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EL-17-2430Miami Shores Village Building Department OCT 1 20ri 10050 N.E.2nd Avenue, Miami Shores, Florida 33138O�___, Tel: (305) 795-2204 Fax: (305) 756-8972 �� , l INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201(-( BUILDING Master Permit No. _ 1 " 2L-I2(0) PERMIT APPLICATION Sub Permit n.1 1q — 2C13_0 ❑BUILDING ® ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING. D MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP j A ! ONTRACTORAI• DRAWINGS JOB ADDRESS: (� (v , l ©� CA CELL City: Miamin �® : tv Shores County: Miami Dade Zip• Follo/Parcel#: (pp cx 3OS -" a.D-v Is the Building Historically Designated: Yes NO Occupancy Type: M1-e-5. Load: Construction Type: Flood Zone: BFE: FFE: nn e oZ OWNER: Name (Fee Simple Titleholder): l�//I CCUG�i-O Rod At' CJe7i Phone#: SOS- )l�`o�a0-`T Address: ( 4 � tJ �6 ` C--\- • Q City: 1\ A ((),...rs -Ni A or.4--o State: IP) • Zip: 3 3133 Tenant/Lessee Name: Phone#: Email: C .\ CDC l b r/l N U -I I 1 vAsz C-2,- /V- eJm c • C'-_.rYu--- IP 11 0 .r. 305 6345570 CONTRACTOR: Company Name: CPS Electric, : a ; . . '1 e f , Phoned: . Address: 1600 NW 28th Ave City: Miami State: FI Zip: 33125 Qualifier Name: Angel Romero Phone#: 305 6345570 State Certification or Registration #: EC13005401 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ CI 5 C J (Th Square/Unear Footage of Work: Type of Work: ❑ Addition ❑ Alteration, Ellac Ne ❑ Repair/Re e ❑ De lition Description of Work: At o c'�t t-' - (4O, -.cy � c $,),-, i O r-ep l Cj i -- 3 =43 Specify color of color thru tile: Submittal Fee $ Permit Fee $ .3 Z SD CCF $ CO/CC $ Scanning Fee $ Radon Fee $ 3 • 3 3 DBPR $ LI • ( Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE$ 36'7.- 1— (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. 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." Notke 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 low brochure will be delivered to the person whose property is subject to attachment. Also, o 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. CANCELLED Signature Signatur= // �i OWNER or AGENT The foregoing instrumentwasacknowledged before me this t `' day of '1. U- 20 . by C AO ¢,C1�' b46`b•pLrsonally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Si Print: Seal: APPROVED BY MAHARAI K. GONZALEZ EXPIRES: November 2, 2020 i�tE t O� R1eJ Ylxu Nutery Puuni. unt,e n ers as / 9aa — /21 Plans Examiner NTRACTOR The foregoing instrument was has acknowledged before me this Z da of ®c?7 €%2- , 20 / 7 , by dj3.7 S? o , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUB Sign: Print: Seal: lfh?"'161r ",P.MIr,E? Notary Public - State of Florida My Comm. Expires Feb 3, 2018 Commission # FF 089240 Zoning (Revised02/24/2014) Structural Review Clerk Submittal Fee Scanning Fee $ Notary $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: Z 6o W ]� jG d �. 5 City: Miami Shores FBC 20 `O Permit No. 2 — 3 — 3 7- Master Permit No. , - { 2.-2. I ¶ S County: Miami Dade 3 (3. Folio/Parcel#: Is the Building Historically Designated: Yes NO ✓ OWNER: Name (Fee Simple Titleholder): C I. v T7 2,44 P c Address::/�.� j Z 6 j t d. Q .L 5 1 City: I 4 5 �s� r C S State: l Zip: 3 i g Flood Zone: Tenant/Lessee Name: Phone#: Q . 2 / , 2 2 2.1y Phone#: Email: CONTRACTOR: Companyy Name: C r nS MndfuG / L Phone#: 30 S C.-3"i 7 o Address: / l0 6 O (V w City: Zip: _�� Zip: 3 hi '4piii State: Qualifier Name: , 7 )lr�G/ I'LF i -O State Certification or Registration #: & C(') 0 0 S 0 1 Certificate of Competency #: Contact Phone#: r E Address: DESIGNER: Architect/Engineer: is r L.'-r (Q �F Phone#: efsetee a,c L c ` etze. Phone#: 9 S- Z— d 6 Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address Description of Work: ❑Altera� ❑New ORepair/Replace fr- Cam- %ice-c-r`o °Demolition ***************************************Fees******************************************** $ Permit Fee $ >S ,, m© CCF $ CO/CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ �� ' CO Bondh g 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 occ seven (7) days after the building permit is issued. In the '' ence of such posted notice, the inspection will not be approved a dare spection fee will be charged Signature Owner or Agent Signature ontractor The foregoing instrument was acknowledged before me this 0 I The foregoing instrument was acknowledged before me this day of 1%1 A`t , 20 i�, by MAUD s C Ql day of 4 , 20 /37 by who is personally known to me or who has produced I vW . wh U CENSt personally kiLo_wa.Ae or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: S ) ND Ul My Commission Expires: Notary Public State of Florida Sindia Alvarez ��rr My Commission FF 156750 or qo Expires 09/03/2018 NOTARY P ' . C: Sign: nt: y Commission E r:►"y JEANNINE RAMIREZ ,. , My Comm. ExpitaFeb 3. 2018 'Eos r. Commission a FF 089240 ************************************************************************************************************ APPROVED BY i/� l /-fb)7 Plans Examiner Zoning Structural Review Clerk (Revised 3/12R012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) • • Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. 2 — Owner's Name (Fee Simple Title Holder): ( eve4e- Owner's Address: l Z A) j ¢. 5 City: rt Of, 5 State : b- ( Job Address (Of where work is being done): City: Miami Shores Contractor's Company Name: Phone #: Zip Code:______La t26. /&% E JQL ' t State: Florida Zip Code: 3 3 i �/%'c.-/ / #&-<, Phone #: Address: /5.e 1) S)- City: ` .ii-44s/ State: F/4 Qualifier's Name : rh1z%riv Architect/ Engineer of Record Name: Address: 40 City: 6 i S S Zip Code: -.`") / %0- Lic. Number: C / ,c..92607 Phone #:3 S,2 f Z 566? zr(› State: -f — f Describe Work: G 40. c era f Zip Code: 3 ( �, hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Mi i Shores harmless of all legal involvement. Signature Signature��--- Owner or Agent Contractor or Architect The fore oing instrument was aknowledged before me�,j Z The foregoing instrument was aknowledged before me ,20t by G IO Rlir[Cthis U day of / .Qi , 20/� �„-1 v , J 1v JGh known to me or who has produced o is p rsonally known to me or who has produced this ay of Who is personall Notary P Sign: Seal: as indentification. TIFFANY JO KESTER s Notary Public - State of Florida • E My Comm. Expires Nov 18, 2018 iAi Commission # FF 177523 Bonded through, National Notary Assn. Notary Publi • Sign: • Seal• as indentification. ieY PL, Notary Public StatS t Fle,ritlq � Joanna Feliela!10 9 COPY °f POrcraiSSian FF 0 2753 F. E pjre 0.11121201a