REV-17-481\„),
o'Pc\/t
t,
BUILDING
PERMIT APPLICATI
❑ BUILDING ❑ ELECTRIC
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: (30S) 7624949
❑ PLUMBING ❑ MECHANICAL
❑ ROOFING
REVISION
❑PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: (O t V
Fra a ,v0;
RR�F� V
Eo
FBC 20 Nl sth
it No. 4--I-9'47—
mit No. PEA( fl
❑ EXTENSION El RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type:
County: Miami Dade
Zip: ,27 9,
NO ✓
Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder):OP{A(i4 - J /TEA wif Phone#:
Address: Ct 0 ( ?A i —K
City: 1, -A-V1 OQ_ 2 S State: Zip: '3, V 1 '.1"�
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:9i61
Address: 46? 1,)&"
104
City: .-AAre
Qualifier Name: r
C, 04, 117
Phone#:
State:
Zip:
Phone#:'
State Certification or Registration #: �_'r C f.�451 ,3 Certificate of Competency #:
DESIGNER: Architect/Engineer: �Cl - Gt.4xQ. �ii ' (,(n c(eVs �, b, Phone#: Sc21
Address:
rigCo N u.1 i46 ree3A-
City: 11. )L,P/) State: Tsa-
Value of Work for this Permit: $�'� i`S"—e-5quare/Linear Footage of Work:
Type of Work:
❑ Addition
Descr-ption of Work:
❑ Alteration
❑ New
epair/Replace
41
Zip: 3301
Demo' ion
7
Specify color of color thru tile:
Submittal Fee $ c)
rD Permit Fee $ CCF $ t - Z�
Radon Fee $ 2_ DBPR $ 2
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
CO/CC $
r �r'� Notary $
Training/Education Fee $ 10 \! Double Fee $
Bond $ - Zd
TOTAL FEE NOW DUE$ 2�(O
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 Signatur
OWNER or AGENT
The foregoing instrument was acknowledged before me this
Z� day of k7 viptcw, , 20 17 , by
e"—z 4(.2441-74..,h , who is personally kn to
g e_or who has produced as Egg or who has produced as
CON
The foregoing instrument •ged before me this
.2 day of £ Y�' , 20 /7 , by
c 00 Sei-i, who is personally kkn_own to
s acknowle
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
a a a aa a.
CASSANDRA NEBBIA
Notary Public • State of Florida
Commission s FF 97243
►= My Comm. Expires Jul 25, 2020
Bonded through National Noivy Assn.
c_ASSAI-N.IDF 4 1.1 t�ls
identification and who did take an oath.
NOTARY PU LIC:
Sign:
Print:
Seal:
I
CASSANDRA NEBBIA
' S y omm. xp res Jul , 020
'6„Bonded through National Notary Assn.
C.A! N)4- 1,f E Ak-
****************************y******************************************************************** s**M+I�*
�
APPROVED BY
(Revised02/24/2014)
Plans Examiner
� ) S/7
Zoning
Structural Review Clerk
Arco Construction Corporation
March 06, 2017
Building Official
Mr. Ismael Naranjo
Village of Miami Shores
10050 NE 2nd Ave.
Miami Shores, FL 33138
Re: Revision Process # 17-481 (permit # CC -4-16-947)
Dear Mr. Naranjo,
The changes reflected on submittal revision drawings are minor structural details that did not
result in any change order or price adjustment to the contract.
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Sincerely,
Lester Jensen
For Arco Construction Corporation
General Contractors/CGC1505163/1665 N.E. 137111 Terrace/N. Miami, FL 33181
305.892-6507
02/22/2017 10:07 3054779142
EZ PAINT PAGE 02/04
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
2601 BLAIR STONE ROAD
TALLAHASSEE FL 32399-0783
COELLO, ARTHUR
COASTAL GROUP CONSULTANTS LLC
2210 WEST 10TH COURT
HIALEAH FL 33010
Congratulations! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
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and congratulations on your new license!
RICK SCOTT, GOVERNOR
STATE OF FLORIDA
DEPARTMENT QF,BUSINESS AND
PROFESSIQNAL.REGULATION
CGC 1514271. UE.p: Q7/24/2016
(850) 487-1395
CERTIFIED GE
COELLO, ARTH
()OAS IAL CiFtULJk ..e0W 14
OR
d;S LLU
IS CERTIFIED under the provisions of Ch.469 FS.
Fnilrotlon date ' Alln 31, 7016 11607740001936
DETACH -HERE
KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OP BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
LICENSE NUMBER
CGC1514271.
4e,°r, .
Named below IS CERTIFIED
Undor.tho provisions of Chapter 480 PS.
Expiation date: AUG 31, 2018
COELLO, ARTHUR • •''`":
COASTAL GROUP CONS .. • S LLC
2210 WEST 10TH_COUR f;"� •
HIALEAH t . •... y .�;�:;...
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