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RC-15-782 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-251701 Permit Number: RC-4-15-782 Scheduled Inspection Date: January 27,2016 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Final Owner: HERBITS,STEPHEN Work Classification: Alteration Job Address:246 NE 101 Street Miami Shores, FL Phone Number (305)962-5552 Parcel Number 1132060134630 Project: <NONE> Contractor: B.ALLEN GROUP LLC Phone: (305)978-9101 Building Department Comments REMODEL MASTER BATH AND CLOSET AND KITCHEN Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed ag— Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid January 26,2016 For Inspections please call: (305)762-4949 Page 61 of 62 - Miami Shores Village %L 1(s ��� OR 0 6 2015 ' chi Building Department artment BY 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No.42-c,I S --I t r PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP <� CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 4313 J- Folio/Parcel#: //- o6 s ,113 �2 Is the Building Historically Designated:Yes NO ?C Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): -TH:o e- Phone#: 305' Address: N )�& V— to ! f City: lyf if-m'iI �; ftw Lkpr1; State:_ �'n Zip: 3-31,39 Tenant/Lessee Name: An`-� Phone#: Email: S $ iMtta(o C.&V" CONTRACTOR:Company Name: I`�� �`� Phone#: 3� ?3 "9 (v) Address: /� 1- LIO N w 1674 l d 3 City: 6 U2 State: FL- Zip: 3 3 tl 1 8 Qualifier Name: i77 d`� l f ' 'PS Phone#: 3 �" B '`r t°/ State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: 14(�' y '�" T �!L S Phone#: Address: dSw 33ird G®,(4- City: State: i;L Zip: 33/ro Value of Work for this Permit: 000 , Square/Linear Footage of Work: 61 Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description-of Work: I`�t M c d,Q �aS �� r(v SST Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ g TOTAL FEE NOW DUE$ ( " (Revised02/24/2014) 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,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 fee will be charged. Signature _ afV C nature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was/acknowledged before me this day of ho rl 020 ,by day of ;20 r' ,by ' Y ---//��__ J _ ho— ersonally know to who is ersonall kno to �1� P4 . S- who me or who has produced as me or who has produced as identification nd who did take oath. identification and who did take an oath. NOTARY BLI NOTARY PUBLIC: i �G Sign: Sign: Print: Q �Z— Print: CO C� Seal: P AYARI MARQUEZ Seal: '` AYARI MARQUEZ MY COMMISSION H EE195838 MY COMMISSION#EE195838 O EXPIRES:May 06,2016 *5 ET EXPIRES:May 06.2016 APPROVED BY IJ Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �►,5N0 SES G,t move ® ���.�� Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. `f COPY OF LOCAL BUSINESS TAX RECEIPT C. `� COPY OF LIABILITY INSURANCE*--- -_ D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: , (9 rte® L-L-�— BUSINESS ADDRESS: '1.6�O (02-4 010-? ( Opo i I' STATE ', ZIP 3 i BUSINESS PHONE:_) 171 -1121 FAX NUMBER�--�-- CELL PHONE(`3oS 1 '11 d I QUALIFIER'S NAME: l7d'e �►'� r '�"�PS QUALIFIER'S LIC NUMBER: C&C- tog-1 '3'-?(o7 RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY i STATE OF FLORIDA j - DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION - '- CONSTRUCTION INDUSTRY LICENSING BOARD 5 c j CGC151876T.- 1 Tiffs GENERAL CONTRACTOR_' N med-below IS:CERTIEIEQ='` -Underthe-provisions-of.Chapter489 FS ,� x=, Exptretion dafie:AUG 31 t;2Q16 ' -E(. ALLEN'�GRnOUPr.IoLf/.� YVY4.�N I�C����°"I"„l� .�sa�.d�a. { h�,�.h. k , 'ha M�,. '� �`°"y��4�'y�':�"1�'k '. ■ ■ {`��'I v- � MC"JRA 1i�'"`.r p�' 'd`�r_,....;�``w� ��`"'�_.