REV-17-1290 Miami Shores Village
C�11 Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 - �c
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201 ,45 —
BUILDING
0I ,45BUILDING Master Permit No. F6 1-7 -4P5
PERMIT APPLICATION Sub Permit No. !_-�
FE-]BUILDING ❑■ ELECTRIC - ❑ ROOFING 0 REVISION ❑ EXTENSION ORENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 10550 NE 2 PL
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-2231-013-0550 Is the Building Historically Designated:Yes NO
Occupancy Type: SFR Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Vulcan Dynamic Realty Phone#:3059701692
Address: 175 SW 7 ST
City: Miami State: FL Zip: 33130
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Alyjosh Construction Inc Phone#: 3059701692
Address: 18973 sw 33 ct
City: miramar State: FL Zip: 33029
Qualifier Name: Charles Levy Phone#: 305-970-1692
State Certification or Registration#: CGC1511937 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$500 Square/Linear Footage of Work:
Type of Work: ❑ Addition N Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Revision to reflect that the permit is for legalization of work done without a permit
and to turn in an as-built certificate for framing.
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee Radon Fee$ DBPR$ Notary$
Technology Fee$ <3Qj 0 Training/Education Fee$ ® 210 Double Fee$' Q <00
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ �� GO
(Revised02/24/2014)
0
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 perm' is issu Int absence of such posted notice, the
inspection will not be approved d a reins ection fee will be charged.
Signature I Sign ture
INNER or T CONTRACTOR
The foregoing instrument was acknowledged before me this The f r g instru
en was acknowledged before me this
day of 20 by day of 20 by
- !7who is personally known to e,6 who is personally known to
m0r who has roduced as me or who has produced as
idee ntifi tion and wh did tak an oath. identificatio nd who did take an oath.
NOT RY PUBLI NOTARY UB C:
Si n• Sig
Pr nt: �# 3 Print:
;• C RERA
Sea. tAr Xdc°•� Seal ••; . MY COMMISSION#FF 988144 )
EXPIRES:August 30,2020 i
J „°s•'_ Bonded Thrt�Notary Public Underwriters
APPROVED BY / Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)