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PL-17-2431Miami 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 Is'4 BUILDING 4 fw L " aster Permit No. -9 �2C �, r 2 PERMIT APPLICATION Sub Permit No. •PA 2.1A3 1 El BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION •RENEWAL RECEIVED ()Aria( sh FBC 2010 •PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1263 NE 101 Street City: s Miami Shores Folio/Parcel#:1132050250040 County: Miami Dade Zip: Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: EAef4od Zone: BFE: FFE: 11FP e r Phone#: (305)216-2224 OWNER: Name (Fee Simple Titleholder):CLAUDIO RODRIGUEZ Address: SAME City: State: Zip: Tenant/Lessee Name: Phone#: Email: CA 1 ©nm C`j _N t (5\k, e.rX\ -- U CONTRACTOR: Company Name: ALLTECH PLUMBING, INC Phone#: (305)345-4368 Address: 2520 SW 22 ST, SUITE 2-408 City: MIAMI State: FL Zip: 33145 Qualifier Name: ALFONSO CIFUENTES Phone#: (305)345-4368 State Certification or Registration #: CFC1427250 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: City: State: Zip: 4 i,V,4 a e'V e (�^ CA Value of Work for this Permit $ W O 1 ‘Square/Linear Footage of Work: Type of Work:'`•'Addition "❑■ Alteration ❑'New• .• ❑ Repair/Replace ❑ Demolition Description of Work: RENEW'PERMIT i Specify color of color thru tile: \\ Submittal Fee $ Permit Fee $ ?T 3 (, d) CCF $ ' CO/CC $ Scanning Fee $ Radon Fee $ 2 - 31 DBPR $ 3 ' 1+:1 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ c - - qfl (Revised02/24/2014) Bonding Company's Name (if applicable) , ' is , i, • i Bonding Company''s Address . i, City State _ _ Zip Mortgage Lender's Name (if applicable) _ w� Mortgage Lender's Address City' State • Zip r r `� >•l 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 ORAN 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 f OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was /acknowledged _ before me this t`�I v " day of 20 • 1 me'1� by !i'J day of _ ( )41i , 20 y [ , by (Ctt CIA 0 P,C)C , iv PAL Ily known to 41 f f1ttC0 CipAy s � me or who has produced "astir; me or who has produced 1 4 as identification and who did take an oath. NOTARY PUBLIC: Sig Print: Seal: '*' V.•EXPIRES: November 2, 2020 ••,,,or , to. Bonded Tlw Notary Public Underwriters 044. identification and who di 04. NOTARY PUBLIC: Sign:` who is personally known to a*OANNA HERNANDEZ MY COMMISSION #FF177199 EXPIRES November 18, 2018 7) 34-0153_ FloridallotaryService.com Print: Seal: *************************************l*aR*ak*+k"k"R************************* r"RJR**** ************R*******"k"k+k"k" *** APPROVED BY /0 4''if Plans Examiner Zoning s. Clerk (Revised02/24/2014) Structural Review