��..'-`^'tet-�ea�' �" 91.��i�_, � '."�' G�., ��� "_>...�,y.S_a_.�`�t..�'.at'y,�'•.�5s-�{i�_'t_,'�..'+.�.aEry;$�Q/i ISSUED: 09/0412014 DISPLAYAS REQUIRED BY LAW SEQ# L1409040002514 MIAMI-DADE COUNTY - STATE OF FLORIDA N/A October 05,2015 MImm AMFDIAD LOCAL BUSINESS TAX RENEWAL 6658547 2015 -2016 APPLICATION RECEIPT:6929690 STATE#CGC1518767 DBA/BUSINESS NAME: BUS.COMMENCEMENT DATE:07/01/2010 B ALLEN GROUP LLC SEC TYPE OF BUSINESS BUSINESS LOCATION: BLDG1 GENERAL BUILDING CONTRACTOR 4640 NW 102 AVE 103 1 DORAL,FL 33178 OWNER/CORP. APPLICATION DETAILS B ALLEN GROUP LLC FEE AMOUNT PHONE# 305-978-9101 Receipt Fee 30.00 UMSA Fee 0.00 4640 NW 102 AVE 103 Beacon Council Fee 15.00 DORAL,FL 33178 Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi-Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 NTransfer Fee 0.00 AICS CODE: 2389 Doing Business without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0.00 Prior Years Due 0.00 Amount Recently Paid TOTAL AMOUNT DUE: 0.00 ................................................................................................................................................................................................................................................................................................................. If no longer in business,please notify us in writing. To pay online go to www.miamidade.aov/taxcollector Review and correct the information shown on this application. To pay by mail,make check payable to: Miami-Dade County Tax Collector A 25%penalty will be assessed to anyone found operating Business Tax without a paid local business tax, in addition to any other 200 NW 2nd Avenue penalty provided by law or ordinance(Sec 8A-176(2)). Miami FL 33128 To pay in person go to: A Certificate of Use and/or City Business Tax 200 NW 2nd Avenue Receipt may also be required. (305)270-4949,fax(305)372-6368 A service fee of not less than$25.00 up to a minimum of 5% will be charged for all returned checks. I' RETAIN FOR YOUR RECORDS t ................................................................................................................................................................................................................................................................................................................. MIAMI-DADE COUNTY- DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + N/A October 05,2015 STATE OF FLORIDA LOCAL BUSINESS TAX RENEWAL 2015 -2016 APPLICATIONI III I1111111IIIIIIII III II111111 I 1 STATE I #CGC15108767 6658547 BUSINESS LOCATION: 4640 NW 102 AVE 103 DORAL,FL 33178 BUS.COMMENCEMENT DATE:07/01/2010 SEC TYPE OF BUSINESS OWNERICORP. BLDG1 GENERAL BUILDING CONTRACTOR B ALLEN GROUP LLC 1 APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPATION DESCRIBED HEREON.I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT. I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT. B ALLEN GROUP LLC BRENT PHILLIPS PRES 4640 NW 102 AVE 103 SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE DORAL,FL 33178 Please pay only one amount The amounts due after Sept 30th Include penalties per FS 205.053. ff Received By Oct 31,2015 Nov 30,2015 Dec 31,2015 Jan 31,2016 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000006929690201600000004500000000000006 11.1 s5:r "'' SIr t ��,,, �u a° ('� r"..!' Si Wt� '��.g� $�` � t ' .'I 1 � �t✓�.�t Ua ��• 92 MUM .�,o�t�ros'4 - s h � tt IMMUNE, x M �],�,�a nnll- "Islam Ilk .��v�j'a"'�i��>s�,�v.ls„"�,k`�i�`i#��y,sP�`�1,�.�f`°�S• 'h t'`�.4 � I���.. t� ,�;,a�A$ � fv�, ���i3�;���•, '� r'}(a��,� �i}� r`r•�� � ft �,i�{�� �u �s4�r ;��Py5�'"�' � Y'� .