RC-17-1342}. PERMIT p` 177 "?1(47 - -
CONTRACTOR: f -c z rJn� ;kA1�S�C IrL'tl • +
SUBMITTAL DATE•" (f I.�S>I-l. "'�s.., _ �"+ Sad
xy" ADDRESS:'.: Lj9 ;IV IZct I S-r
NAME• .51-(�Ae. .-f2�i.Sl iirr _�.t,C•,;:
RESUBMITAL DATES
i'
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
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS: 144 1J 1 S �-
City: Miami Shores County:
Folio/Parcel#: 11`b10I • OVA ' dC)jQ
Occupancy Type: Load: Construction Type:
Master Permit No.
Sub Permit No.
❑ REVISION
❑ CHANGE OF
CONTRACTOR
Miami Dade
FBC2011 c"
PiCn-1-134Z
❑ EXTENSION El RENEWAL
CANCELLATIO
Zip:
❑ SHOP
DRAWINGS
Is the Building Historically Designated: Yes NO
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 3 U (rQ Ce Re' 1 denA--ic.I Phone#:
Address: 31�0 1J (P3 ID I S+.
City: l'-k \ State: F
Tenant/Lessee Name: Phone#:
Email:
Zip: 15 •1 43
CONTRACTOR: Company Name: \\? (1\ @1J1).s coc.kCC Phone#: QS4 S C1 4 }
Address: q ` AN/ - 2.\ \ 0
City: t State: FA . 136.
n
Qualifier Name: C'C P \2O Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
�r-,vct11a--oY)
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ 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
(*AMER'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 a 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
' t I (1444-11::
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 ' , by S day of A-pr.; i , 20 18 , by
, who is personally known tor\ a Pt- IZCt 1-P , who is personally known to
me or who has produced as me or who has produced 1) rr V e ►' 1 i CkevISP as
identification and who did take an oath.
identification a ho did e a .ath.
NOTARY PUBLIC: NOTARY PUBL
Sign: Sign:
Print: Print: UvnA
Seal: Seal: t�YP %V Y` �IYPRIETO r
°__• MY COMMISSION # FF 214031
' �:= EXPIRES: March 25, 2019
,,gf ;;°Q` Bonded Thru Notary Public Underwriters
****************************************e***************************sssress+s**m**4RM&*a.
APPROVED BY
Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
construction
General Contractors
Project Managers
Licensed & Insured
■ Ana I. Alzate
President
CSC #1511721
Tel: 954-599-8434
Faxt305 974-5460
915 N.W. 1 st Avenue # H 2110 Miami, Fl 33136
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\1)\� mi Shores Village
Building Department
Department
10050 N.E.2nd Avenue, Miami Shores, Florida 3313
10050 Avenue, Miami Shores. Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
BUILDING D ELECTRIC ❑ ROOFING
❑PLUMBING El MECHANICAL QPUBLIC WORKS
JOB ADDRESS: ' 1 44 „' L -
5
FBC 2014.
Master Permit No. ? e- 4 7 - 342_
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
[] CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County:
Miami Dade
Ziip:
Folio/Parcel#: I i - 31 O'I - O 19 - too S"aD Is the Budding Historically Designated: Yes
Occupancy Type: S- Load: r2 Construction Type: l.tq U ' Flood Zone: BFE:
OWNER: Name (Fee Simple Titleholder): • iZ FAO-C ' S 11'`) A( Li e_ Phone#:
Address: 3 1 3C. (J u)
NO k
FFE:
City: Pia.(
Tenant/Lessee Name: Email: A-SeJer{ex rc h 12.d1'u
CONTRACTOR: Company Name: ,Zlk\e•
State: ('L
Address: q, 4 S PJ W `/ j OF \AZ 110
City: V ( A ` f State:Ft
Qualifier Name:
Zip: 33144.
Phone#:
Zr 3e(i ) gm "I
Phone#: q,S4.S-c c 6434
Zip. J
Phone#:
State Certification or Registration #: C G C 15 II 7 2,k Certifica of Copozetency#:
DESIGNER: Architect/Engineer: �•E N3�' SA4J (�A Lj11,Zt d V }� ctf ne#. 3 1 e Zg,6
Address: 10 Z S 1 Ski.) ? Z 4/ 4010,
City: 4" � (►th.4)t State: Zip: 3 3 1 a-3 .
Value of Work for this Permit: $ "'=i' /f / o Square/Linear Footage of Work: b-}•@-s'-- up 02
Type of Work: ❑ Add' 'on I_ Alteration /+ El New Repair/Replace ❑ Demolitio
TJJ�1 i
Description of Work: Q{- CAJ �"'�}-�� �JC � S;� � �� hiCti,er �pl�,(q LY ��r-�
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ .3, IJ G 6 •9 $ 1 • Lio c0/CC $ DD• GO
Scanning Fee $ 60 ' Radon Fee $ 3 S • �� DBPR $ 3 • 0 Notary $
fij
Technology Fee $ 9-Nn . 20 Training/Education Fee $ 2.3 - 8 0 Double Fee $ e SG ( , 9 O
Structural Reviews $ t&J ' 1 O ' °3 Bond $ G°° • OD
l -L - :(pp,c7z)
TOTAL FEE NOW DUE $ S 1 3-4 .. 4I
(Revised02/24/2014) 7 L1 f'4 \ N -Afar': 2oO ` oO
44-
• n
P.-kJ N:c 5 OZD
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 (barged
CANCE((ES,,,,..
OWNER or AGENT
The foregoing instru was acknowledged before me this
1 i5— day of ikf 204_ by
�D�'!�l!` ,.who is persona known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC
CONTRACTOR
The foregoing instrument was tent before me this
5 day of � 1 , 20 _ t i 1. by
A l .,1�(,�-G` ,who is personally nown to
as m�e oor whb has produced
identification and who did take an oath.
NOTARY PUBLIC
Seal:
**:sss:sssssssssssssss*
Strractraai Review
Zoning
Clerk