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REV-17-2597PERMIT #.EN 2 q ---4 n _ J CONTRACTOR: F & -I n^ QKl r1'v�� (� A pry\ _n -- SUBMITTAL DATE: 10 L 3 1 1 '.� ADDRESS: 2: - I) E S -}-- NAME: P 1 e S-h Y I Dpo 1 eS RESUBMITAL DATES: PROJECT TYPE: V__,vv S L C91 ZONING PLUMBING STRUCTURAL e. NICAL ii�� ELECTRICAL Y.) BU( ING License Insurance - Liability Insurance - Workers Comp Local License Occ. Florida Roofing License # NJCGL000000062303 083043296 185-976 BROWARD CCC1325516 Expiration Date 10/20/2014 10/20/2014 09/30/2015 08/31/2016 OFING INDUSTRIES INC Insurance - Liability Local License Occ Insurance - Workers Comp Local License Occ Florida Roofing t CONSTRUCTION INC Local License Occ Worker Comp Exemption Insurance - Liability Florida General GL0211718 MUNI-30-1434224 WC71949 1434224 CCC044009 CGC1509421 202736948 0185FL000395 q. CGC1509421.,, 05/25/2012 09/30/2007 01/01/2012 09/30/2012 08/31/2012 ` r09/30/2014 `10/12/2014 09/25/2014 08/31 /2014 AS PLUMBING CORP Worker Comp Exemption Insurance - Liability x Plumbing License x Plumbing License Local License Occ 010907945 CP323949 �e . 25916 LP GAS INSTALLER 24720 MASTER QUALIFIER 6573050 10/05/2014. 07/09/2015 ;,. 08/31/2014 07/15/2017 09/30/2014 IVlldl I II JI IUI CJ V IIId�C \� 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: 12 I- NE 9 t RECEIVED OCT 31 2017 FBC 201� Master Permit No. 1C-- 1 Sub Permit No U 1=1- ZSci+ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Folio/Parcel#: AA -3g06 - 0 ( -054(0 Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: 6 k Flood Zone: Zip: 33i( 8 NO X BFE: FFE: OWNER: Name (Fee Simple Titleholder)TC61 c C � e( 4e 5 J(JC57 Phone#: r86 / 588 Address: 93 3 61,0 a �e P City: Coconut WOO ?_ Tenant/Lessee Name: 1 11I/A Email: (V A State: CONTRACTOR: Company Name: G .l�r)f cove met Address: ,25 3 6 W 8 6 City: Hi Q l ec_ b State: Qualifier Name: -F dor Oct c �/�(i� ,/ State Certification or Registration #: (, C 4 5 98 0 "1 DESIGNER: Architect/Engineer: ,f f'55V)QtI JI cf C 11 Phone#: Zip: 3 3 4 33 Phone#: rs6Q.9 0551 Address/UL 65 6 c2 7 5 Value of Work for this Permit: $ 3600 r 00 Type of Work: ❑ Addition XI Alteration Description of Work: 0,haO e d n I\ ikdi - 5+a ((dl 'I 001 t nut) eiectc'cpcxe Sh Phone#: Zip: 330(6 Certificate of Competency #: (7 -i1 Phone#: rg5232& City: %7rQ YYl & State: Zip: ,5 J _` 5 Square/Linear Footage of Work: ,I 0 0 ❑ New ❑ Repair/Re lace ❑ Demolition ein I (ft n �a�f�� nq i L+l beck►rcoca W �c heo -fb c 5e_ i et 42, Specify color of color thru tile: Submittal Fee $ " Permit Fee $ (VS • Scanning Fee $ (5 • Cok. Radon Fee $ 2. - Technology Fee $ 3 - 2-0 Structural Reviews $ Training/Education Fee $ CCF $ 2. 6 CO/CC $ DBPR $ 2 ' -PI Po) Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE 5 130 ' �� 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 approa a reinspection fee will be charged. Signature 0 ENT The foregoing instrumen��t``"s ac''owledged before me this 2 3 day of OLi��' 11 , 20 11 , by FFCf1occdv pIQ , who is personally known to me or who has produced 1LO� identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 1i1)-RhaS raL4LA&t `t Seal: ********* P' Notary Public State of Florida WAQAAS MERCHANT My Commission GG 151486 or Expires 10/15/2021 APPROVED BY as The foregoing instrument was acknowledged before me this 7..3 day yof..�� L ©\Q i , 20 11 , by Neet() /?��JGt.S" U ( p,, who is personally known to me or who has produced 'FL DI.- as identification and who did take an oath. NOTARY PUBLIC: f Sign: Print: Seal: ******************* $ Notary Public State of Florida 11 WAQAAS MERCHANT . z My Commission GG 151486 "ia dr Expires 10/15/2021 Plans Examiner Zoning Structural Review Clerk