[`$ ( "• �r s. r�py.F.a;,}� �� s� sa}�f�}� .a� � y�,.•. ��� � '?�r��; ���,t.;.��i•*�r,�� e y_�., r�'��� thSXs .� ��� p,� ,� B rt � x"�k •9sa� ,:* � Priv r I 'K� 5���� ��•> _ ��� �y i�, �i r. �5 Apr 0315 03:32a First Solution Insurance 305-740-8211 p.1 CERTIFICATE OF LIABILITY INSURANCE044/03/03/22015G15 Y) DAT / THIS CERTIFICATE IS 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 ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION 1S WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT J JANULIONIS 4LM4I�{...- '– ANUL FIRST SOLUTION INSURANCE PHONE —- --— -- "- — -•- (A+G tta._E?stl.-3056676530— _ - }��Nol: 3057408211 6530 CORAL WAY EMAIL INFO F - MIAMI FL 33155 -AnoRENs__.. @ SIMIAMI.COM INSURERS)AFFORDING COVERAGE.___ NAIL# --..---...------_..----...._-.._...---..__.. INSURER A: ARCH SPECIALTY INSURANCE INSURED _INSURER.B B.ALLEN GROUP LLC. -'-- — --' -"' INSURER C:-—_ 4640 NW 120 AVE#103 —_SURE IN .. --_..-._._—...._.._.......-:. MIAMI FL 33144 , .. R D —_.._..-_......._.....—..---.._. ----...._._—._—..._. INSURER E: ! INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER 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_. LTR TYPE OF INSURANCE ; POLICY EFF i POLICY EXAl'--""'—"' — •_—•_....__..__..___ POLICY NUMBER GENERAL LIABILITY MMIDDIYYYY ! MMIOD I LIMITS � i I ! ..EACH. OCCURRENCE I$ 1000000 +XCOMMERCIAL GENERAL LIABILITY j _PRE�ES.(Ep-ong rfancs ...i.5 100000 CLAIMS-MADE LXJ ocCUR 11 MED EXP(Ar,y one person) $ 10000 AGLOO19898-00 - I- - -••-�.....-_, I J 11/26/2014 111/26/2015 It PERsoNAL a ADV INJURY i g 1000000 -� - '— .GENERAL AGGREGATE $ 2000000 -•~-- �G/EN'L AGGREGATE LIMIT APPLIES PER: i PRODUCTS-COMP/Op AGG_2000OOO /� POLICY' PRO- 1—!LOC j I '_ .$- ._.._._....---•- AUTOMOBILE UABIUTI' I i CO INED SINGLE LIMI ANY AUTO I i.S.� ent1 $ ALL OWNEDI BODILY INJURY(Per person)1$ AUTOS I ! __ _--..... .....—:AUTOS NON-OWNED ' BODILY INJURY(Per accident)i$ HIRED AUTOS •-� ['*'-I .._.,AUTOS I PROPERTY bAMAGB -- �psr. UMBRELLA LIAR, •$ !OCCUR { EXCESS UAB ! I EACH OCCURRENCE g _—. FCGC#1518767 _— .._ AGGREGATEED RETENTION$RS COMPENSATION PLOYERS'UABILITY + I WC STATU- OTH-OPRIETOR/PAR7NER/EXECUTVE Y/N' I—_,..:.S4RY..LiMLT. ' ERR/MEMBER EXCLUDED? N/A i E.L.EACH ACCIDENT $tory in NH)escribe under ! E.L.DISEASE-EA EMPLOYE SIPTION. OPERATIONS below -iEL.DISEASE-POLICY LIMIT OF OPERATIONS/LOCATIONS 1 VEHICLES (Attaeh ACORD 101,Additional Remarks Schodule,If more space is required)767 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIRN DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE BLDG DEPT. ACCORDANCETHE POUC*PROVISIONS. 10050 NE 2ND AVE \• MIAMI SHORES FL 33138 AUTHORIZED REPRESENTA'1 'Et ' ACORD 25(2010/05) ©1988-2010 AC;R ORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD'\\ OA Al JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 11/17/2014 EXPIRATION DATE: 11/16/2016 PERSON: PHILLIPS BRENT FEIN: 271144445 BUSINESS NAME AND ADDRESS: B ALLEN GROUP LLC 4640 NW 102ND AVE#103 DORAL FL 33178 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.05(14),F.S.,an office of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only within the scope of the business or trade listedon the notice of election to be exempt Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a DFS-F2-DWC-252 CERTIFICATE OF EL CTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 � oJQ v� \moo �P 04/03/2105 State of Florida County of Miami Dade Before me this day personally appeared Brent Phillips,who, being duly sworn, deposes and says: That he will be the only person working on the project located at 246 NE 101 