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MC-16-164 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-251342 Permit Number: MC-1-16-164 Scheduled Inspection Date: February 24,2016 Permit Type: Mechanical - Residential Inspector: Perez,JanPierre Inspection Type: Final Owner: MAMULA, LOIS Work Classification: A/C Replacement Job Address: 1513 NE 105 Street 1-5 Miami Shores, FL Phone Number Parcel Number 1122300530530 Project: <NONE> Contractor: NO SWEAT A/C CONDITIONING CONTRACTOR Phone: (954)423-9696 Building Department Comments 3 TON CHANGE OUT WITH 10 KW Infractio Passed Comments INSPECTOR COMMENTS False TO CLOSE PERMIT#MC05-1053 I� Inspector Comments Passed 19 Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid February 23,2016 For Inspections please call: (305)762-4949 Page 14 of 40 F�ermrt� f�C -1 6-1 ,� �sKm r, Miami Shores Village 'fi ?11 T eGiet� (, eS[l�lei fir• 10050 N.E.2nd Avenue NE Wt7lk C/03476atrar: AM Replacement' Miami Shores,FL 33138-0000 ; 3 F?k� t11 ft Staftrs.APPR( UE1 Phone: (305)795-2204p Expiration: 1 tate " 120'1 p� Project Address Parcel Number Applicant 1513 NE 105 Street Number: 1-5 1122300530530 Miami Shores, FL Block: Lot: LOIS MAMULA Owner Information Address Phone Cell LOIS MAMULA 1513 NE 105 ST#1-5 MIAMI FL 33138-2115 Contractor(s) Phone Cell Phone Valuation: $ 4,500.00 NO SWEAT A/C CONDITIONING CONI (954)423-9696 (954)557-6179 Total Sq Feet: 0 Tons:3 Available Inspections: Additional Info:3 TON CHANGE OUT WITH 10 INV Inspection Type: Classification:Residential Final Approved:In Review Review Mechanical Comments: Date Approved::In Review Date Denied: Type of Work: Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.00 DBPR Fee Invoice# MC-1-16-58402 $2.36 01/27/2016 Check#:22653 $ 184.22 $0.00 DCA Fee $2.36 Education Surcharge $1.00 Notary Fee $5.00 Permit Fee $157.50 Scanning Fee $9.00 Technology Fee $4.00 Total: $184.22 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 in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore,I authorize the above-na2 ed con actor t do the wo stated. `744f - January 27, 2016 Authorized Signature:Owner / Applicant / C61tractor / Agent ate Building Department Copy January 27,2016 1 ! Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 N Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 VAX&-n FBC 20 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING k MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: � �3 /1/c le-1— City: e-City: Miami Shores Countv: Miami Dade Zip: 33� Folio/Parcel#: //.-3 Is the Building Historically Designated:Yes NO Occupancy Type: 16 Load: Construction Type: 40 Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): I-ela /;a '4`'W4L4 Phone#: Address: /S i3 /2/r7 lFj, ' City: o -IA7711 J1/A0,10- State: 'Pry Zip: 3 _�13do- Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: O //VL ` Phone#: Address: City: �?�� State: Zip: Qualifier Name: -� K ` �� �'� `i��'� Phone#: State Certification or Registration#: /W ivle Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ y��� `"' Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Re lace p El Demolition Description of Work: 70-,v cel! ITC LA� r lT MC1 G C_:�o (0.� Specify color of color thru tile: e Submittal Fee$ Permit Fee$ (�� CCF$ G CO/CC$ Scanning Fee$ Radon Fee$ c DBPR$ Notary$ ` Technology Fee$ `60 Training/Education Fee$ i • CO Double Fee$ Structural Reviews$ Bond$ 7? r� 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 Signature OWNER or AGENT CONTRACTOR 67 The forgoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 49 day of J,41V� r20 by ' day of ` Q02 20 ��r , by who is persona known to -s ��ENW:C -( t''Wll is persoWgry known to me or who has produced as me or who has produced F-- WS)E las identification and who did take an oath. identification an who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: ` Sign: Print: ''•o Print: MY COMMISSION M PY205274 Seal: :,4a EXPIRES Mwch 03 2019 .;/�:tf�F..O'st5 FlunAsPMNM•Savra rew Q44Vf PL®4 Notary'�;:.i,:.;c State �1u`'rb•�rla P a Sindia APva'`:=7 (5 «15P7=11 `� ¢= ea AAPPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �SHos D Miami Shores Village Building Department ... n...l" 10050 N.E.2nd