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REV-16-2980
Miami Shores Village �,� Building Department No SYN 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 OtV) FBC 2010 BUILDING Master Permit No.RC-6-16-1501 PERMIT APPLICATION sub Permit No. g eV l 0,:.?q&o ©BUILDING ❑ ELECTRIC ❑ ROOFING Q REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION El SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10433 N.E. 6 Ave. City Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-2231-012-0180 Is the Building Historically Designated:Yes NO-- Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Carol Invest, USA Phone#: Address: 990 Biscayne Blvd. Suite 801 city: Miami State: Florida zip: 33132 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Joseph S. Robbio, Inc Phonem (954)663-6743 Address: 9400 S. Meadows Circle City: Miramar state:Florida Zip: 33025 Qualifier Name: Joseph S. Robbio Phone#:(954)663-6743 State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Victor Bruce Phone#: Address: 370 N.E. 101 St. City: Miami Shores State:Fl. zip:33138 Value of Work for this Permit:$ got•°•°Square/Linear Footage of work: 30 VF Type of Work: ❑ Addition X1 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Remove existing wood beam before pouring be beam /qdj q a 'STEE! %dBW' cc j /.ih Specify color of color athru tile: /�, I ,,� y( Submittal Fee$ �Permit Fee$ C VW.� CCF$�•ALJ CO/CC$�[J s d, Scanning Fee S ��,,,��� _ Radon Fee$ , DBPR$ 2. Notary$ Technology Fee$n.'OlJ Training/Education Fee$ 0. 2© Double Fee$ Structural Reviews$ k 0 Bond$ r TOTAL FEE NOW DUE$ L-40- GO (Revised02/24/2014) Bonding Company's Name(if applicable) N/A Bonding Company's Address _ City State Zip Mortgage Lender's Name(if applicable) NSA 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Stefan' I a (Secre ) Joseph S. Ro 'o Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _1G day of QGtalae--v ,20 1 C by A day of 0C*DbeY 20 by ri �t'aYl SCA 1CXkY�C� who is per onally know to in--p4)vN 5• 'Poln 0�Q.who is pe onally known' me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: �Cvc— CX-ILA Sign: Print: LucAct C, Print: 1A Ai C-� �GJC1`Ji Se Seal ,,.......�.,�.�,. LUCIA Gi ISASI LUCIA Q ISASI fi' O� 00. `Pfi MY COMMISSION#FF182828 •i Ji' MY COMMISSION#FF182828 a�" I.`4s'x,s� r.�`bla9i Of< sb £<i'<>kM X� ffi � +'F ��3 L'%�F xQ S43<%F aY sY,e q's is tis' 0`'3�'c >R k'N AY k k$:N Ati Bsa+ffis$$ (407)30"153 Floridallot Service.com ` {40�398.0153 FlorldaNOtaryServtce.com APPROVED BY an Examiner Zoning Structural Review Clerk (ftevised02/24/2024)