Street, Miami Shores, Florida . Sworn to(or affirmed)and subscribed before me this 03 day of 2015 By Brent Phillips o Pesonally known to me , G�/Air 4Q, AYARI MARQUEZ / MY COMMISSION#EE193838 EXPIRES:May 06,2016 I/ 4640 N.W. 102 Avenue,#103 • Doral,Florida 33178 •Tel:305-978-9101 •www.ballengroupgc.com General Contractor/Construction Manager rrr it 19;1 R767 'Eggs Miami shores Village Building Department Lit m 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature:3�� �It Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this ® 3 day of A By S FQ r�i.' who is personally known to me or has produced as identification. Notary: a SEAL: MY COISSION#EE19S838FXs:May 06,20161!�71AYA�rkl 11!!111!ill1111111iiii lllli 1111111111 llil lilt C_FN 2014RB�8 7:3612 _. Of: Ek 29438 Pss 293+; - 2937e r2p98: RECORDED 12/22/201 13:00:4 This Document Prepared By: DEED DOC TAX ,F601.80HARVEY RUVIN? CLERK OF COURT RICHARD A. GOLDEN, ESQ HIAHI-DARE COUNTYP FLORIDA KRAMER AND GOLDEN, P.A. 1175 N.E. 125TH STREET SUITE 512 NORTH MIAMI, FLORIDA 33161 KGPA FILE NO.162-14R Parcel[D Number. 11-3206-013-4630 Warranty Deed This Indenture, Made this l day of December , 2014 &D., Between JOHN PAUL CARR, a single man and GHISLAINE B. CARR, a single woman of the County of Dorchester , State of South Carolina ,grantors, and STEPHEN E. HERBITS, a single man whose address is: 1000 Venetian Way, #1904, Miami, FL 33139 of the County of MIAMI—DADE , State of Florida ,grantee. Witnesseth that the GRANTORS,for and in consideration of the sum of ------------.--------TEN DOLLARS ($10)----------------------- DOLLARS, and other good and valuable consideration to GRANTORS in hand paid by GRANTEE, the receipt whereof is hereby acknowledged, have granted, bargained and sold to the said GRANTEE and GRANTEE'S heirs, successors and assigns forever, the following described land, situate, lying and being in the County of ISI—DADE State of Florida to wit: Lot 7, and the East 1/2 of Lot S, in Block 34, of AMENDED PLAT OF MIAMI SHORES, SECTION ONE, according to the plat thereof as recorded in Plat Book 10, at Page 70, Public Records of Dade County, Florida. and the grantors do hereby fully warrant the title to said land, and will defend the same against lawful claims of all persons whomsoever. >m«G=WMW by 9 Mpyy syuw.,,tom,2014 (863)763-555S tm,FLWD-2 �df OR BK 29438 PG 2937 Warranty Deed -Page 2 LAST E_AGE Parcel ID Nmnber: 11--3206-013-4630 In eS,�Whereof, the grantors have hereunto set their hands and seals the day and year fust above written. S 's ed and delivour presence: t (Seal) P in e: V ;/o— JOHN OPL CARR Witness as to Pirva a P.O.Address:100 Amberjaek Way,SummerAfle,SC 29486 Printed Name: Witness as to John Paul Carr ILI (Seal) Printed Name: i i6jL;:1A (I. k-', rZy GHIS NE B. CARR W'I ess as to G�iisla�.ne B, Carr' P.O.Address:9167 S.W.48 PLACE,GaluaWle,M1 32608 Printed Name: Witness as to Ghis alae B. Carr STATE OF Florida COUNTY OF Miami-Dade The foregoing instrument was acknowledged before me this /-7 day of December , 2014 by JOHN PAUL CARR, a single man who are personally known tome or who have produced their ]Florida dr r' iCense as id chip on. nted N e: --;�1' �-9: pqp COMMI�$IAZ N terry Publ i c� v/ FFo16627 �'oq;= EXPIRES:June 17,2017 M ommission Expires: STATE OF Flori Q' BondeditwNfuyPuV.0°thea: COUNTY OF QX,, u,.k The foregoing instrument was acknowledged before me this rp4%- day of December , 2014 by GHISLAINE B. CARR, a single woman who is personally known tome or who has produced their Florida driver's lieen�Senas identification. Prin e: Te�frea �a►r�►� Notary Puhlic�— My Commission Expires: 04.1n Jeffrey Carlin Notary Public State of Florida 4iGgmmission No. EE 185567 tit**tom 0112016 162-14R L—oea9Wby0nbyaysyuem% a.,2014 (9a)763-5555 FDrmFtwn.2 x rM.jt o s y Miami Shores Village �s" " �8i?t1lr T) IiilS.