REV-16-2425 Miami Shor Village >�r
Buildi tment
10050 nd ; e` e, '° Sh� , Florida 33138 BY:
del:( a 5)756-8972
5 611ON . 10 BER:(305)762-4949
FBC 20)y�
BUILDING Master Permit No.
PERMIT APPLI O . Sub Permit No.
❑BUILDING M ELECT ❑ ROOFING 0 REVISION EXTENSION EJRENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
1
JOB ADDRESS: 1� 0 t P E ) ( '* .
City: Miami Shores County: Miami Dade Zip: f >D
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: 1 BFE: FFE:
OWNER:Name(Fee Simple Titleholder): t�0+j du,_ J'.� S,2 c, •.n Phone#: 305 y
Address: ) 'N 'i
City: l ,> k, S State: C Zip:
6c
Tenant/Lessee Name: Phone#:
Email: A \ �` "� - U(A, t .
CONTRACTOR:Company Name: Paradise Awnings Corp Phone#: 305 597-5714
Address: 4310 nw 36th avenue
City: miami State: fl zip: 33142
Qualifier Name: manuel alcibar Phone#: 305 597-5714
State Certification or Registration#: cgc-1512997 Certificate of Competency#:
DESIGNER:Architect/Engineer: thorn kelaher Phone#: 954 360-9628
Address:1108 se 14th terrace City: deerfield State: fl zip: 33441
Value of Work for this Permit:$ Sra•—e_ Square/Linear Footage of Work: .L -7
Type of Work: ❑ Addition ❑ Alteration ew ❑ Repair/Replace ❑ Demolition
Description of Work: 1%t ---, C V,VA_040H Ct
Specify color o color thru tile:
Submittal Fee$ Permit Fee$ S CCF$ CO/CC$
Scanning Fee$ 1� Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ 12,0 Bond$
TOTAL FEE NOW DUE$ Qt 0 •�'
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State /� Zip
Mortgage Lender's Name(if applicable) C�5 c' 3 Nfl/T
Mortgage Lender's Address
City �A, 2State C— Zip ( X
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 peLre
. In he absence of such posted notice, the
inspection will not be approv d and a reinspection fee will be charged.
s
Signature Signat
OWNER or AGENTCONTRA R
The foregoing i strument was acknowledged beforemethis The foregoing instrument was acknowledged before me this
S t day of J� 20 1r' by day of ,20 by
Gaal!VJ N,who is personally known to ,who is personally known to
me or who has produced r ��— as me or who has produXf .
MARIA CFCII IA CAI[ASO
otary Public -State of Florida
identification and who did take an oath. identification and why Comm. Expires Apr 1,2017
Commission # FF 3814
NOTARY PUBLIC: NOTARY PUBLIC: ndetl Through National Notary Assn.
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Print: = >�� �� 9N !c Print: OL0
Seal: FF9547so .tee Seal:
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)