REV-17-2490\0\
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
WED
CT190,1?
BY.
5�kt
FBC 20,f9{
BUILDING Master Permit No7RA) ( _ 2.:A43
PERMIT APPLICATION Sub Permit No. l—v14 2C��\
4 'v
OBUILDING ❑ ELECTRIC ❑ ROOFING IA REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
JOB ADDRESS: IS.-/ O 1 I H
60
DRAWINGS
City: Miami Shores County: - Miami Dade Zip: 3 3/ S 6
Folio/Parcel#: • Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): t NGU V (t \ 'fl Fi Phone#: 0 S 3 0 5,(•/ 9
Address: qS1 /Un2T M t )9 V
City: p (P M l /`r 0 2L" S State: �L
Zip: 3 3 7 g d
Tenant/Lessee Name: Phone#:
Email: Qf1(teo Yo'tc(`ib0 _com
CONTRACTOR: Company Name: Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ S7 QC, , v
Square/Linear Footage of Work: C(J S 12 G .
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: Li O cP t iv CT —t c' /1 71 I- -L, U ty i Mo lv
❑ Demolition
Specify color of color thru tile: �' 4
Submittal Fee $7Permit Fee $ I Q s CCF $ J /N
V •
Scanning Fee $ . 3 Radon Fee $ 2 . g'° DBPR $ Z. `ie Notary $
Technology Fee $ 0 .80 Training/Education Fee $ 0 W Double Fee $
Structural Reviews $ ZS, Bond $
. CO/CC $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
`18.60
Pw
I ,
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
Signature
CONTRACTOR
The foregoing,instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
ICI day of 60TOi5 l2- , 20 _ n , by day of , 20 , by
MI GO .L - , 7-Ep—p-A• , who is personally known to , who is personally known to
me or who has produced .1)(24 We--- Ur—EOSas 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: n: Print
Print: 1e���'7�",t�.A/ L���Z�-�i Print:
-T'IrYYw.. Y r
Seal: 2� 7P`' Notary Public State of Florida Seal:
Sindia Alvarez
),-.4, z-- My Commission FF•156750 —-' .
• > 4o, toy E pires 09/03/2018
****************s,�lk�?*4*lk*#***4.41*jt*iir **s******************`***************** sue. ************* **********
APPROVED BY
647;(5/()
Plans Examiner
•
I.. J Zoning
�f
(Revised02/24/2014)
Structural Review Clerk
95 0 POQ7N MIRh1i Av
d"11cNOQeS 33P56
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R CEI f
DE 277
Fences Good Side Out. The vei:ical and horizontal I
supporting members of a fence shall face the
interior of the plot on which the fence is located
and the finished side shall face the adjoining
lot or any abutting right-of-way. _ 44
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Out. the vertical and horizo l
Fences Good Side
r,b�rB ot a fence shall faceSri
supporting n,e�is ioc,
lot on ^.hlch the fence s �i +9
interior of the PA l alde shall face the adl
and the fini51 ��c. -� ---r
lot or any abutting right-of-way.
•/Y, /or 5
FLAI OF • SU Y=:Y
for
I. R . RANKIE
ENGINEE '•S CE.-tTIFICATE:
0
7.0
I hereby certify that -
Lot 4 and the North half of Lot 5,
in Block 131, of "MIAAL:I MORES.
Section 6," according to the plat
thereof recorded in. Plat Book 10,
rage 39, of the Public Recorde •
of Dade County, Florida, have
been surveyed under my direction
and the building located ae ehoan
hereon, November 28, 1938.
There were no encroachmente.
Liegistered Land 3u.rveyor
:-tegistered Engineer 6.67
State of Florida.
Miami Shores Village
APPROVED
BY
DATE
ZONING DEPT
113
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BLDG DEPT
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';I IIIJI CT I O C0MI'I IANCE WITH ALL FEDERAL
-_
',IAIt /\NI)(A'1 NIYRIJ%L.6AND- RFa1JC7VT1UNS
32.
ONE Jlo.P f N
/30 0
Fences Good lde` •ut. The vertical and horizontal
suppDrttng members of a fence shall face the
inte for of the plot on which the fence is located
an the finished side shall face the adjoining
lot r any abutti g right-of-way.
• ..
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.
W. T. EEP'TING
5150 N.MV. 22nd, Ave.
Miami, Florida.
fB / "9 96
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RE-
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Fences Good Side Out. The vertical and horizontal
supporting members of a fence shall face the
interior of the plot on which the fence is located
and the finished side shall face the adjoining
lot or any abutting right-of-way.
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