REV-17-449 OUCe. �oIY J •y.�
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 �•,�
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 s
FBC 2014
B I LD I N G Master Permit No.ACT-6-16-1780
PERMIT APPLICATION Sub Permit No. y�T Q
BUILDING ❑ ELECTRIC ❑ ROOFING 0 REVISION EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1201 NE 102 Street
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:1132050250160 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Macadam $ Denise Glinn Phone#:
Address: 1201 NE 102 Street
City: Miami Shores State: FAL) Zip: 33138
Tenant/Lessee Name: — 9" A- Phone#:
Email:
CONTRACTOR: Name: Paradise Awnings Phone#: 305-597-5714
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Address: �0 G�--4c r'w
City: Mu fit y0 D , State: —Ff Zip:
Qualifier Name: 6(A z� A� Phone#:
State Certification or Registration#: ct. ������ Certificate of Competency#:
DESIGNER:Architect/Engineer: Thomas M. Kelaher P.E. Phone#: 954-360-9628
Address: 1108 SE 14 Terr city. Deerfield Beach state: FL Zip: 33441
Value of Work for this Permit:$NSA Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration N New ❑ Repair/Replace ❑ Demolition
Description of Work: Plans Revision to roofing detail
Specify color of color thru tile: N [I(
Submittal Fee$ Permit Fee$':jr ° CCF$ CO/CC$
Scanning Fee$ % Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$_ ® Bond$
TOTAL FEE NOW DUE$
(ReAsed02/24/2014)
4
Bonding Company's Name(if applicable) N/A
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) N/A
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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature _ Signature
OWNER or AGENT CO TRA OR
The foregoing instrument was acknowledged before me this The foregoing instrument wasacknowledgedbefore me this
'Z11 day of ,20 t- ,by &I day of p � {iib �21'7 by
�0y`N who is personally known to rionyel f�F`l04"b� who to
me or who has produced L 1A'i"S � � as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTAR NOTARY PUBLIC,
Sig Sign:
1 �
( 4""v p"'•., MARIA CECILIA CALERO
Print: �^�� Print:( n C l n: Not Publk-StateofFlorida
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APPROVED BY oPlans Examiner Zoning
y )� Structural Review Clerk
(Revised02/24/2014)