PLC-17-967 Miami Shores Village RECEIVED
Building Department APR 061017
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 201(-�
BUILDING Master Permit No. Cc
PERMIT APPLICATION Sub Permit No.e IC Q(n
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: CI �t� ' . 1?7
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): AN �„ �toOs S Phone#:
Address: q NG
City: 1A ` or-M (. State: �� Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: r Pn c-A C-4:>aQ , Phone#:
Address: �;0 O IJ C t�—d l e'P_L
City: � 101 a A i State: Zip:
Qualifier Name: 0 Phone#:
State Certification or Registration#: c. F G / ? O �Ce ificate of Competency#:
DESIGNER:Architect/Engineer: 7 / Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 2�92 . �� Square/linear Footage of Work: r—� -
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace u Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ ��� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ /�y
TOTAL FEE NOW DUE$ • 6a
(Revised02/24/2014)
J
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 thjabsen of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature I
OWNER or AGENT CONTRACTOR
Theforegoinginstru �tacknowleclgecl before me this The foregoing instrument was acknowledged before me this
�✓ day of 20 t) by day of ���� 20 by
E V -q Or 5 .who is personally known to who is personally known to
me or who has produced as me or who has produ as
identification and who did take an oath. identification and who did takwWd . VINCENZOBRUNO
* Y COMMISSION#FF 017169
NOTARY PUBLIC: NOTARY PUB LI EXPIRES:May 19,2017
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Sign: Sign: e /
Print: 'u Notary Public State of norida Print: V�1..L✓�v� �i71"u bye
an re Dee art
Seal: MI)
My Commiosion FF 010644 Seal:
Expires 04/21/2017
APPROVED BY °it�`l't Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
STATE OF FLORIDA
t : DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
"{S
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
" .� 2601 BLAIR STONE ROAD
TALLAHASSEE FL 32399-0783
BRADLEY, DAVID SCOTT
EPOCA CORP
2055 ALAMANDA DRIVE
MIAMI FL 33181
Congratulations! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range S° a► STATE OF FLORIDA
from architects to yacht brokers,from boxers to barbeque DEPARTMENT OF BUSINESS AND
restaurants,and they keep Florida's economy strong. PROFESSIONAL REGULATION
Every day we work to improve the way we do business in order CFC1428595 ISSUED: 09/06/2016
to serve you better. For information about our services, please
log onto www.myfloridalicense.com. There you can find more CERTIFIED PLUMBING CONTRACTOR
information about our divisions and the regulations that impact BRADLEY, DAVID SCOTT
you,subscribe to department newsletters and learn more about EPOCA CORP
the Department's initiatives.
Our mission at the Department is: License Efficiently, Regulate
Fairly.We constantly strive to serve you better so that you can
serve your customers. Thank you for doing business in Florida, IS CERTIFIED under the provisions of Ch.489 FS.
and congratulations on your new license! Expi zt=,date AUG 31 2018 LIWSDWOC1480
DETACH HERE
RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD t ,`xi
�s�
40
,r
CFC1428595 !
The PLUMBING CONTRACTOR p
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2018
01
BRADLEY, DAVID SCOTT t
EPOCA CORP
800 NE 125 STREET IL
MIAMI FL 33161 E.
ISSUED: 09/0612016 DISPLAY AS REQUIRED BY LAW SEo a L1609060001480