REV-16-742 IVlldl I II JI IVl CJ V IIId6C
g p _
Building Department
MA 2 2 2016
10050 N.E.2nd Avenue, Miami Shores,Florida 33138 ,
Tel:(305)795-2204 Fax:(305)756-8972 BY:
INSPECTION LINE PHONE NUMBER:(305)762-4949 _
C 2�1Lfe_
BUILDING Master Permit No. RC 215-375
PERMIT APPLICATION Sub Permit No.1`-J I 6-9 qZ-
❑BUILDING M ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
r-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
�oBADDREss: 9935 NE 13TH AVENUE
City: Miami Shores County: Miami Dade Zip:
11-3205-009-0470 no
Folio/Parcel#: is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):Fabiano Silveira Phone#:571-2368093
Address:9935 NE 13 ave
City:
Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: KINGWIRE ELECTRIC INC Phone#:gs' -31,07
Address:
521 NW 86 AVE
City:
PEMBROKE PINES State: FL Zip: 33024
Qualifier Name:
JULIO TORRES Phone#: 954 3470852
State Certification or Registration#: EC13003678 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: rCity: State: Zip:
Value of Work for this Permit:$ / M2 Q-0 Square/Linear Footage of Work:
Type of Work: M Addition ❑ Alteration ❑ New ❑■ Repair/Replace ❑ Demolition
Description of Work: New electric, complete renovation and addition as per plans
Specify color of color thru tile: (� �•1
Submittal Fee$ Permit Fee$ _� �( (�- O'V_ CCF$ W CO/CC$
Scanning Fee$ "��\ Radon Fee$ %2 DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$0 /
Ir TOTAL FEE NOW DUES j �t�'j
Bonding Company's Name(if applicable)
)Wding 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 Signatur , 'L'
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
91 day of f�'`'����,�,,// 20 `� by � day of f O-rO' ,20 �� by
cn 61 Q.�S • 0t WMrho is personally known to ijU I'O Tort-e S who is personally known to
me or who has produced- as me or who has produced&1 G Z �1
O I 2�0"X-2,3--Vas
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
P
Sign: _ Sign:
oa�-Q-
Print: Y 0 I GEREZ Print:
;'_°, �? Notary Public-State of Florida
Seal: '• My Comm.Expires Sep 30,2018 Seal: '_. o. Notary Public-State of Florida
.• My Comm.Expires Sep 30,2018
%?,� �A.• Commission#FF 164325 �� �,
Bonded through Ndlonal Notary Assn. =+, Commission#FF 164325
F° �•P�� Bonded through National Notary Assn.
************************************************************************************************************
APPROVED BY /L Plans Examiner Zoning
Structural Review Clerk