REV-16-2712 Miami Shores Village Xxjc�c�' jv
ops
Building Department OCT o 4
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No. Cc • 3 . 15. 5W
1
PERMIT APPLICATION Sub Permit No.�At V ,l160 - 2=�'1 Z
❑BUILDING ❑ ELECTRIC ❑ ROOFING Z REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING (MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHO IP
CONTRACTOR DRAWINGS
JOB ADDRESS: Naa
City;- Miami Shores County Miami Dade Zip:
�313�
Folio/Parcel#: w - •Is the Building Historically Designated:Yes NO t
,Occupancy Type: Load: .Construction Type: - Flood Zone: ` BFE:' . FFE`
OWNER: Name(Fee Simple Titleholder): Anne L I f zqw) YCA n. r Phone#:
Address: Vge 103 -�:)T
City: M1 tel) 'Z nANYV:> State: V,L. Zip:
Tenant/Lessee Name: Phone#:` '
Email: t'
CONTRACTOR:C mpa7n Name: C.> cksblwd, Ph ne#: r1C2ff 77D
Address:
City: f State: Zip:
Qualifier Name: n� Phone#:
State Certification or Registration#: C r Certificate of Competency#:
t
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of WorVfor this Permit:$ Square/Linear Footage of Work:
it 1 F
Type of Work ❑ Addition '',,,�❑ Alteration New ❑ Repair/Replace E:1 Demolition
Description of Work: P t Ic>f-N Q4 exis4wiQ so' 0 (. -;� L
w.s.+f+••m..».ir.,.Y.rn..ar w..a. ..-•+w.wwe.rer;,�ww.+,?' �'e"hiu'"v v- .n l.sJ. ;' r:c. r Tt
v
GI rv- ^`. • S ;, �'i�� i �1�,�tY(i^_:1{� �s "ti� w —ti's rt
Specify color of color"°thru file :
f +Pao-K Nt:vl. c
Submittal Fee$ ). _ .� _.»�..:-Permit Fee$a^^ S. CCF$. CO/CC$
Scanning Fee$ �'2) Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ Q
TOTAL FEE NOW DUE$ S
(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 ANATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT." 1
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 attachmen Iso,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspectio s ve (7J days after the,building permit is issued. In the absence of such posted notice, the
inspection not be approved and a einsp ee will be charged.
s
Si ature Signature
OWNERorA E PCONTRACTOR
The foregoing instrumme�en,, Rp c nowledged before me this The foregoing instrument was acknowledged before me this
day of 1l Q�� 20 k LD by,.- vday of �� 20 1(D by
frrw (_&c" �E-�l who i ersonally kno to �iD 2 - 1Z W6;:;;;�Ilyto
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 PUBLIC: NOTARY PUBLIC:
Sign: l t. C. /V� Sign: C J
Print: Print:
s
Seal: '• r MYCOMMISSION MFF242181 , ••,, RAWELaSCARBORO
• :- EXPIRES:October 18 2019 Seal: ;;'r'a UGN
Hooded rhru wary Pubis unftm%rs a COMMISSIONa FF 242181
�,, 'as %:Xt'igFS October 18 2019
:hN W!?•11?u*UndernrRen
4
APPROVED BY by 1� �' Plans Examiner Zoning
A• Structural Review Clerk
(Revised02/24/2014)
9
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
'
CONSTRI.CTION INDUSTRY LICENSING BOARD (850)4617-1395
2601 BLAI R STONE ROAD
TALLAHA SEE FL 32399-0783
RUIZ, JORGE
RUIZ.CONSTRUC nON INCORPORATED
14028 NW 82ND AVE
MIAMI LAKES FL 33016
Congratulations! With this licen a you become one of the nearly
one million Floridians licensed b the Department of Business and
Professional Regulation_ Our prAessionals and businesses range ,, STATE OF FLORIDA
from architects to yacht brokers;from boxers to barbeque DEPARTMENT OF BUSINESS AND
restaurants,and they keep Florida's economy strong. s PROFESSIONAL REGULATION
�
fm�
Every day we work to improve t way we do business in order CAC 1817314 _1, ISSUED: 06/3012016
to serve you better. For informa on about our services,please '
log onto www.myfloridalicense cam. There you can find more CERTIFIED AIR COND-CONTR
information about our divisions a A the regulations that impact RUIZ,JORGE• o- '
you,subscribe to department ne sletters and seam more about RUIZ CONSTRUCTION iNGORP1ORATED
the Department's initiatives. r,+r<'•
'•�. J'
Our mission at the Department i :License Efficiently,Regulate
Fairly.We constantly strive to sei ve you better so that you can
serve your customers. Thank yo Li for doing business in Florida, 1S CERTIFIED under the provisions of"Ch.489 FS.