[denti4 l�rtstructlor► 10050 N.E.2nd Avenue NEAltara#on Miami Shores,FL 33138 0000stat 1s.AIPPROVED y Phone: (305)795-2204 Expiration: 04/03/2016 Is$i��D�te.lvr6r2c1~1�� p" Project Address Parcel Number Applicant 246 NE 101 Street 1132060134630 STEPHEN HERBITS Miami Shores, FL Block: Lot: Owner Information Address Phone Cell STEPHEN HERBITS 246 NE 101 Street (305)962-5552 MIAMI SHORES FL 33139- 1000 VENETIAN Way MIAMI FL 33139- Contractor(s) Phone Cell Phone Valuation: $ 38,000.00 B.ALLEN GROUP LLC (305)978-9101 __..__. Total Sq Feet: 1600 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Fill Cells Columns Date Denied: Final PE Certification Type of Construction:REMODEL MASTER BATH AND CL Occupancy:Single Family Window Door Attachment Stories: Exterior: Framing Front Setback: Rear Setback: Insulation Left Setback: Right Setback: Drywall Screw Bedrooms: Bathrooms: Window and Door Buck Plans Submitted:Yes Certificate Status: Review Planning Certificate Date: Additional Info: Review Structural Review Mechanical Bond Return: Classification:Residential Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Electrical CCF $22.80 Review Building DBPR Fee $17.10 Invoice# RC-4-15-55087 Review Building DCA Fee $17.10 10/06/2015 Check#: 1502 $ 1,146.00 $150.00 Review Mechanical Education Surcharge $7.60 04/06/2015 Credit Card $ 150.00 $0.00 Review Plumbing Permit Fee $1,140.00 Review Plumbing Plan Review Fee(Engineer) $40.00 Scanning Fee $21.00 Technology Fee $30.40 Total: $1,296.00 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and iy strict conformity witlfthe plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit l'assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MOCHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. / OWNERS AFFIDAVIT: I c rtify that all he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and z rang., tH the above-named contractor to do the work stated. Cti 1 October 06,2015 Authorize igna re:Owner / Applicant / Contractor / Agent Date Building Dep rtm nt Copy October 06,2015 1 Miami Shores e Villag Building Department JAN I 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 e. 6-8972 AE !N I N B 05)762-4949 1' FBC io LO BUILDING — - - _ aster Permit No.0-r I(z:' x-`10 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING REVISIO ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP pp-- CONTRACTOR DRAWINGS JOB ADDRESS: F I C[ ST- S+rek t City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): f-��161�\ �`"' Uma Phone#: 3 CDS 'y 2 �-$ gqj Address: Z`l(o N+� t0 C S S ky u- City: V\%,G nn1 S 6ON-S State: FL Zip: 3 313$ Tenant/Lessee Name: 1 Phone#: Email: S kT 09 g rm0.t�e C "V\ CONTRACTOR:Company Name: 11 `�n G `w p Phone#: 30 _�9 IS -q(d r Address: S�+l �JW W" City: C-°'D ea State: C_L Zip: 3 3 O 24 Qualifier Name: i�J P�a► �' 1 ��I®� Phone#: State Certification or Registration M C h;_1 .7 Certificate of Competency M DESIGNER:Architect/Engineer: At ll e'Oy L-vN at GS P 15, Phone#: Address: ``A)a 1 �.V l 3 rd C �' City: 6til j,dwv+ State: 1'L Zip: 31 (�6 Value of Work for this Permit:$ I O O° Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: d �tc a on &o t 4o U_� CAS ' � 57 Specify color of color thru tile: Submittal Fee$I ` Permit Fee$ J CCF$ CO/CC$ Scanning Fee$ ° UD Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ co (ReAsed02/24/2014) 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,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 fee will be charged. /11 Signature Signatu OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 3(AbL dayof 0te.Lwt�r.