PW-16-2934BUILDING
PERMIT APPLICATION
El BUILDING 0 ELECTRIC
[] PLUMBING ❑ MECHANICAL
JOS ADDRESS: 9125 NE 2ND AVE
Miami Shores 'Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 7624949
0 ROOFING
n PUBLIC WORKS
RECEIVED
OCT 2 8 2018
t
-144
FBC 20 lq
Master Permit ,No G 3
Sub Permit No.
0 REVISION ❑ EXTENSION (RENEWAL
[l CHANGE OF
CONTRACTOR
❑ CANCELLATION
n SHOP
DRAWINGS
City: Miami Shores County:
Folio/Parcel#:
Occupancy Type: Load:
Miami Dade
zip: 33150
Is the Building Historically Designated: Yes NO
Construction Type: POLE Flood Zone:
OWNER: Name (Fee Simple Titleholder): AT&T Telecommunications
Address: 9101 SW 24TH ST
RFE: FFE:
Phone#: 305-222-8249
City: MIAMI
Tenant/Lessee Name:
Email:
State: FL hip; 33165
Phone#:
CONTRACTOR: Company Name: MASTEC NORTH AMERICA, Inc
Address: 2801 SW 46TH AVE
Phone#: 954-587-4774
city: DAVIE
Qualifier Name: ROBERT HERNANDEZ
State: FL Zip: 33314
State Certification or Registration #: EC002759
DESIGNER: Architect/Engineer: RAUL J. VILLANUEVA
Address:9101 SW 24TH ST
Phone#:
Certificate of Competency #:
Value of Work for this Permit: $ 690
Type of Work: n Addition El Alteration
Description of Work: POLE REPLACEMENT
City: MIAMI
Phonelf: 305-222-8249
State: FL Lip: 33165
Square/Linear Footage of Work: 25 SQ T FT
❑ New 0 Repair/Replace
❑ Demolition
Specify color of color�thru tile: W
Submittal Fee $ EO •
Scanning Fee $ CT •
Technology Fee $
Structural Reviews $
{Revised02/24/2014}
Permit Fee $ CCF $ r•7 (C70 CO/CC $
Radon Fee $ 2- DBPR $ . • Notary $
Training/Education Fee $ , Zo Double Fee $ -163'
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 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
!/ OWNER or AGENT
The foregoing instrument was acknowledged before me this day of O2 vY/er� , 20 .1(Q--, by_-
r�ls ersonally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
Le.e44--(47y—
is !�1 :� r • �' ::[
.%. a EXPIRES: May 3, 2017
Bonded Thru Notary Public Underwriters
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
rc7� S day of't—� 20 Z by
r -v \-Vr) . ki.who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
**************************************************************
APPROVED BY
(Revised02/24/2024)
XicAOP— cT/6' Plans Examiner
Structural Review
r;•.•A MAYLIN EXPOSITO
..! tv1Y COMMISSION #FI:0719•11
EXPIRES November 20, 2017
+444741d1E1•91,***4i esid,k+ianpieri•e•su,t•**. ******+ts**
Zoning
Clerk
vnp
r
zl
1711
NI
Zi
NE 92ND ST
9125
9101
ALLEY
WORK SITE:
F/0 9125 NE 2ND AVE
NE 91ST ST
91ST ST
REemnrED
cT2820,16
BY
1 ELECTRICAL REVIEW „z 6;®,e/70
41311"11t'' DATE
Paiam. Shores Village 1
w
.--
a Q
0
Y FLORIDA
i�`DIAL 811 or
1-800-432-4770
www.cal1811.com
TWO FULL BUS. DAYS BEFORE YOU DIG
.1I,JI Ci 10 CC -:131.. VI,TH AI_L FEDERAL
IAIf ANDCt : I1"YIIUtI'S AND I1 GUI AI IONS
C
APPROVED
7ONING DEPT
BLDG DEPT
AERIAL GA./TI IN
Volts to Ground
7.6KV
1
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PB 10-70 PER MIAMI DADE •' ••
COUNTY WEB PORTAL
PERMI TS REQUI RED:
CHECK ALL THAT APPLY
❑ F. D. 0. T.
