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RC-14-185 PERMIT S y^ CONTRACTOR: F SUBMITTAL DATE: ADDRESS: W NAME: I/ RESUBMITAL DATES: PROJECTTYPE:le- ZONING r: t„1\ FIRE STRUCTURAL IMPACT FEES N ELECTRICAL (t/ HRS(DERM 3- PLUMBING NOC MECHANICAL p V 1 ;BY: N 2��4 � Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No. P—C. Permit Type: BUILDING ROOFING JOB ADDRESS: "Qt:3 (C( . kit pqAAI // City: Miami Shores County: Miami Dade Zip: bE� Folio/Parcel#: 'I Z�6 v�^f'1�`"!�LI_em) Is the Building Historically Designated:Yes NO Flood Zone: G � OWNER:Name(Fee Simple Titleholder): 01-W Ct (i�L-C Phone#: eK6 ®L1 gt" i Address: �L 8 �� City: t State: Zi � f a Tenant/Lessee Name: Phone#: Email: W ee CONTRACTOR:Company Name: �l Mh NM!6vc4.oyt C Phone#: 161v 564 1b 6 1 Address: City: ay.� wl l?[AAJ'L• `' 1 State: Zip: --3:7,7y Qualifier Name: +t V n � �I 1�, x6a in a Phone#:��ie rj 64-1&lij J State Certification or Registration#: CAG L rP 11,419 ,_C,ertificate of Com� /,p`etency#: Contact Phone#: p i�1 Q 4 1/o 6L Email Address:��1A7 U 1 I l unj o ha.�2 L� ` & DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit:$ 1�7 cid Square/Linear Footage of Work: ) OD. Type of Work: ❑Addition ❑Alteration ON 6R'epair/Replace ❑Demolition Descriptio of Work: l C Color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 ;eecorded } i tt e j slue exceeding$2500, the applicant must promise in good faith that a co o the notice o commencemenL1 �ten law brochure will be delivered to the person P S f Py f f ` �whose property is subject to attachment. Also, a certified copy of 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 appy ed and a reinspection fee will be charged. Signature ` ( Signature Own�or Agent � Contra for The foE;;;O ent was acknowledged before me this A— The for oing instrument was ackn ledged before this day of �,by V-�l �P'l��,1� day of�,2015,by U® , who is personally known to me or who has produced who is personally known t me or who produced As identification and who did take an oath. as id ation and who did take an oath. NOTAR LIC: NOTARY PUB i Sign: Sign Print: Print:` My Com opiArERONICA PIMA My C m ' Ex �ONICA R SPINA MY COMMISSION;N EE201881 =•:I• �`� MY COMMISSION#EE222581 EXPIRES AuBttst 06.2018 EXPIRES August 00.2016 .x CEOx. leftx� *.x.x.x*.x*.xxxx .xxx � x APPROVED BY 77 Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Miami Shores Village , Building Department JAN 3 p 2014 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 "BY INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No.0-1 f ''l. l�� PERMIT APPLICATION Master Permit No.Rte. M Permit Type: Electrical JOB ADDRESS: RP) .1. I .1 1 n l City: Miami Shores County: Miami Dade Zip: Foho/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): clu Phone#: Address: o 1 ��1,x A Zip: city state: c` Tenant/Lessee Name: Phone#: Email: @ ��'�C l I C—► C1(�c (C'��-� CONTRACTOR:Company Name: Phone#: ® Address: Z la 4 l® t��r City: %4� �' n State: ®G� Zip: QualifierName: ,57r-e Phone#• State Certification or Registration#: zc--(E—e,3 CT 1,P70 Certificate of Competency#• 7 G Contact Phone#: Email Address:we4;G -7*0/ P, 4,�.�ar� � DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ - Square/Linear Footage of Work: Type of Work: OAddress Alteration ONew ORepair/Replace ODemolition Description of Work: Submittal Fee$ �0`06 Permit Fee$ 747,AA CCF$ CO/CC$ . Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ I 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 oi p �J \th1 an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of mm �construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a c i ebb f the recorded notice of commencement must be posted at theJob site for the first inspection which occurs seven (7) days after the building permit is issued. In tl nce of such posted notice, the inspection will not b approv and a reinspection fee will be charged. e Signature Signa " Owner or Agent Contractor The foregoing instrument was acknowledged before me this-2–,--:) The foregoing instrument was acknow ged before me this day of QE ,20 S by day of .20_,by 11—U44 who is personally known to me or who has produced who is personally-known to me or who Rias produced As itake an oath. as identification and who did take an oath. VERONICA R OS�INA , ..., NOTARY PUBLIC: My COMMISSit9N#EIr222881 N Y tUBMCISSE LUZARDn r WMISSION#EE224ty,, EXPIRES AugW 06,2018 J! Sign: ;59 �•"!.. a �:ES gust 13,2016 ' N Si '" Si 388-pir Print: – Print: Lrvp PlSSP My Commission Expires: ] 'f� My Commission Expires: `3 �tl& An APPROVED BY Plans Examiner Zomig Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009XRevised 3/15/09) Miami Shores Village , Building Department JEAN 3 0 2014 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PRONE NUMBER:(305)762.4949 FBC 20 BUILDING Permit No. P/ PERMIT APPLICATION Master Permit No,L, Permit Type: PLUMBING JOB ADDRESS: m i 1 _41 l City: Miami Shores County: Miami Dade zip: � Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: iJ OWNER:Name(Fee Simple Titleholder): de- Phone#:_—A Address: ,��'7f`, n F. 4 i City: until State: -f—L— Zip: Tenant/Lessee Name: Phone#• Email: � f,P. CONTRACTOR:Company Name: � C ��9 ®� Phone#: ?(,e a i®c.� %C Address- 4 �!"� 7— City: NA,o c..a' State: Qualifier Name ,rvo ` $ a Phone#• State Certification or Registration#: C,Fc t Cert"c* #: r Contact Phone#:. Email Address: DESIGNER Architect/Engineer. Phone#: " Value of Work for this Permit:$_ L + Square/Linear Footage of Work: Type of Work: OAddress OAlteration ONepv ORepair/Replace ODemolition Description of Work: Q,00—,n,V b �' d ex j—? /L, *,x*****«*,x*,r,�*�*,Jr�,�r,�,�,t**,�*�,�*,�**,�,t,�r*r►�rF�,�***,�**,�,�* +�,�**x***,skirt*,��******,r,�*,�**�r*� Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$__ 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 ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 RAPROVEMENTS 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 notbpapprov nd a reinspection fee will be charged. Signature �LA /� Signature �Y " 04� Owner or Agent Contractor The foregoing instrument was acknowledged before- e �114 The foregoing instrument was acknowled ed before me this 3 �� vis 20 '� b 0 l day of (' ,20�by '�`� � day of ,L y who is personally known to me or4ho has produced who is personally known to me or who hat produced As identification and who did take an oath. as identification and who did take an oath NOTARY PUB9C: Arn. VERORt�+; a ^SPINA O dl '� B .[SSE LUZAR00 •'= MY Gam; MY COMMISSION 3 EE224895 ` ::;+�•:,:06,20113 � EXPIRES August 1 , ° ' �A 3 2018 Sign: 163 ta+r* i�:a: raav{oeA= ign 0713860133FWrMaN Print: Print: rT ve lls 2�r My Commission Expires: My Commission Expires: U �� 3 ���ro II�T APPROVED BY L/ Plans Examiner Zoning Structural Review Clerk (Revised3/12/2012XRevised 07/10/07XRevised 06/10/2009)(Revised 3/15/09)