NOW DUE $ � l.•�
Bonding Company's Name ff applicable)
Bonding Company's Address
city State zip
Mortgage Lender's Name (if
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 Jurisdictiol . I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and ALR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT- 1 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.
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 eppy 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 (7j 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. ►
Signature Sign
+Ownor Agent Contractor
The foregoing instrument was ac wledged before me s The f;pei
in was ackno edg bf ttu
day of _ > 20 I'1, bSi day o ; 2010% bye .� 7
f
who is personally known to me or who has produced who son y known to me or who has produced
As identification and who did take an oath. z as identification and who did take an oath.
a
NOTARY P+LIC-
NOTARY PUBLIC:
ic:
Sign: Y&
Print: r �y * EXPIRES:Octobet 13c2013
My Commission Expire ieOF i
APPROVED BY_j�n , J JVJrU plans I aXaminer
2t� Structural Review
(Revised 3112/2012)(Revised 07/10/07Mvised 06/10MM)(Revised 3/15104)
My
Zoning
Clerk
CFN: 20130452489 BOOK 28667 PAGE 1594
DATE:06/06/2013 05:13:10 PM
HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST
I HE POSTED ON THE JOB SITE AT TIME OF FIRST IN,
PERMIT NOry 1 l
—5— 1 ° `+ TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF MIAMWADE:
THE UNDERSIGNED hereby gives notice that Improvements will be made
property, and in accordance with Chapter 713, Florida Statutes, the followir
is provided in this Notice of Commencement.
3.Owner(s) name and address: b ! l )
Interest in property:
Name and address of fee simple titleholder.
4. Contractor's name, address and phone number: -r a - rs _
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 Uenor'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:
(tire v94ation date is 1 year from file date of recording unless a afferem date Is specified)
WARNIN0 TO OWNED ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENTARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTFR 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FO
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WO
OR RECORDING YO NOTICE OF COMMENCEMENT, cy
Signature(s) of O ) or Owner(s)' Authorized Officer/Director/Partner/Manager o
Prepared By Prepared By
Print Name o r Print Name
Tftle/Oflice Title/Office
STATE OF FLORIDA W(
COUNTY OF MIAM DADE ®'
The f oing Ins nt was ac ow
before me this day of
—<
ey If
❑ Individually, or as for Q�
*rPersonally (mown or ❑ produced the following type of Identification:
Signature of Notary Public: Z
Print Name:
(SEAL) hipRR Bo�dTfNYSuvioae
VERIFICATION PURSUANT TO SECTION 82.525, 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.
Signatures) of Owner(s) or Owner(s)'s Authorized Officer/Direotor/Partner/Manager who signed above: M
U.
By BY ii Z
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W o W
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