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EL-15-3190 Miami Shores Village ID Building Department DEC 2 8 2 15 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Biro Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 sq-" _L 1 FBC 20(4 BUILDING Ma i6il Pe�cli�t No, IAC -/5 -o2'719 PERMIT APPLICATION sub Perm t`No: ❑BUILDING PKELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP Al �/d� ONTRACTOR DRAWINGS AB ADDRESS: L �-f !v J Sr� City: Miami Shores Countv: Miami Dade Zip: 313 b Folio/Parcel#: It.213 4 -01.3 —1 5--6 I Is the Building istorically Designated:Yes NO x Occupancy Type: Load: Construction Type: FJ od Zone: 130. -FFE: OWNER: Name(Fee Simple Titleholder):Z;"1Vf_s J,.,41n eo—(%Z Phone#6— ffr,2 Address: 18D 1 -S FL's -74kt- City: ,(9C� �,�-10A-1 State: Zip: :3-3 Tenant/Lessee Name: Phone#: Email: 4 14e-6 ,Pm Y9 ,6��� ' v CONTRACTOR:Company Name: G� bbl Address: /04I et) l City: -� A State: Z' r Qualifier Name: " �' Phone#: %f�//��d State Certification or Registration#: . �l�'/�f/4� Certificate of Compet6h,0# DESIGNER:Architect/Engineer: S rCV&- LL,eZS Phone#:lso� 'o --zro Address: /® ��69 /�D � City: State: /'--& Zip: Value of Work for this Permit:$ Q� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ ®Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Ct_f- Specify color of color thru tile: :A Submittal Fee$ A, 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$ I 0 , (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 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. 0 Signature Signature OWNER or AGENT 49OR The foregoing instrument was acknowledged before me The foregoing ins(rumentlwas acknowledged before me this �2I day of D CC' ,20 e� by / day of �(✓ eC .20 ,s , by (.�LVj ��e p���- U��t/ ,who is personally known to ar tz c��'arl es ,who is personally known to me or who has producedas me or who has produced A/,L/ey- �. rC as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: Seal: TARSMANOM Seal: n TARSMAIMWLM * * W WIWISSION 9 FF 059152 * * MY Cow . n,a q rF 059152 EXPIRES:January 31,2018 ��'AA� 9oaITMuB ! ��'�`�~ i1!<tlBuOpe(N&,ISINit� NdFyWdW APPROVED BY ��.d,�L f� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Local Business Tax Receipt Miami—Dade County, State of Florida THIS IS NOTA BILL-DO NOT PAY LBT 84561$0 T_j BUSINESS NAME/LOCAnON RECEIPT NO. EXPIRES FARADAY ELECTRICAL RENEWAL SEPTEMBER 30, 2016 CONTRACTOR INC 8724570 4952 NW 7 AVE 8 Must be displayed at place of business MIAMI,FL 33127 Pursuant to County Code Chapter 8A-Art.9&10 OWNER SEC.TYPE OF BUSINESS FARADAY ELECTRICAL198 ELECTRICAL PAYMENT RECEIVED CONTRACTOR INC BY TAX COLLECTOR CONTRACTOR 45,E Og/01/2015 Worker(s) 2 09E000348 0221-15-007587 This Local Busiasss Tax Receipt only CMI&RIS payment of the local Business TwL The Receipt is art a Itcense, permit,or a cartisicNima of tyre holdWs qualillastimM to do bushmm Holder sant comply with ally gorerome tol Or ntmMNISHIS al NePh ry Iaws ami requiremmms which apply to the business. The RECEIPT NO.above amort be displayed an all commercial vehiclus-Mlami-Dole Code Sec 8a-276. ® For more Worm ati m,visit www