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REV-17-1321 Miami Shores Village 2 AY 2017 �\ Building Department \ � g p �� - 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 --- -�®-- -- Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 9-t4 FBC 2011 BUILDING Master Permit No.f::k) I -I -:�- — q q PERMIT APPLICATION sub Permit No. kPV 1_1- 13 21 BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL F_JPLUIMBING ❑ MECHANICAL PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Z�( Z kjL q 3,4-- City: ,4--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: d OWNER:Name(Fee Simple Titleholder): \%A I�C,\ A Phone#: .0S 'C/q(1 _ 6 S l Address: 1 ,C1 (l.� V L q City: ,"'l{�+� 'ir'e SISState: C7-C, Zip: 3 3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 4c) ®(1�1�`�r Phone#: Address: City: State Zip: Qualifier Name: Phone#: State Certification or Registration M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �/ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New IE6 Repair/Replace ❑ Demolition Description of Work: I t\ 0 '`"-� -e— -1- Specify color of color thru tile: a� Submittal Fee$ N 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$ (Revised02/24/2014) 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)Ch)ch occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be a pr eRng'areinspection fee will be charged. SignatureZ Signatu 61-1 OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instru nt was acknowledged before me this day of 20 1- by day of 20 by i •t'• (A who is personally known to _Xis personally known to me or who has produced 1D. V%V'Qf �c c°QnS'� as me or who has produced as identification and who did take an oat identification and who did take an oath. NOTARY P ELIC: NOTARY PUBLIC: 2 Sign: Sign: Print: )`Q Print: Seal: �, Y myPRIET Seal: MYCOMMSSIONOFF214031 ES:March 25,2019 Bonded Thru WWW Puma Unde wribru APPROVED BY �" I — 1Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) FF- Professional �. s 5h"^Jb^J.!l-3A5^PAi.AfC,.P.fl-y rj q, +'IY AVENUE .'804 L I I-AD 'It V0 U'S 'aU L f k 20 td I t II N IR<\1t N,OPID6 3;)T 2R rp C UORAL L_1,1--1' l n. ... o w F (A� GJG�MIDUA11041 I,Y Mqu, 1`r — 1 W I' a � > L p r7 A5,'1-AJ �7 p 95th ,S T REFT II i m II lJ 0 ,^ U ■ ■ rr I • r7r Hl! 0 zLLJ *07 C."', mO Q ••• • ••••i A, ~LLQ J'1J 'P,P:< s ,sc v✓ J I Iv �k-" i•i� ' •• i•••• 0 • N m n n • dO CA= 0•06.0 (A) i0 __ .P••4• ••••• 00008000• • ! �I • el' . �� x,. — '-J21JC P-,� •0- 0 �17 ii• �••i•• P ,L •� I VJ �I LOT-1 (� � BLOCK-Fig Li 1.� rj -- N LOT-2 � n BLOCK-85 r -70 Qa l -- �� B� I�. - { PEMA'd;.Lr. 'A.di1 sF�• ar'J� ` II p 'Cities ' LOT r. Ile, P I 1.7 ff IN Iv.ti „n ..I i c) ® � .- it r.l':''. I � _ -.l 't_•. &NCf?UACHMENT NUI&S: A NORTH SIDE OF THE SUBJECT PROPERTY,BRICK DRNEWAY IS ENCROACHING INTO ® THE RIGHT OF WAY OF NE SSM STREET AND NEIGHBOR'S CBW IS ENCROACHING 8 WEST SIDE OF THE SUBJECT PROPERTY,IRON FENCE IS ENCROACHING INTO THE ALLEY. • Q (r Try,.A"I fT�F SC.'I`•i11FOF t`T I,IntJF Uf> rr,F't,1 Ifn r.F_i^„ �• 'F.I �f --A Wkvv 0 Y.uj LML DESCMMON, 17 Pa C).5204 5TATE OF II c.p..4(.G 4r kik r^A;2s DELLT T:.PPE _. .- it