EL-17-1009 4 ,
Miami Shores Village VZECEIVED
Building Department
APR 112017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305)795-2204 Fax: (305)756-8972 1 y1•�1/
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201
BUILDING Master Permit No. �' �-' — 3 S
PERMIT APPLICATION Sub Permit No. 1^4 " I b09
❑BUILDING FX-] ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
I
JOB ADDRESS: 672 NE 98 St.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3206-017-1780 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:'Name(Fee Simple Titleholder): Carol Invest USA, Inc Phone#:
Address: 990 Biscayne Blvd. Suite 801
city: Miami state: Florida zip: 33132
Tenant/Lessee Name: Phone#:
Email:
- I
CONTRACTOR:Company Name:'-Cassia Electrical Contractors Phone#: ; l
Address. 8261 NW 48 St.
city: Lauderhill State: Florida Zip: 33351
Qualifier Name: Glenworth Walker Phone#:(954) 650-5840
Stafte Certification or Registration#: EC 13005907 Certificate of Competency#:
DESIGNER:Architect/Engineer: Victor Bruce Phone#:(305) 310-5030
Address: 370 NE 101 St. City:Miami Shores State:FI. zip: 33138'
Value of Work for this Permit:$ 1800.00 Square/Linear Footage of Work:
3
Type of Work: ❑ Addition ❑ Alteration ® New ❑ Repair/Replace ❑ Demolition
Description of work: Wire new A/C unit and add outside sconces and switches
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ —le o CCF$ CO/Ccs--, w-'
Scanning Fee'$ __.Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
�. TOTAL FEE NOW DUE$.1 J)
(R6ised02/24/2014)
.I.
Bonding Company's,Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lenders 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. 1 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."
i.
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.
Marco Bruzzi ( Carol Invest USA,Inc.) Glenworth alker ( Cassia Electric)
SignatureSignature G4tJ
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
a,-3 day of_JCA Y-)OCI Y 0 20 11 by Z2� day of 14�3 20- by
wh0 is GIenWOh Walker Bruzzi who is ersona cy 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 PUBLIC: NOTARY PUBLIC:
Sign: CXA11 Sign:
Print: LUC,+G 6051 Print:
Seal: Seal: ;; TERRI L FLAHERTY
r' LUCIA G ISASI
t
=i?'"• "'.o t �� �� MY COMMISSION#FF078781
'= MY COMMISSION#FF182628 ''ra;� A EXPIRES January 28,2018
st 'ca
EXPIRES
(4073880 53***Flw**�#SCom�st#
APPROVED BY 7/e ) Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)