The URL can be used to link to this page

ACT-18-432riAc- eta et. 1,1 3-7444/,c/v4 dAhdJI - t, ActisT 43 2 PERMIT CONTRACTOR: SUBMITTAL DATE: ADDRESS: 11 S LD a $4-$__ 2 44— NAME: RESUBMITAL DATES: PROJECT TYPE:1O12 --crr-F.1.1 ZONING PLUMBING -VP Ill'' STRUCTURA ' MECHANICAL ELECTRICAL BUILD! J BUILDING PERMIT APPLICATION ❑ BUILDING El PLUMBING JOB ADDRESS: City: 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 ❑ ELECTRIC ❑ ROOFING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CONTRACTOR OD /t}ee 2 FBC 201 Master Permit No. ADti3 " �3 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL CANCELLATION ❑ SHOP DRAWINGS Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: ` Flood Zone: r, BFE: FFE: OWNER: Name (Fee Simple Titleholder): Phone#: Address: // 3 OO tic 2 City: 1(Li, g es State: Zip: Tenant/Lessee Name: Phone#: "3 3/ ( ' Email: T x/In @ BavYy • (4✓i/ CONTRACTOR: Company Name: J 12-42,( 4 1 p„ --r (z C Phone#:. 0 j 67 a K 0 , Address: q2. S'5? -,1-1"..e57,7- , .eST 9 d 4C.-4-- City: /-/1a,/ e- a ! State:1I FC Qualifier Name: �c —C yJ O U Z C%Ldd Phone#: State Certification or Registration #:1, (�.- R S'�l s',�ii C3 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: I Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Zip: 37e Type of Work: ❑ Addition ❑ Alteration Description of Work: q ❑ New ❑ Repair/Replace Ce_ AT I q32. ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ Scanning Fee $ Radon Fee $ DBPR $'"e CO/CC $ \ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) \ 4 t )1 F f sl Bonding Company's Address ) 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 t'he 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 Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this }, i day of , 20 , by . 17-. day of1 "` /"`X'1 , 20 frig , by , who is personally known to 6t-reix- l rt IACA-tA " ,`a/v i rsce7s�a?, known to me or who has produced as me or who has produced CPO Ii 7E - (J Nomas identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY Sign: Sign: //�� Print: Print: t) -P. AUJ-L Seal: Seal: }0 ` r °,e Notary Public State of Florida e X2• Sindia Alvarez tt, � c My Commission FF 156750 1. or %,aP Expires 09/0312015 c.. J. s.:s db :m. w .ti. LIC: APPROVED BY (Revised02/24/2014) Plans Examiner Zoning Structural Review Clerk BUILDING PERMIT APPLICATION UILDING ❑ 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: (305) 762-4949 RECEIVED FEB 2 0 2018 FBC ton wilA Master Permit No. aur 1 Ice --132 b Permit No. ❑ ROOFING ❑ RE • N EXTENSION El PLUMBING ❑ MECHANICAL PUBLIC WORKS JOB ADDRESS: 1/ 3O0 CH NG '.0 ❑ CANCELLATION CNTROR 2 Z,,v�6""4„. ✓` ' Do ❑ RENEWAL ❑ SHOP DRAWINGS City: Miami Shores Folio/Parcel#:. Occupancy Type: Load: Constructi County ��?iami Dade Zip: .3 3/ 6/ uilding Historically Designated: Yes Flood Zone: NO BFE: FFE: OWNER: Name (Fee Simple Titleholder): RA w , .,. try Phone#: 30S- Ili. 39It Address: nn I� 3 0 V 1 � 1 i�if Y,N City: _ I SuO��s Tenant/Lessee Name: '/� /� Email: J'/Ao �i wiry CONTRACTOR: Company Nam Address: g 2 $ S City: r i e^141.-0. Qualifier Name: State Certification or Regis DESIGNER: Architect/Enginee Address: �? -7 / a ion #: (9dra Zip: 33A Z t Phone#: Phone#: 9Sci ?$”Yd 141S State: rF e_ Zip: —3-30/e/ Phone#: 9 4 C/T`7 ? S 7-q z( 00 SO') Certificate of Competency #: cKP i (Or ei5L tree (\.ui5,.4hone#: 3& 19.-) .30 /teQ s7ey,:rk �r , i P City: Pr &sr.e S T State: P(Zip: Value of Work for this Permit: $ Type of Work: ❑ Addition 26e,®") e/loO ❑ Alteration Square/Linear Footage of Work: ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 77 Sylo,JAIt f G� c�J�-Q S 7iJ7.j \trr fl `ITjt S 2 D - ZI 21r Specify color of color thru tile: Submittal Fee $ SCJ' Permit Fee $ CCF $ CO/CC $ rD Scanning Fee $ cpPi Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 1 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 wil be charged. Signature OWNER or AGENT The foregoingjinstrumentnwas acknowledged beforemethis I� ` day of P 7 Q 20 t 2' by SNL wersonally known,Xo me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign. Print: * a Notary Public State of Florida Jeffry J Yao •,, : • My Commission FF 188481 Expires 11/12/201a Signature The foregoing instrument was acknowledged before e this day of r �� 20 , by 6-1oYd() MGCwh O a y k own 1.7e me or who has produced'F'I (i C ef identification and who did take an oath. NOTARY PUBLIC: Siglb/: Print: Seal: as COMMISSION s'ZAIEZ MYCO o,; ON#GGi•_,� ° ;; ;° '' Bonded em' 2020 2 Thru Nota erg, `'- ry Public Underwriters Hunters ****************************************************************** APPROVED BY Plans Examiner Structural Review (Revised02/24/2014) Zoning Clerk