WS-16-1356 (2) Miami Shores Village
�RREECTVE�D
Building Department 0 i 0 3 2010
10050 N.E.2nd Avenue, Miami Shores,Florida 33138 11 9
Tel:(305)795-2204 Fax:(305)756-8972 BY: f
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201
BUILDING Master Permit No. 1315(0
PE MIT APPLICATION Sub Permit No.
BUILDING ELECTRIC ROOFING REVISION EXTENSION [:]RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS HANGE OF ❑ CANCELLATION ❑ SHOP
/ CONTRACTOR DRAWINGS
JOB ADDRESS: 1099 NE Q6 �JTR�E-e✓T
City: Miami Shores ^ / County: Miami Dade Zip: 33138
Folio/Parcel#: 1 2-06.;10 114 3640 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: '/
OWNER:Name(Fee Simple Titleholder): 3QNF:M4 N ��LDMRN Phone#: CiG )99Z-0336
Address: 10:49 NE 96 STRECT
City: i A 1 R M 1 S I'1 ORAS State: fL. zip: 33138
Tenant/Lessee Name: Phone#:
Email: {►
CONTRACTOR: R
Company Name: M I(SPI DESIGN BUILD , INC Phone#:
Address:: 155 NiipamI Lewes D .
A 6
City: "ll R iA I L-(--T V 6--s State: FL. Zip:�3l3 C14
Qualifier Name: p�i`�0 MiKPBAL ��rr Phone#: (1EQ586—z981
I)(--
State Certification or Registration#: C is 14 f�4 Certificate of Competency#:
DESIGNER:Architect/Engineer: 01-6R V• CCEDER0 Phone#:
Address: gZZO S.W. 39T" Tc__F�RAGA, City: Mt(-)MI State: f zip: 33155
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New �epair/Replace ❑ Demolition
Description of Work: XTilc`�t�. ICOR
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$ '7jS'Q
(Revised02/24/2014) � 9D
/�
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 plicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure ill be de/ivere to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commenceme t must be post d at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the a ence of such ooted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
O NER AGENT CONTRACTOR
The foregoing ins uMetft was�knowledged before me this The foregoing instrument was acknowledged before me this
day o 20 by v day of 20 JJ by
—3p1 ho is personally known to �h0 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:
11 � //►► i
Print: 1 lib I �rh% Print: tri L
Seal: Seal:
c Notary Public State of Florida Notary Public State of Florida
? Pilar Labiste Pilar Labiste
Ntc My Commission EE 868148 My Commission EE 868148
op Expires 01/23/2017 p Expirea 0112341017
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
=828
Local Business Tax Receipt
Miami—Dade County, State of Florida
—THIS IS NOTA BILL — DO NOT PAY LBT
6672522
BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES
MIRA DESIGN BUILD INC RENEWAL SEPTEMBER 30, 2019
6155 MIAMI LAKES DR 6944707 Must be displayed at place of business
MIAMI LAKES FL 33014 Pursuant to County Code
Chapter BA—Art.9&10
OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED
MIRA DESIGN BUILD INC 196 GENERAL BUILDING CONTRACTOR BY TAX COLLECTOR
Worker(s) 2 CGC1517404 $51.75 11/02/2015
CREDITCARD-16-003443
This Local Business Tax Receiptonly confirms payment of the Local Business Tax.The Receipt is not a license,
permit,or a certification of the holder squalifications,to do business.Holder must comply with any governmental
or nongovernmental regulatory laws end requirements which apply to the husimrss.
The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec 8a-276.
For more information,visit www miamidade.aoyl axcollector
TT, - - --- KEN LAWSON, SECRETARY
RICK SCOGOVERNOR
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD ;o
CGC1517404
The GENERAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2018
MIRABAL, PEDRO
MIRA DESIGN BUILD INC
16731 NW 82ND COURT, ,
MIAMI LAKES FL.33016
ISSUED: 08/23/2016 DISPLAY AS REQUIRED BY LAW SEa# L1608230002975
♦5�oR ms`s`j' Miami
(` Village shores
sell Building Department
�iOR'1DP 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR / ARCHITECT ca�i Q
Permit N. _ ` 5
Owners Name (Fee Simple Title,Holder):C o 14141 rV Hone#:
Owner's Address: qr12
City: Al I sem` are S State: L, Zip Code:
Job Address (Of where work is being done): �! o. e,
City: Miami Shores State:—Florida Zip Code:
14
Contractor's CpmpannlyJJName: ��/ G''t LG�I Phone
Address: 22 ~6 C
City: State: Zip Code:
Qualifier's Name,: t',r Lic. Number.
Architect/ Engineer of Record Name: Phone#:
Address:
City: State: Zip Code:
Describe Worlc
hereby certify that the work has been abandoned and/or the contractor/architect
is unable or unwilling to complete the contract. I hold the Building Official and the
' Shores harmless of all legal involvement.
Signature Signature
Own or Agen Contractor or Architect
The foregoing instr nt as owledged before me The foregoing instrument was aknowledged before me
this Xday of Q 20%,by W tq S .Ft kYhav, this day of ,20 by
Who is personally known to me or who has produced who is personally known to me or who has produced
hi i CAhS as indentification. as indentification.
Notary blit Notary Public:
Sign: Sign:
Seal: Seal:
YANADY PRIETO
MY COMMISSION 0 FF 214031
tea' o EXPIRES:March 25,2019
y pf F4"•° Bonded Thru Note y MUG Undenrafteis
F
I
UNITED STATPFAL SERVICE
� First-Class Mail
Aft '.'*J:l Postage&Foes Paid
-1 `lP 'ttS Permit No.G-90
•Sender: Please print your name,address, and ZIP+4®in this box*
JC'�N nT H�N fi�LOM�N
10?q NE �G STS►
N11nt\nI , FL. 33138
=,c i -,.• 1111111,1„1i1,.,��l1�,11!„1!'11!11"111"11'1"111'!1,11"1'11!
sCOMPLETE THIS SECTIOff0 • ON DELIVERY.
■ CompleO Items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ❑Agent
IN Print your name and address on the reverse X ❑Addressee
so that we can return the card to you. B. "Ived by(Printed Name) C.Date of Delivery
■ Attach this card to the back of the mailplece,
or on the front if space permits.
1. Article Addressed to: D. Is delivery address different from Item 1? ❑Yes
If YES,enter delivery address below: ❑No
D\JG 31 01LDEP,s III 11111111111111111111111111111111111111111
13q(� W 38 PL -7 Seryl Type
f L 3�� Z Certified Matte ❑Priority Mail Express-
Registered ❑Return Receipt for Merchandise
❑Insured Mail ❑Collect on Delivery
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article 7014 2870 0000 0196 2083
(Trans}
PS Form 3811,July 2013 Domestic Return Receipt
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