REV-17-1402 s s
Miami Shores VillageC
IVE
Building Department My
z 6 201?
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
11� FBC 201
BUILDING Master Permit No. [16 T
PERMIT APPLICATION Sub Permit No. f "(� - )ID-2—
r-]BUILDING
) D2—
BUILDING [-] ELECTRIC ROOFING /REVISION 0 EXTENSION DRENEWAL
❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: C�
City Miami Shores County: Miami Dade Zip: 1
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): R)0,!, � N.i e, Phone#:200 ?_-2-500
Address: !i—I P - R- ° Ci g 3 F
3
City; �'1 ail '56111 State: F�® 6 Zip: 313
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Y'f'm ® �h Phone#:
Address: 1 %4 �A P •IF` '�- C 5
nn
City .))L\ ✓�
". Vh e\ ' _` State: � I O a 'rX V- Zip: 3313 -7
Qualifier Name: DL tv TU CDV\4� F�-S Phone#:
State Certification or Registration#: CCL-OS -19 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State Zip:
Value of Work for this Permit:$ 00" Square/linear Footage of Work:
Type of Work: ❑ Addition ElAlteration ❑ New ❑ Repair/Replace( ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ ° OZ�). 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)
• y
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 .by 41 d y of L 20 / / by
lr who is personally known to ho is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
a
Sign: Sign:
Print: Print:
°•
Seal:,'°vp',
t*'z. , Heather Leigh Seal:��.; '4r4, Heather Leigh
SA. "COMMMIM#FF0577245 C�16AISSIO1#FF057243
od�;�'EXPIRES::NOV 17,2017 %'��od�;,�FIRES:NOV 17,ZOI7
a. a• '$of VAVLW
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)
Florida Building Code 5th Edition(2014)
v := High-Velocity Hurricane Zone Uniform Permit Application Form
Section C (Low Siou®d Roof Svsteml
Fill In Speciflc Roof AsownW Composts Fastener Spadft for Andta se Shad
and Ivry Mwkukckww Attachment
(If a convonsnt is not ucse4 WenffYss'M')
G�1— F��•oc 0�.#Ro,Ms�e2-oc
+
s � I®3 C) -6 a— Pew� R,o
.w@LOA# m •cc
MOA Ida.:
.Corm ac @ lam.#Raaes
DesW Wind Pres ,From RAS 128 or CGICUISOMM
Prr�ocl: a PSL Pmt !L of Fa�rers Per
Max Design Prue.FroNOA Field Perimeter 1-t Cam
Dedc mustraba Components Notes
y,v ®o�
Two, �� Details as Applicable:Ed
Wrippir ci t
Fie g Contin Cwt. Gent
..r�
, pr r88M �' C - 'SIope: _C--64V ***so*
Cophtg.Etc.
Sheet 8 No.of Ply(s): Mew Roof 1.1014 . P8 'i •••• ••••••
Haight of Owe Rash tg. Componem Material..";'. •.
An twdBaw Sheet FastenffifiWIMV Mme: Motorist 11dciuress. Fastener TYM;fir •+ • ••••••
Spacing or Submit Mamifackmv COtlift #W • • •
7 Comply with RAS 111 and Chapter I&••• •••••• :••••
t3ase7ayer 0000 0000 •.••.
.•.... a • .•:..�
Iron Size and Tlx: %� jC'1 \ •
Doodle
ru
C a Insulation FasWwfiWWDV Materiel:
't' 3- �� •0000•
Irsrlafflor layer: • �; ••••••
/� �o((pp p.I� •• • • •
To i Iragation Size and M �� 1J A 1�� J p Parapet
•
T treuWw AaW1at: 1'' �l
CO
(�w Sheci{s)&Wo of
PW-44—P-2-1
{y(sk4 1
? - - I
FT.
69
c F n „r L + 4 i,, e 5 MGM
1
Stoet(s)&NO..of Ply(, p RHaight
oof
�T
Shad F!s�IBmt ��-11A e i_
/�t(�S n
TOP�: (_``i�j Of) Jp0 dB'J
Top Ply F r/t,rA I F- —A401
OPPERMIT #:
Miami Shores Villa e
�EIVEO
1 zoN-11 _
Jim q) rT BI
SUBJECT 10 GcaIPL.Vf,10E WI rH ALL FEDERAL
STATE ANu L;r_U v i'!riL,L..:S AND REGULATIONS