PL-16-2237 (2)Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
'74
FBC 201Ce
Master Permit No. P' V -y-4-a /0
Sub Permit No. P1••' 8'46-422 39
REVISION ❑ EXTENSION RENEWAL
[PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: ISO N E IOy
City: Miami Shores County: Miami Dade Zip: 33/39
^
Folio/Parcel#: 11- aa 32.- 0 32.-0 3 60 Is the Building Historically Designated: Yes NO K
Occupancy Type: Re.S Load: Construction Type: Plumb Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ba(/'; cl L. '3he42t2 Phone#: O (' 77 992.0
Address: 1516 Ni lb 4 51 -
City: t4ia /IA, i ' hfr e' State: Flt..- Zip: 3S/38
Tenant/Lessee Name: Phone#:
Email: pp
CONTRACTOR: Company Name: Mar L (n �m �ji n5 O.t' Mi el .tvti4T�( Phone#: a05' i6z-303)
Address: Roi s NE /b Plage.,. v
City: tJOY4) M 1 ee M"i 8441-CAState: FL-
Zip:3/79
Qualifier Name: Ecitoox 1. 7 Walker Phone#:315-65.2-Sc3/
State Certification or Registration #: CR.0 4 9 29 a Certificate of Competency #: l 4— 877 - (g O
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
..- v sixitiblfAclpr this Permit: $ Q Square/Linear Footage of Work: 0
Aqk Type of Work: LTJ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolitign
Description of Work: .TJ 01 Tc F%)C� 1 piej - 6i'n1 0 S IPP IA -of)-�,�1�% ,, ^sem' 4 ,
(31. 6ero° to `1) %5- ,i-.
lam''.. 0.o i(i e - t. ,.,
Specify�cb)or of color thru tile: '
Submittal Fee $ Permit Fee $ CCF $le
CO/CC $ `..,-7%ud, say 0'
1
ScanningFee $
1 Radon Fee $ DBPR $ Notary $__ ' ' '""''
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ .ci
-
(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.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
24 day of Tiz4 Val , 20 'I''7 , by
QV 1 d t '3 h,01 , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
Signature j."Ca
ONTRACTOR
The foregoing instrument was acknowledged before me this
a4 day of nv , 20 41 . by
E 1 Wa , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
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4Ie : i��—�� ' 2' �. Sign: � a. _! M`-ti�ce = No FF o7oes7
NOTARY
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Prin'� M!rL�a��•fr G� A'1 ' 1 _' �,._ L 1 ' �
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Seal: NO FF 070697 (Seal:
NOTARY
PUBLIC
•
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APPROVED BY i /-,74-17 Plans Examiner Zoning
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(Revised02/24/2014)
Structural Review Clerk
MARLIN PLUMBING OF MIAMI, INC
EDWARD J WALKER
CFC048292
305-652-3031
Da, 6c1 ghosaiC
151k, IJ&. 104
mi ri4 Ghoresi FL 3 3 I 38
?earl 4-* PL -18-1(2 - aQ 37
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APPROVED
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BLDG DEPT
DATE
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AA 0002534
AR 0008679
4,,
33013 RI•E -
COCONUT GROVE, FL 33133
M ow/Sturm:14v
305 216 2641
MAX@MAXWOLFEARCHITECT.COM
ISSUED 4125116
12/15116 (REV 5)
flooring repairs to the
Diane & David Shoaf Residence
1516 NE 104 Street
Miami Shores, Florida 33138
REVISED PLUMBING
RISER DIAGRAM
SHEET
27