❑ DADE COUNTY
CI TY• MIAMI SHORES
❑ OTHER:
❑ NONE
•• •
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A TTSE
PROPOSED TELEPHONE FACILITIES
ON RIGHT OF WAY OF
MIAMI SHORES
F/0 9125 NE 2ND AVE
Exchange:
305751
Designer:
Villanueva,Raul
Phone:
305-222-8249
Authorization:
6MP05318N
Dwg. I of 2
10/26/2016 10: 44: 38 AM
CALL BEFORE YOU DIG
Y FLORIDA
i�`DIAL 811 or
1-800-432-4770
www.cal1811.com
TWO FULL BUS. DAYS BEFORE YOU DIG
AERIAL GA./TI IN
Volts to Ground
7.6KV
1
CO •
.•
. ••
•. •
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•
•••• •
• •
•.••
•.•• •. •
• • • . •
•••• • ••
• •
PB 10-70 PER MIAMI DADE •' ••
COUNTY WEB PORTAL
PERMI TS REQUI RED:
CHECK ALL THAT APPLY
❑ F. D. 0. T.
❑ DADE COUNTY
CI TY• MIAMI SHORES
❑ OTHER:
❑ NONE
•• •
• • •
•• •
•
•. •
• •
•
•
• •
.••
• • • •
• • .
•• • •••• •
•
•.
. .
A TTSE
PROPOSED TELEPHONE FACILITIES
ON RIGHT OF WAY OF
MIAMI SHORES
F/0 9125 NE 2ND AVE
Exchange:
305751
Designer:
Villanueva,Raul
Phone:
305-222-8249
Authorization:
6MP05318N
Dwg. I of 2
10/26/2016 10: 44: 38 AM
EOP
E/L
OP
m
LJ
m
1
-R/W
NE 92ND ST-
R/W
EXISTING DOWNGUY/ANCHOR
91?5
e:
R/W
0
POLE PROPOSED
EXISTING POLE
J
147'
23/1
ALLEY
X35=
R/W -
GPS COORO. POLE
Y=25.859174, X=-80.192739
NJUNS: PT2917038
R/W--
/W--
-NE
-NE 91TH ST----C/L
EOP—
R/W
1 I
I I
I I
I I
EOP-
EOP-
R/W-- --
lioA
FP&L:22'.7"
CATV:19'.6"
AT&T:19'.6"
AT&T:19'
AT&T:18'
SYMBOL LEGEND
Proposed
Existing
Description
AERIAL CABLE
BURIED CABLE
B
B
BUR JOINT -TRENCH
8J
BJ
•
0
BST POLE
*
*
POWER POLE
�4c1C
ANCHOR & GUY
<
PB
PUSH BRACE
—4—PB
—(
—__A_
ENCLOSURE
40
ENCLOSURE
Z
MANHOLE
PIPE/CONDUIT
I I
CA-MKR
CA-MKR
CABLE MARKER
N./'%./`/••
‘-'"N-'-.N.-/-N-
AERIAL SVC WIRE
— — e — —
— — B — —
BURIED ;1(C. 1Y4
---aJ---
- - -8j- - -
JOINT -TIE •SVC
N/A
BORE • •
Vj////1
N/A
CUT PA V.ElidEyi •
II
N/A •
SPLICING•PIT• :
200'7(24')
N/A
TRENCH tWPDErTH
4EIWIJ GAU/T/ON
Volts to Ground
7.6KV
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• . •
•• •
ATTSE
PROPOSED TELEPHONE FACILITIES
ON RIGHT OF WAY OF
MIAMI SHORES
F/O 9125 NE 2ND AVE
Exchange:
305751
Designer:
Villanueva,Raul
Phone:
305-222-8249
Authorization:
6MP05318N
Dwg. 2 of 2
10/26/2016 10: 44: 50 AM
Arlenis Silvera
From: Arlenis Silvera
Sent: Wednesday, May 03, 2017 10:43 AM
To: 'SF5641@ATT.COM'
Subject: PW16-2934
Attachments: Permit.pdf
Please advise when we can schedule a inspection.
Best Regards,
Arlenis Silvera
Permit Clerk Supervisor
Miami Shores Village
10050 NE 2 AVE
Miami Shores, FI 33138
305-795-2204
www.miamishoresvillage.com
1