RC-17-874 Ptmlt NoRC-3-17-874 1
�eNO1 S L,` Miami Shores Village F fIT?ti>"T,01—e ,ROSt000tlotGoons tllctian
10050 N.E.2nd Avenue NE Work assOcatfon Repair
Miami Shores,FL 33138-0000
•• �e � Phone: (305)795 2204 Permit Status:APPROVED
FtOR1DF' .-
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4113120,17Expiration: 10!10!241
Project Address Parcel Number Applicant
133 NE 103 Street 1121360130820
Miami Shores, FL 33138-2328 Block: Lot: BRYANT GROSSO
Owner Information Address Phone Cell
BRYANT GROSSO 133 NE 103 Street
MIAMI SHORES FL 33138-
133 NE 103 Street
MIAMI SHORES FL
Contractor(s) Phone Cell Phone $ 5,000.00
HOME OWNER Valuation:
Total Sq Feet. 0
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Review Building
Type of Construction:TEXTURED STUCCO ON ALL WALL Occupancy:Single Family Review Planning
Stories: Exterior:
Front Setback: Rear Setback:
Left Setback: Right Setback:
Bedrooms: Bathrooms:
Plans Submitted:Yes Certificate Status:
Certificate Date: Additional Info:
Bond Return: Classification:Residential
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $3.00 Invoice# RC-3-17-63509
DBPR Fee $2.25 04/13/2017 Credit Card $ 176.50 $0.00
DCA Fee $2.25
Education Surcharge $1.00
Notary Fee $5.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $4.00
Total: $176.50
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all wo one by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MEC INDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I ce at a for g information is accurate and that all work will be done in compliance with all applicable laws regulating
constr ing. hermore I tho' above- ctor to do the work stated.
April 13,2017
Authorized S nature:O ner pl cant / Contractor / Agent Date
Building Depart e C y
April 13,2017 1
Miami Shores Village RECEIVED
L41 LAI Building Department MAR 30 7017
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION UNE PHONE NUMBER:(305)762-4949
FBC 20H
BUILDING Master Permit No. QL l-7 —2-7
PERMIT APPLICATION Sub Permit No.
OBUILDING ❑ELECTRIC ROOFING REVISION ❑EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 133 N.E. 103 ST.
City: Miami Shores County: Miami Dade Zip:
FoOo/Parcel#: 11-2136-013-0820 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): BRYANT GROSSO Phone#: 305-619-7588
Address: 133 N.E. 103 ST.
City: MIAMI SHORES State: FLORIDA Zip: 33138
Tenant/Lessee Name: N/A Phone#: N/A
Email: N/A
CONTRACTOR:Company Name: Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Eng(neer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ®•�-� Square/Ungar Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ■❑ Repair/Replace ❑ Demolition
Description of Work: TEXTURED STUCCO ON ALL WALLS OF THE HOME EXCEPT THE MIDDLE
FRONT WALL(WINDOWS/DOOR). THAT AREA WILL HAVE GRAY LEDGE STONE-ALSO KNOWN
AS STACKED STONE. ( C_ 1(,o® Z
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ - CCF$ 3 Cap CO/CC$ „a
Scanning Fee$ Radon Fee$ �' `� DBPR$0 • �S Notary$ 5•
Technology Fee$ ' 0 y Training/Education Fee$ Double Fee$ X71
Structural Reviews$ 0
Bond$
TOTAL FEE NOW DUE$
(Rev1sed02/24/2014)
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 reins5r7— Signature
arged.
Signat
OWN R or A CONTRACTOR
The foregoing instrument was ack le ed before me this The foregoing instrument was acknowledged before me this
31D day
yy7of rml-r-.4 20 1 ,by day of 20 by
,whhoo iss personally known to who is personally known to
me or who has produced f�l_ -� -� as me or who has produced as
identification and who did take an oath. �`e®699I►Nd6Ngi®®1/ identification and who did take an oath.
NOTARY PUBLIC:
e 0
_
NOTARY PUBLIC:°COftSS. G��
Marchoy.�
3
Signt4 -
Sign:
Print: ah, 'a Print:
Seal: �� 1110P���\\ Seal:
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)