and congratulations on your new license! Expiration date:AUG 31,2018 L1606300000534
DETACH HERE
RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRYLICENSINGBOARD
CAC 1817314 ur
The CLASS B AIR CONDITIONING CONTRACTOR
Named'below IS CERTIFIED, -
Under the provisions of Chapi er 489 FS. wst"'�.
Expiration date: AUG 31;2018
` ZW".
RUIZ, JORGE f
RUIZ CONSTRUCTIO INCORPORATED ;
1'4028 NW 82ND AVE
MIAMI LAKES -rF (33016 N
013
..{y:�+'r ,t':...�r• "i -r,�e. i 4.. sic, •r'a'" yy4 -
ISSUED: 06/30/2 1 DISPLAYAS REQUIRED BY E W SEd# L1606300000534
a
Miami-Dade County, State of Florida
THIS IS NOTA BILL-DO NOT PAY
7080021
BUSINESS NAME/LOCATION- RECEIPT NO. EXPIRES
RUIZ CONSTRUCTION INCORPORATED RENEWAL SEPTEMBER 30, 2017
14028 NW 82 AVE 7357999 Must be displayed at place of business
MIAMI 4AKES FL 33016 Pursuant to County Code
Chapter BA-Art.9&10
OWNER SEC.TYPE OF BUSINESS
RUIZ`CONSTRUCTION INCORPORATED 196 SPEC MECHANICAL CONTRACTOR PAYMENT RECEIVED
C/O JORGE RUIZ PRES CAC1817314 BY TAX COLLECTOR
Worker(s) 1 $45.00 08/.11/2016
CREDITCARD-16-046955
This Local Business Tax Receipt only confines payment of the Local Business Tax.The Receipt is not a license,
permit,or o certification of the holder's qualifications,to do business.Holder must comply with any govenanotal
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Cade Sec Ra-276.
For more Information,visit www.miamidadegoa/taxcoliectol
003469
Local Business Tax Receipt
Miami-Dade County, State of Florida
-THIS IS NOTA BILL-DO NOT PAY LBT
6430383 1
BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES
RUIZ CONSTRUCTION INCORPORATED RENEWAL SEPTEMBER 30, 2017
14028 NW 82 AVE 6698725 Must be displayed at place of business
MIAMI LAKES FL 33016 Pursuant to County Code
Chapter 8A-Art.9&10
OWNER SEC.TYPE OF BUSINESS
196 GENERAL BUILDING CONTRACTOR PAYMENT RECEIVED
RUIZ CONSTRUCTION INCORPORATED BY TAX coLL.FcroR
C/O LISSETTE RUIZ PRES CBC059296 $45.00 08/18/2016
Worker(s) 1
CREDITCARD-16-047949
This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is nota license,
permit or a certification of the bolder s qualifications,to do business.Holder must comply with any governmental
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec 80-27s.
For more information,visit www.miamidade.gov/toxcollector
1
03843
Local Business Tax Receipt
Miami-Dade County, State of Florida
-THIS IS NOT A BILL-DO NOT PAY
6713706 LBT ,
BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES
RUIZ CONSTRUCTION INC RENEWAL SEPTEMBER 30, 2017
14028 NW 82 AVE 6987011 Must be displayed at place of business
MIAMI LAKES FL 33016 Pursuant to County Code
Chapter 8A-Art.9&10
OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED
RUIZ'CONSTRUCTION INC 196 SPECIALTY BUILDING CONTRACTOR BY TAX COLLECTOR
C/O JORGE RUIZ CCC1329241 $45.00 D8/18/2016
Worker(s) 1 CREDiTCARD-16-047946
This L°rzi5esi�ss T-x
oezei__t a C aarse0t cf�e L•xzt 3csiaess Tax:T Fr"":�ss .a._ s$