REV-17-1457 Miami Shores Village
Building Department RECEIVED
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 JUN U 2017e',,J&
Tel:(305)795-2204 Fax:(305)756-8972
LINE PHONE NUMBER:(305)762-4949 V;
FBC 20th
BUILDING aster Permit No.
PERMIT APPLICATION Sub Permit No. yr
�UILDING F-1ELECTRIC F-1ROOFINGREVISION ❑EXTENSION ❑RENEWAL
❑PLUMBING [:] MECHANICAL ❑PUBLIC WORKS M CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: nasi 0'a k(31 e �
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Constructio Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): \oma a r.r.dLYPhon #: .1^S L -2,7-,-7
Address: '` z AA,
� aim-
Q
City: ►cxw�� ¢�_C State: lOi`� Zip:
Tenant/L ee Name: Phone#:
Email:
CONTRACTOR:Company Name: �CC� Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip: `
Value of Work for this Permit:$ Square/Linear Footage of Work: k--vyr li—�-c�T
Type of Work: ❑ Addition ❑ Alteration New � 1:1Repair/Replace 1:1 Demolition
Description of Work: 6 ®Ri 2° 00 i`/2:oe "M
C2G'Z'
Specify color of for ru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE S
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 fir"' spection which occurs seven (7) do y after the building permit is issued. In the absence of such posted notice, the
inspection ill t be approved a d a rein ection f will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 l by day of 20 by
L"4, tfe—,who is personally known to who is personally known to
me or who has produced/�Wj QSZ-7.Sd—ai2-� -me or who has produced as
identification and who did take an oath I ��Y identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
r jQPZ1-?fgtiN:?�•c .; MAHARAI K.GONZA,LEZ
Sign Sign
Print: E== Print:
Seal: Seal:
****************************** **************************************************************************
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
a MIAMI.FLORIDA 33126 CAPE CORAL,FL 33904
PH: (308)262-0400 PH: (239)640-2660 va `
R
FAX:(306)262-0401 FAX:(239)640-2664
MAP OF BOUNDARY SURVEY
429 NE 101st STREET,MIAMI SHORES,FL 33138
LOTBLOCK 91 BLOCK-91 f BLOCK 991 U-PO'H Oaver:Heao wIRE95'ALLEY o U N c, gII ;J3
ASPHALT NI F.I.P. 1/2F.I.P. 1/2' NRETURN (N.A.P.) . . J NO CAP
NO CAP 75.00 1.
os 0.38'Cl.
0.73'Cl. _ �, UTIL. -r'� q��
d p CONC.SLAB..
2'C.B.W.iE '
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DRIVEWAY CONC.SLAB ,� p
o
4'C.L.F. ° t tI i i P
CONC:.SLAB:
13.55' I} e t
9.67' 1 I 18.bC7 . 10. 11 � G '
LOT- 14 ' LOT- 16 01 4
BLOCK-91 g LOT- 15 in
i BLOCK-91
BLOCK-91 I f LOT- 17
wi I KEMAINDEE_R
TWO STORY OF BLOCK-91
RES. #429 ( LOT - 16
vs
`t m BLOCK - 91
FAST UNE OF
0.30-CL ( LOT-16
3 I.65' 10
WEST LINE OF 9.85' 23.40' -
C 5 �£l f
LOT-15 i /
\ 5'C. STEPS
s
} THE WEST 112
N i o OF LOT 18
N / %CONC.WALK 9 ✓UN® /
F.I.P. 1/2'NO
�� I `!'Og, �"'�✓v►�""1 I 1�
P CCS 74.88' FMD F.I.P. 1/2'
NO ID 0 NO CAP 25.00
.75.00'
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75 TOTA!RIGHT-0F-WAY ANII?RMULATIO �i
1X6 PRESSURE TREATED WOOD
PLANKS
WITH 2 CORROSION RESISTANT
FASTENERS
PER CONNECTION
4X4 PRESSURE TREATED POSTS
EMBEDDED 2' INTO CONCRETE
FOOTING 10' DIAMETER X 2' DEEP
® SPACED 4' ON CENTER
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