FW-16-2047 Miami Shores Village RECEIVED
Building Department MAR 3 0 1017
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 6t
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2014541A
BUILDING Master Permit No. �W ( ('P
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ROOFING REVISION EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR �i ' DRAWINGS
JOB ADDRESS: 133 N.E. 103 ST.
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: 11-2136-013-0820 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): BRYANT GROSSO Phone#: 305-619-7588
Address: 133 N.E. 103 ST.
City: MIAMI SHORES State: FLORIDA Zip: 33138
Tenant/Lessee Name: N/A Phone* NIA
Email: N/A
CONTRACTOR:Company Name: Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: TEXTI IR1=D STI IC:C`O ON Al I WALLS OF THE HOME EXCEPT THF MInnI E
INDOVVS/DOOR) THAT AREA Wil L WM/ F_= GRAY I_EDGE-STQN€ A' Sb1-KNOIAAI
�O
CA r-4C_%l� `KNOB 1'i It- Cw (, — ZO`t om
Specify color o 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$
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.
Signatur Signature
OW 4
R or qN CONTRACTOR
The foregoing instrument was a oged before me this The foregoing instrument was acknowledged before me this
n`tA
day of V 20 1 by day of 20 by
—yoI Gla l Z(,:�ho is personally known to who is personally known to
me or who has produced K as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: ���� IEN NOTARY PUBLIC:
S
Sign: Sign:
�J •� rn ?
Print: Print:
A• 0, �
Seal: %,G6 j'Runde •:•oQ�O\` Seal:
s*s*****ss*ssss*******ssssss****s*ss*s**s*********s*ss**************sssssss**s***********s*s**ss****s****sss
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
-C ;I V"
Miami Shores Village JUL 21 2016
Building Department 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/t/ .
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
FE]BUILDING r-1 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING F-1 MECHANICAL PUBLIC WORKS ❑ CHANGE OF F-1 CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBADDRESS: 133 N.E. 103rd ST.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-2136-013-0820 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: ° BFE: FFE:
OWNER: Name(Fee Simple Titleholder): Bryant Grosso Phone#: 305-619-7588
Address: 133 N.E. 103rd ST.
City. Miami Shores State: Florida Zip: 33138
Tenant/Lessee Name: N/A Phone#: N/A
Email: N/A
CONTRACTOR:Company Name: HOMEOWNE Phone#:
Address:,
City: A (ft to: R Zip:
0
Qualifier Name: r•, Ll 1 Phone#:
State Certification or Registration Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ $900.00 Square/Linear Footage of Work: 75 L/F
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑■ Repair/Replace ❑ Demolition
Description of Work: Repair/Replace wooden fence along alley. Vertical Wooden Slats, 6 ft in Height,
Simple Wood Gate on back fence and western side of the front.
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Mr
•
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 anda reins cti on fee will be charg .
04*
101
Signature ' eqiSignature
OWN or G T CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 Ie by day of:/ 20 by
ta.LEC2 (who is personally known to who is personally known 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: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
rye Notary Public State of Flori a
Seal: 11Joanna I Feliciano Seal:
4. My Commission FF 082753
Npa Expires 01I12I2018
9F P
APPROVED BY Plans Examiner ��JW(Zoning
Structural Review Clerk
(Revised02/24/2014)