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EL-16-2958 CEI`4�E� Miami Shores Village OCT 31 2616 Building Department BY: 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 y INSPECTION LINE PHONE NUMBER:(305)762-4949 4 I h FBC 20 I BUILDING Master Permit No. 1bQ P b Zqs� PERMIT APPLICATION Sub Permit No. ,L BUILDING ELECTRIC ❑ ROOFING REVISION [] EXTENSION RENEWAL PLUMBING ❑ MECHANICAL []PUBLIC WORKS [:] CHANGE OF CANCELLATION Ej SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 14-- 1 1 N F 1 =, L 5'T C) • Miami Shores County: Miami Dade Zp: Folio/Parcel#• 1132-�� ©2'-"4' E'3 0Z=) Is the Building Historicaiiy Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): G-F t'-- ® — —1 r5 G c_ Phone#: e-4-C' Address: 1 4- 1 1 —::' I L ST p� I �� j 1.-, r 5 State: L-- Zip: 3 3 City: ' "I 1 3 .-Y> i .� c--5 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: SHINE ELECTRICAL ENGINEERING Phone#: 305-688-2000 Address: 3876 NW 125 ST City: OPA-LOCKA State: FL Zip; 33025 Qualifier Name: FRANCISCO SANTOS Phone#: 305-688-2000 State Certification or Registration#: EC0001514 Certificate of Competency#: DESIGNER:Architect/Engineer: P1=� r-=-F= r r'�'q c_ r ^q Phone#: �� Address.>7 S9- Svc/ Z�C— �� City: �� State i=L Zip: 318x1 Value of Work for this Permit: —Square/Linear Footage of Work: Type of Work• ❑ Addition ❑ Alteration [ lew ElRepair/Replace El Demolition Description of Work: I t�GTY G ��'r Specify color of color thru tile: Submittal Fee$ 0 Q1 Permit Fee$ � �/�' f®� CCF$ f• 2.0 CO/CC$ --� Scanning Fee$ Radon Fee$ Y • S� DBPR$O • S ® Notary$ '� Technology Fee$ f • (.o® Training/Education Fee$ �( Double Fee$ –4e�– Structural Reviews$ Bond$ •�_ TOTAL FEE NOW DUE$ 62�5 (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 Trp 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 coy rstruiftion 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. ASignature Signature ki— OWNER or AGENT 7L CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 23� day of�(�c=r- '�".20 l ,by 29:: tday of r 20 l by J a`�� 0Sr--`14-who is personally known to FRANCISCO SANTOS who is personally known to me or who has produced F L__ D. L-!-C-c,- me or who has produced as identification and who did take o th. identification and who did take ;ajHv'P;a••, YORLENV'rA.HERPfANUEZ `t N T Y PUBLIC: —- MV CU # 0 r ' NOTARY UBLIC• _: r 9h1 SSIuN n rL_2�ti6 `� Ge LEfr'Y PA.HERNANUt� t `- S� ?m06r 27 2017 =t MYC EXPIRES' Pt MMISSIGN#FF, � �' hru Nal:•y' _iiC Under`++r�te�s EXPIR S • ,h � �-- b 1 ' :September27•?et- Sig Banded T ru Notary PUtdic Unden:r _ Sign: Print: Print: . _ Se I: Seal: I � - ColulMiSSiGN#F' PIRES:Septembe r id:d Thru Notaiy P ,Ir Xe�:akakga akak akak>tege aieak�akekakrkakakakak+k akakAageakgea]nk:)eekakNe+kNeakakakak akakak Teak&akak+kakakak akakak akakak akak ak ekakak deakak akakakakakak akakak Hoak ak ak tka]e�eagak$egeaja akgaHeAbakak akak 9a&akak akAeakakak�ak APPROVED BY /L�,!/C��© Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)