PL-17-1740 (2) Miami Shores Village
B u i l d i n _D _(-�+f-'�_f�.� �R�c��v�n�ri +7 •
_ g _epartmen_t_
10050 N.E.2nd Avenue,-Miami Shores,Florida 33138 L OCT g 2017 ,
-Tel:(305)795-2204 Fax:(305)756=8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 74'
FBC
BUILDING__ _ __ Ivlaster'Permit.No.��l1-r I
PERMIT APPLICATION Sub Permit No. '1" I"] 4D
7 1 1 vrf , 1 ) I f' 7' C ) ` , i . , rY
❑BUILDING t (] ELECTRIC j -;:0 ROOFING.r, 4u ❑ REVISION w" F1 EXTENSION <_" QRENEWAL �
`tii'i;G i''1`'•i ��-.1vj
f' 'f 1J.-�.7 ^n;71 )` 'f(17. •fay 7 !1 s7c., Y1i:+. ':i f'l iil~9;,
K,PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTORS ,. r 'j `: , + DRAWINGS .+ .tom
JOB ADDRESS:
City:— -Miami-Shores r'Miami Dade wi nV 10VAAir
Folio/Parcel#_ * 1 -..¢fis;ttieBuiiding;Histo�icallyD'esignaLed YesE ° P.)(' O ivo<I'(E ..,ifl
.l
OccupancyType:j •'Coristruction;Type:)-B' ° " Flood Zon'e`I?7, 4 %3 BFE',_-)',iiAl +FFE 44 $ ' yI
OWNER:Name(Fee Simple Titleholder): 'Nk-CIJ "TVA 4 i vi Fp �'r% Phone#: '7 'SSI SSI to
Addres ;t �j � F — �. ) J �f a%t� V )' ! f t,r 4 el,
City:` ;7^, ,li^2 d' .,* . . \.rl f ••�W c .. r' A f. � .N� {t.. 1i _:! ` s�,v jr+i`.,7 ,'fit a s �4` *,,( ,ti`.
D1/�-� State: f -1 Zlp: 33I 1'.44
Tenant/Lessee Name: 'A:n Phone#'
Email: �
CONTRACTOR:Company Name: /1• VVo ' WL S �L Phone#:
Address: 304 _ �^... :� 4f-
` �t ,� sit .. �,�• _ �
City: V�J��Z/� State: Zip:�33__L(_
Qualifier Name: Z02y o�� ,- Phone#: 3oy--xj -4
State Certification or Registration#: C'C�G` I Sf�i I Certificate of Competency#::
2Z.i I>„1•� 'g�l j �! - - «. s ,rxrFi. � . .( fs �, .. y - ..,. ..�.y._
DESIGNER:Architect/Engineer: Phone#:
Address: _ � .,. ,,•{ _ _'! City: -' State: � ,zip:
Value of Work for this Permit:$ 17160 Square/Linear Footage of Work:
T e of Work:' ❑:Addition�/ �"+' ��°x."* ,F ❑ Repair/Replace ❑ Demolition
yp -❑\ Alteration New
Description ) .�.,�`?�VV`I' s{I ^tJ�'Y'`'L; � a''t`..�Y�J�.v of•.°��"'t.�u".,,,.•.,.^e,i'.,,•*v•M1�„�
tion of Work:
.__ � - �'•,_ n._xSStBof�a ,,aw3 'ger� � �� ^� �'`{� � q"
.•s'''t!'ti-�`r=SeI':e�i„'�,�h,f'',,.!•1P`wy',,r'4.fl;.V"en''t,o•
Specify color of color thru tile: �1 C
Submittal Fee$- _ Permit.Fee$ o`a J• CCF$ CO/CC$
a
Scanning Fee$ Radon Fee$ ' oZ� DBPR$ 3 ' 3 Notary$
Technology'Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$`
Irt.f - – y_ °' ' f�', •j' TOTAL FEE NOW DUE$
(Revised02/24/2014) -
ID I I� " �-- -1."-f
Bonding Company's Name(if applicable)
Bonding Company's Address
T i
tf.-1 1 3r I j It, A jo ",at,'I- �1.0 Xj
City State lilp
-Mortgage Lender's Name(if applicable) iA-0H1t 1"d 2,10,T1394,
.-,Mortgage LendeVsA2jr'es`s.-j
City
4,.-_State.,2p-a% Zip r
Applicationis herebymadeto,ob6in a permit to do the work and installations as indicated. I 'certify that no work or installation has
commenced,prior,,to:the issuance:.pfi a,permit and that-,.aill work Will be performiclto, meet the standard's of all la�vs,regulating
construction in this jOrisdIction.l' understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.....
r I tq Di -%!%I L3 1:11.',111
-Information OWNER,s�'AKNWm bI certify that all the foregoing inWraV� 1is accurate and that all work will be done in compliance with all
,applicable laws regulating construction and zoning.
