REV-18-322BUILDING
PERMIT APPLICATION
Npl BUILDING� ELECTRIC
PLUMBING I I MECHANICAL
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) 762-4949
II
RECEIVED
FEB 0 8 me
FBZQ��
Master Permit No. PW`G
Sub Permit No. heti/ -322-
ROOFING REVISION ❑ EXTENSION 1 I RENEWAL
PUBLIC WORKS 1 I CHANGE OF ❑ CANCELLATION I I SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: r� /�'�/QC�
City: Miami Shores
County: Miami Dade
Zip: 5/ l�
Folio/Parcel#: / /32 O '70 2 Is the Building Historically Designated: Yes NO °<
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): P, ezz&-- l/:) /9'Po-7J/2 T/7y(
/Z
Address: 3Vb ? iPG/ICC.
Phone#: 2 770 26 77
City: H('4 /4
Tenant/Lessee Name:
Email:
State:
FL
Phone#:
Zip:
CONTRACTOR: Company Name: Re -6e Sw (/e6R0y4" S Phone#: -,78(3 4
Address:
City: f`l4tti/ State: F!
Qualifier Name: 4/ s 779 Vc If�C C
State Certification or Registration #: (6C /5089 3-2
DESIGNER: Architect/Engineer:
Address:
Zip: 3 3 / O
Phone#: rYe151/7
Certificate of Competency #:
Phone#:
Value of Work for this Permit: $
40*
Type of Work: I I Addition ❑ Alteration
City: State: Zip:
Square/Linear Footage of Work:
New ❑ Repair/Replace
Description of Work: gC�UC%%Q/Y 5S L F
Demolition
Specify color of color thru tile:
Submittal Fee$ 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 $
(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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNE
The foregoing instrument
r AGENT
Signature
CON
ACTOR
s acknowledged before me this The foregoing instrument was acknowledged before me this
_ day of t'CG , 20 / �' , by °.f day of , 20 /g
, by
bny1el it, L FCl is personally known to 6's7/9V4 �1� � , who is personally known to
me or who has produced �' ,L� as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
•
Si: X9'1/
Print: •..6". •. MAHARAI K. GONZALEZ
Seal:
APPROVED BY
(Revised02/24/2014)
MY COMMISSION # G ••••1
EXPIRES: November 2, 2020
�•: ebr Fro?• Bonded Thru Notary Public Underwriters
/1
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Plans Examiner
• or�ive
N - sa
WASHINGTON 0 SCARANO
FxP,RES Oc$ober 15. 2019
F krdaNaa'YSe :it•.oun
*******
Zoning
Structural Review Clerk
COUNTY -WIDE • LAND SURVEYORS INC.
LAND SURVEYORS* PLANNERS
P.O. BOX 823271 SOUTH FLORIDA,. FL. 33082-3271 (305) 772-0766
U
N.E, 13 $7•
LOCA7loW tVCN Alo7.7OScAcE
LEGAL DESCRIPTION
Lot 7 of REDDTNG HEIGHTS, ,according to the plat thereof,
as recorded in Plat Book 45 at Page 84 of the Public Records
of Miami -Dade County, Florida.
SURVEYORS NOTES:
1). Legal description provided by client.
2). Right of way information obtained from
3). Only record plat easements are shown.
record plat.
RECEIVED
FEB 082019
-BOUNDARY.& IMPROVEMENTS SURVEY
BEY FOR David & Nancy Smith
9312 N.E.
9 PL. Miami
Shores, F1:33138
CERTIFICATE
I HEREBY CE
MINIMUM TEC!
MAPPERS IN
SECTION 972E
OTEI " NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYORS SEAL.'
IFY THAT THE SURVEY REPRESENTED HEREON COMPLIES WITH TAE
ICAL STANDARDS ADOPTED BY THE FLORIDA BOARD OF SURVEYORS AND
APTER 61C 17-6, FLORIDA ADMINISTRATIVE CODE, PURSURANT TO
27, Florida Statutes,
JOSEPH L. MARTIN
PRoFEsstNAL LANO SURVEYOR * 4368
STATE OF FLORIOA
REVISIONS
BY DATE
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Miami Shores Village
.,PPROVED
BY DATE
'-'ONING DEPT
._LDG DEPT
SUC3JECT TO COMPLIANCE WITH ALL FEDERAL
TATE AND GOt1NTY RULES AND REGULATIONS
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