Avenue _ Miami Shores, Florida 33138 � y Tel: (305)795.2204 Fax:(305)756.8972 AIR CONDITIONING REPLACEMENT DATA PERMIT NUMBER: MC This form must accompany ALL air conditioning replacement permit applications. Each unit change-out must be on its own data sheet. Multiple units on single sheets are not acceptable. Job Address(where the work is being done): City: Miami Shores Village County: Miami Dade Zip Code: ALL CONDENSING UNITS MUST BE ON A 4 INCH SOLID CONCRETE SLAB ALL UNITS MUST COMPLY WITH F.E.M.A MINIMUM FLOOD ELEVATION A COPY OF THE CONTRACT IS REQUIRED WITH ALL SUBMITALS AHRI DATA SHEET REQUIRED Change disconnecting means:YES❑ NO❑ ARHI Sheet Attached:YES ❑ NO ❑ Contract Attached:YES ❑ UNIT BEING REPLACED DATA NEW UNIT MANUFACTURER AHU or PKG. UNIT MODEL# COND.UNIT MODEL# KW HEAT NOM TONS AHU CU PKG 1)M.C.A AHU CU PKG AHU CU PKG 2)M.O.P AHU CU PKG AHU CU PKG 3)VOLTS AHU CU PKG PKG UNIT / / PKG UNIT EER/SEER YES NO REPLACING DUCTS YES NO YES NO REPLACING THERMOSTAT YES NO YES NO NEW 4"CONCRETE SLAB YES NO YES NO NEW ROOF STAND YES NO YES NO NEW RETURN PLENUM BOX YES NO 1. Minimum Circuit Ampacity(Wire Size): 2. Maximum Overcurrent Protection (Fuse/Breaker Size): 3. Voltage of Circuit(208/240/480): 4. Size Disconnecting Means: Contractor's Company Name: Phone: State Certificate or Registration No. Certificate of Competency No. Signature Date: (Qualifier's signature) (Revised02/24/2014) BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2015 THROUGH SEPTEMBER 30,2016 DBA: Receipt#:HEAT N4 9G/AIRCONDITION CONTRACTR Business Name:NO SWEAT A/C REFRIG & HEATING INC Business Type: (A/C CONTR) Owner Name:K KRAMER JR REGIS Business Opened:o5/18/1995 Business Location: 511 SUMTER AVE State/County/Cert/Reg:CACO26410 DAVIE Exemption Code: Business Phone:423-9696 Rooms Seats Employees Machines Professionals 1 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 1 0.00 0.00 0.00 27.on THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: K KRAMER JR REGIS Receipt #1CP-14-00020879 511 SUMTER AVE Paid 08/12/2015 27.00 DAVIE, FL 33325 08/11/2015 Effective Date 2015 - 2016 ACORN® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) `� F5/6/2015 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 IS 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 NAME: Maria Benitez Jackson Insurance Agency PHONE N o.Ext): (305)824-3464 FAX Ne: (305)822-8535 2075 West 76th St E-MAIL cy ADDRESS: g en mbenitez@'3acksona com INSURERS AFFORDING COVERAGE NAIC# Hialeah FL 33016 INSURERA:American Empire Surplus Lines 35351 INSURED INSURER B: No Sweat Air Conditioning, Refrigeration, And INSURER C: 511 Sumter Ave. INSURER D: INSURER E: Davie, FL 33325 INSURER F: COVERAGES CERTIFICATE NUMBER:CL155601460 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. INSR I L SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM DIYYYY MMIDD/YYYY LIMBS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 300,000 A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ 15CGO189097 5/20/2015 5/20/2016 MED EXP(Any one person) $ 1,000 PERSONAL 8 ADV INJURY $ 300,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 600,000 X POLICY El PRO- ❑ JECT LOC PRODUCTS-COMP/OP AGG $ 300,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OAUTOESULED AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If as,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) This certificate is solely for the use as " Evidence of Insurance" License # CACO26410 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Ed Jackson/MARIAB ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD NS025(201401) 04 JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA 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 fisted below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 9/16/2015 EXPIRATION DATE: 9/15/2017 PERSON: KRAMER REGIS K JR FEIN: 592331027 BUSINESS NAME AND ADDRESS: NO SWEAT AIR CONDITIONING REFRIGERATION AND HEATING INC 511 SUMTER AVENUE DAVIE FL 33325 SCOPES OF BUSINESS OR TRADE: HEATING,VENTILATION, AIR-GOND Pursuant to Chapter 440.05(14),F.S.,an officer 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 listed on the notice of electron 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 ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 ALM 0offrfaraoff[rf REFRIGERATION & HEATING MC. January 19, 2016 State of Florida County of Miami Dade Before me this day personally appeared Regis K Kramer Jr who,being duly sworn, deposes and says: That he will be the only person working on the project located at: 1513 NE 105 Street,Miami Shores,FL 33138 Sworn to (or affirmed) and subscribed before me this ? r day of UA2-!