"WARNING_TO-OWNER:-..YOUR FAILURE-LTO RECORD'-A;_NOTICE--OF COMMENCEMENT •MAY
' I " I " 1' - "
RESULT-IN- YOUR.PAYING:IWICE-FOR IMPROVEMENTS-TO-Yd0`R-*ROPERTY.--'IF-YOU'INTENID
TO OBTAIN,,FINANCING;CONSLILTWITH YOUR LENDER ORrAN ATTORNEY BEFORE RECORDING'
YOUR NOTICE OF COMMENCEMENT." -1 9I
I
1
Notice to Applicant. As a condition to the issuance of a building permit with an estimated-value exceeding$2500, the applicant must.
IW brochure
promise in goo7d faith-th-at-d copy of ihi notice of commencement and;-construction t� will be difivered to
'I, I i1
whose property is.subliErcFto attachment. Also,a certified copy of the recorded notice of commencement must be'poste'd at the'job site
for the first inspection which occurs.seven (7) days after the building permit is issued. In the absence.of such poste¬ice, they
inspectiffw-ill nofbe 5p&bved and a reinspection fee will be charged. fit
_-S
Signature ignatG-re
L-V
--OWNER 6rAGENT C
The foregoing instrument was ac tnnowledged before- i§'this----Th6f6r-egoing instrument wast
o-w-ledged before me this
�
day of 20 �d of ��tj 2 byy
C---CY - w a iskersdnally� ZIspe!sorally known to
�
me or who has'produced - as 7meorwho raiVr&-d6ced as
identification a4 who did talil an oath. iclifitificati65'ancl who-did take ari-oath.
V
NOTARY PUBLIC:- NOTARYPILIBILIC:
Ad
Notary Public State of Florida
Notary Public State of Florida Regino Betancourt
&A filbn GG 0233 7
Sign: Sign:
My Commission GG 023377 Expires 08/22/2020
Print: Fxpira%nF112219n2n' -- Print'--
Seal' __.
rint:--Seal:----. --Seal:
APPROVED BY fv Plans Exa_m_=ine_r Zoning,
ctural Review Clerk
iva I 4Q�f 4 ji i
(Revised02/24/2014)
s 2011
Miami Shores Village �L
Building Department BY:__=�
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 �++h
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 1 4
BUILDING Master Permit No. 90 V1- 1157
PERMIT APPLICATION Sub Permit No. PL I1 " 1 19 o
❑13Ui
DING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
PLUMBING ❑ MECHANICAL [—]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip: 3 3
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fe Simple T'itleholder): Phone#:
Address: _
City:, i;zi.,� ,�,s State: i Zip: 3313j`�
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Le COIF 4;�)e _r;kf CG Phone#: 7k6- 'q3--fi-V
Address: 2 q7 f311;-`b )�J 7-tS
city: CdIZ06 G11-6 ces State: '`L Zip: _531 Y,6
Qualifier Name: bAV 9 -I-01+V Phone#:.
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ laLlo_ Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: L t `
Specify color
o,,11f��color thru tile:
Submittal Fee$ CJU�Q 16 Permit Fee$ y CCF$ CO/CC$
Scanning Fee$ Radon Fee$ D B P R$ 3 ��' 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 Signaturel. 7614 A
OWNER or AGENT CONTRACTOR y
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
2-7 day of 20 ) by 27 day of JyA)E 20/7 by
6'a/ / e,4 !!� �who is personally known to CAVI D \1d 001 A who is personally/known to
me or who has produced as me or who has produced as
,identification and who did take an oath. identification and who did take an oath.
,NOTARY PUB / NOTARY PUBLIC:
'Sign: Sign:
,.:��:Isy•, ALFRED MCKNIGHT
Print °= Print:
Ssi
Expires January 23,2018 �°;•••.,�% GABRIEL REYES
Seal: V ,g Bonded Thm Troy Fain Insurance 800,186-7019 Seal: * * MY COMMISSION 0 FF 007074
EXPIRES:August 11,2017
N'+110,,�V' Bonded Thru Bbget Notary Service:
**s*s*ssss*ssssss****sss*sssssssssss*****s*ss*ssss*sssssssssss*ss***ss****ssssssss***s*ss*****s*ssssss*ss*s*
APPROVED BY Ad �(� r� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)