&," 20 1S' by 2q4:4 day of ____,20 t1 by S -4C p `-J who is�sonallyl;n t0 13i-e' [,Ps who isersonally know to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC:.-17) r NOTARY PUBhFC: Sign: - Sign: - Print � �c� Print Seal: AYARI MARQUEZ Seal: " ARI MARQUEZ MY COMMISSION 9 EE195838 MY COMMIS N N EE195839 EXPIRES:May 06.2016 ` 6pP� EXPII:s. 96,2016 as *******xss*rix*�rrr*�*�******* xt**x**r*�***�*e*****x****�+xa*•a**xx�s****x*t�**�xx***��*�**�**�**��x�*�t�*�** 6�. APPROVED BY I� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Jan 11 16 02:18a First Solution Insurance 305-740-8211 P.1 r CERTIFICATE OF LIABILITY INSURANCE DAMI&WDD1YYYYi 01;1'12016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BOLDER-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 iNSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCED,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER oNTAcr Fry RST SOLUTION 'NSURANCE NASrt '' FIRST SOLUTION INSURANCE PHONE - 305.667,6530 FAX _305.740.8211 6530 CORAL WAY E-MAILADDRESS: INFO�FSIMIAMI.COM �jl -MIAMI,FL 33155 _ WSURERIS AFFORDING COVERAGE NA1C A INSURED wsURERA: ARCH SPECIALTY INSURANCE COMPANY B.ALLEN GROUP,LLC INSURER s: -- 4640 NW 102 AVENUE#103 INSURER C: MIAMI,FL 33144 INSURER D INSURER E: covERAGEsIN3UIiER F: CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 13EEN ISSUED T I 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 SHOArN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE USR POLICY NUMBER POLICY EFF POLICY EXP GENERAL LIABILITY Mfi10l1'Y1'YI 1'1 71 LIMITS COMP,1ERCIAL GENERAL LIABILITY EACH COCURRENCE 5 1,00,000 CLAIMS-WADE C OCCUR PREMISEa occu.-rence S 100,000 AMED EXP An acre person) S `0,000 AGLD032378-00 12/1612015 12/16/2016 p=RSONAL8AD'JINJURY S 1,000,COO 'GENERAL AGGREGATE W. $ 2.000,000 . GEN'L AGGREGATE LIMIT APPLIES PER: nLOC PRODUCTS-COUP:OPAGG s 2.000,000 POI-ICY AUTOMOBILE LIABILITY S (Ea SINGLE L M T ANY AUTO a acc6iant S ALL OWNED SCHEDULED BODILY INJURY'Per Person) S AUTOSAUTOS _ NC'DWNED BODILY INJURY�eracc'idenr,• $ HIRED.4UTOS Al1TOS PRO,PER'T1'DAMAG= PeracdJon,) S UMBRELLA UAB S OCCUR EXCESS LIABI EACH OCCURRENCE g DEO RE rwrl0N CLAIMS-MADE s AGGREGATE g WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN WCSTATU- OTH- ANY PROPR:ETOWPARTNEFIEXECuTIVE R OFFICERlMEMBER EXCLJDED7N f A i E.L.EACH ACCIDENT $ (Mandatory in N141 ❑I ' If Yes,deserbe,under DcSCRIPTION OF OP:R47IONS below E.L.DISEASE-EA EMPLOYEE $ E.L.DISEASE.POLICY LIMIT I$ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VENfCtE9 CGC#1518767 (.4ltaeh ACORD t01,Additional Remorks Schedule,Irmare apace Is required! CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN =,111A LAGE BLDG DEPT. ACCORDANCE W17H THE POLICY PROVISIONS. 33138 AUTNORMW SENTATIVE ACORD 26(2010105) The AGORD name and logo are regist�a mar Sof 01 RCDDRD CORPORATION. All rights reserved. Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 JAN 05 795-2204 Fax:(305)756-8972 E LINE PK 305)762-4949 FBC 20 10 BUILDING aster Permit No.. (10 PERMIT APPLICATION sub Permit No. Fe—'FI� ❑BUILDING [K ELECTRIC ❑ ROOFING ® REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 7-%i. N to l 1 S �� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): S 4e-(p�-4^ C*tv-b 6�j Phone#: Address: Q-4(o r4 s i,o 1 S iv-a k City: 0\\a v✓\ r•t S State: - Zip: -33 t 3 $ Tenant/Lessee Name: Phone#: Email: ``A ' CONTRACTOR:Company Name: JS SP_4. fi�0.c.'