RC-13-897Sl131 V3 - So N
BUILDING
Miami 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: (3 05 762.4949
-IC sluoCIA 01 M" � 404-1 FBC 20
Permit No. fc 2 1
PERMIT APPLICATION
Permit Type: BUILDING
Master Permit No.
ROOFING
JOB ADDRESS: 9301 N BAYSHORE DR
City: Miami Shores County: 42 Miami Dade zip: 33138
Folio/Parcel#: I I a 9205 0Z — ®5,6® , �a
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleh,
AridrPcc•
9301 N Bayshore Dr
City:
Guy Kurlandski
a/
Zone:
305.297.0803
State:
Tenant/Lessee Name: Phone#:
Email: guykurlandski@hotmaii.com
CONTRACTOR: Company Name: M2 Construction Group Phone#:
Address: 17626 SW 90 ST
City:
J 2313
954.822.3590
Qualifier Name:
Joaquin rineros IV
Phone#: 954.822.3590
CGC1511589
State Certification or Registration #: Certificate of Competenc #:
Contact Phone#: 954.822.3590 Email Address: JpineroS@m2-construcion.com
DESIGNER: Architect/Engineer:arkamp ell Architect/Engineer: Phone#: 305.528.3 37
Value of Work for this Permit: $ 401010 ®U ' Square/Linear Footage of Work: 6,000
Type of Work: ❑Addition ❑Alteration ❑New ❑Repair/Replace ODemolition
Description of Work:
Demolish existing roof and interior. gil►'L._fl "Tw0 s�io�
� ON3Q S E
Submittal Fee $.
Scanning Fee $
Notary $
Color thru tile:
Permit Fee $
Radon Fee $
Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
ding Company's Name (if applicable)
didl Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
OIL
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 c o the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after W permit is iss In the absence of such posted notice, the
inspection will not be approve "nd a reinspection fee will b
Si nature ! ril i
Sign
Signature ---L— g
/ Owner or Agent
The foregoing insti*ent was acknowledged before me this
day of 20 jam, by ,
who is personally known to me or who has produced
As identification and who di�ggc�noath.
NOT Y PUBLIC: °®'G�AUDIA
a
oyember
Sign:
Print: A" p G AAif 1 Cs -Ifn fJ
My Commission Expires:
Contractor
Thefore o' g instrument was ckn ledged before
day of , 20 by
14 ' 6etnally kno n to me or who has produces
_ ` lidentification and who did to
.0% 1,
PUBLIC:.
Sign:
Print:
My Commission
ui°
r
APPROVED BY Plans Examiner CI / Ling
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Clerk
TRIS INSTRUMENT PREPARED BY:
Ira R. Shapiro
16375 N.E. l8th Avenue, Suite 225
North Miami Beach, FL 33162
RECORD AND RETURN TO:
ClosiagsMon, Inc.
1124 Ken Concourse (96m Street)
Bay Harbor Islands, Florida 33154
11119 VIII lip 11111 1191 HIM Hill MI Illi
CFN 201380179216
OR Bk 2819 Pss 4932 - 4934; i3pssl
RECORDED 03/07/2013 1047x55
DEED DOC TAX 6.450.00
HARVEY RUVIHr CLERK OF COLT
MIAMI -ME COUNTYr FLORIDA
THIS WARRANTY DEED, made this Irday of013, by George Jacobson, a single man, homer cdW
grantor, to Guy Kurlandsld and Selin Kurlendsk4 husband and wife, h called grantees, whose post office address is 9301 North
Bayshore Drive, Miami Shares, Florida 33138.
WITNESSETH: That the grantor, for and in consideration of the sum of TEN DOLLARS (510.00) and other valuable
co radon, receipt whereofis hereby acknowledged. hereby grants, bargeirm cells, aliens, remises, releases, conveysand confirms unto
the grantees, all that certain land situate in Miami -Dade Conaty, Florida, WE
Folio €l: 11-3205-027-0560
Lot 3, Bloch 4, Bay Lure, according to the Plat t areol; as recorded in Plat Book 44, Page 63, of the Public Records of
Miami -Dads County, Florida
Subject to the following:
1. Taxes for the year 2013 and subsequent years, which are not yet due and payable.
2. Zoning, restrictfons, prohibitions and other requirements imposed by governmemal authority; restrictions and matters
appearing on the plat or otherwise common to the subdivision ad public utility easements of record, without the intention of reimposing
the same.
TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
TO HAVE AND TO HOLD, the same in fee simple forever.
AND the said grantor does hereby fully warrent the tide to said land and will defend the sane against the WWW claims of all
persons whomsoever.
Book28519/Page4932 CFN#20130179216 Page 1 of 3