-4 . 2016 who is personally known to me produced identification Type of identification produced a®j-0 py" Notary Public State of Florida Sindia Alvarez oQ M!Commission FF 156750 OF �p Expires 09/03/2018 Print,Type or St mp a of Notary 511 Sumter Avenue • Davie, FL 33325 • Broward (954) 423-9696 • Dade (305) 623-1500 ♦ OR 5NR>Es D n „ , �, Miami shores Village ..... Building Department R`ipA 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 BE W YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS., Signatur : e Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this �`� day of ��y�i ,20 Ile- . By L® 10,ofW V44- [who is personally known to me r has produced as identification. Notary: MY COMMISSION N FF S?71 SEAL: ' Te, ••••• EXPIRES Manch 03 FT Hi;/r:{l4J�'t.:s iknrHgnM• Sa.rw r.•n Miami Shores Village Building Department 10050 NE 2 Ave, Miami Shores, F133138 Tel: (305)795-2204 9 Fax; (305)756-8972 12/10/2015 To: Current Owner 1513 NE 105 Street. Unit: 1-5 Miami Shores, FL 33138 Permit: MC-12-05-1053 Address: 1513 NE 105 Street. Unit# 1-5 Miami Shores FL Date Expired: 11/14/2006 Dear Sir or Madam, Our records indicate that the above referenced permit has expired without obtaining the proper final inspection. In order to serve you better, we need to keep our files up to date. As per section 105.4.1 of the Florida Building Code, "Every permit issued shall become invalid (expired) unless the work authorized by such permit is commenced within six months after its issuance, or if the work authorized by such permit is suspended or abandoned for a period of six months after the work is commenced, or completed without obtaining the final inspection of the work performed.." Please be advised that open permits will hinder your ability to refinance or sell this property Please contact the Building Department, within 15 days of receipt of this letter in order to take care of this matter. Sincerely, Ismael Naranjo (CBO) Building Director Miami Shores Village Building Department 10050 N.E. =1410,56.8972 Florida 33138 Tel: b0 ( hl C c)5 - t D,53 BUILDING N0, 4 0 Permit No. PERMIT APPLICATION ----- - _- !aster Permit No. FBC 2001 JV Permit Type (circle): Building Electrical Plumbing ( Mechanical Roofing Owner's Name(Fee Simple Titleholder) ,}m i/L,/4 L o/S Phone#.30r--l-�3 �? R3 Owner's Address City / State Zip 3 3 13 J' Tenant/Lessee Name N/,& " Phone# Job Address(where the work is being done) A5_13 IVC ! as' S City lVTiami Shores Villa.ae County Miami-Dade zip Is Building Historically Designated YES Contractor's Company Name Contractor's Address J_/I VIP1 7Z-YL' �i City /t^ ,)State `e, �7— Zip Qualifier �`�j•1 6(L Architect/Engineer's Name(if applicable) Phone# $Value of Work For this Permit Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑Demolition Describe Work:�7 0'`J G /a /,<,t./ Submittal Fee$ Permit Fee$ ` v CCF$ Z- CO/CC Notary$ Training/Education Fee$ - �� Technology Fee$ Scanning$ 3- Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ ' (08, l C (Continued on opposite side) 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 and a reinspection fee will be charged. F' :✓ n r Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this /a The foregoing instrument was acknowle /dbefore me this day of �'�:� ,20 e�,by day of _ �� 20C,9 by who is personally known to me or who has produced who is perpot lylown=tp'nie,,or who has produced As identification and who did take an oath. a/ as identification and who did take an oath NOTARY-PUBLIC: NOTARY PUB Sign: Sign: .s, l Print: _ `a % �m F r e'� Print: �� y 174 r My Commission Expires: My Commission it (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. GA6592_i�/b APPLICATION APPROVED BY: "�6 �v l Plans Examiner Engineer Zoning Chc 12/15/03