��� L'oq (44^q aL^d Ypdrhex; Address: f i`'l SO PL City: to _State: 'r-L. Zip; 3 3 3 2 3 Qualifier Name: �I C.Inv e-� �a toNC Phone#: 309"110 -•'8Y 2 (v State Certification or Registration#: E C 000 15`b S Certificate of Competency#: DESIGNER:Architect/Engineer: 141 I-er 1,w Cc rf t (moi Phone#: '3 OV-1 2 i--%'t6 13 Address: 1 H 3 of S w ) 13 4 4-- City: a w, i State: ri- Zip: Value of Work for this Permit:$ 3,0 c7 •aj Square/Linear Footage of Work: Type of Work: ❑ Addition ® Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: -Gy( S G C",r- Ind Specify color oflor thru tile: Submittal Fee$ Permit Fee$ �Y,®L�r CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ –I CD (Revised02/24/2014) 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS, HEATERS,TANKS,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 fee will be charged. Signature �- Signature A-zA, OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 'b ,by S :!�o // day of,,00���� S.Kva 20 ((9 , by S�U(-cam � '�• ,who is rsonally know to t Gk..[. /vw�e,� ,who is Cersonally known o me or who has produced as me or who has produced as identification and who did take an oath. identification and whe did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: �' Sign: — Print: IM Print: G! ' Ci� d 2 Seal: AYARI MARQUEZ Seal: P ' NAM MARQUEZ Y COMMISSION H EE195838 °� MYCOMMISSWIANEE195838 EXPIRES:May 06,2016 FOR EXPIRES:May.06; 016 ********************* ************************************************************************************* APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village 11, w-lding Department 1 2015 E. v e, Miami Shores, 0 33138 - F 5 6- 92 7 2-4949 FBC 20 l� BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. �-\ I ��. ❑BUILDING ❑ ELECTRIC ROOFING ® REVISION EXTENSION RENEWAL ®PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 7-Lu, Nte (o( &T S 4.pee'k City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): Phone#: Address: 2`uco ar lei S± City: fAta "t S�%a ee-, State: Zip: 3 3 t3 Tenant/Lessee Name: Phone#: Email: n CONTRACTOR:Company Name: L 1' v M i/�y C4- m c.-a rs! Phone#: SO, )6? Z Address: 'L.)K,o 0 w4'`rool_ S 6-cc� City: t awA State: Zip: 3 3 tj 3 Qualifier Name: d lady Ca rh o Nee- Phone#: State Certification or Registration#: c f�(, I Z q l(e7 Certificate of Competency#: DESIGNER:Architect/Engineer: A i rw k (.vo-r.,(tJ PG Phone#: 3®0'- 7 Z 1 �G 13 Address: 141'.0t S`v I `( I City: oil i.o-v•%® State: Ft- Zip: ?3/a G so Value of Work for this Permit:$ ya 0 ' Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑t Demolition Description of Work: C c)(NA C 4- ny!n l / oa%A sAm u l Wact Gc' S�tcam theC1(Kic`Ct!�-��C Specify color of colorIt bro tile: Submittal Fee$ Permit Fee$ ? CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$9 F ' 10 (Revised02/24/2014) 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS, HEATERS,TANKS,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 fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this S}� day of S a«o, ,20 1 6 , by S "' day of J a^ 20 16 by P" q"r, %b -----.,who is ersonall known 1!J t a.,L..& Gy ,who is arson y known o me or who has produced as me or who has produced as identification and who did take an oath. identification and whd did take an oath. NOTARY PU NOTARY PUBLIC: Sign: "' Sign: Print: G/u fI�CQ✓!7� Print: C1�C GroZ�/tZ Seal: Seal: AYARI MARQUEZ MY COMMISSION H EE1938n ' AYARI MARQUEZ ° EXPIRES:May 06,2016 MY COMMISSION N EE19MO alp, EXPIRES:Ma 06,2016 ########### # ########### ####### ##################################################################### APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)