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REV-17-354 Miami Shores Village Building Department BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING rida 33138 972 762-4949 JAN 0 6 2016 FBC�2014 -Y.� Master Permit No. �v 6 — 1`o 1 Sub Permit No. 06-N ` 1 ^-33 REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING 0 MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1201 NE 94 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3205-010-0010 Is the Building Historically Designated: Yes NO n0 Occupancy Type: R-3 Load: Construction Type: V-B Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Bernard Lee & Demetrlo T Loris Address:1201 NE 94 ST Phone#: 954 673 6513 City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: bleehp@gmail.com CONTRACTOR: Company Name: C1 T D COOL; `u vl L�.0 Phone#: 7 3 6 34 4S11 Address: 1 1 /� �J V) (U4- t"� 2L IA City: 4" (P L t. A'R State: Zip: 3 3 0 I Qualifier Name: I-- U I S ?E (Le-2— Phone#: Ib - ? 7 b -'tJ 1 I State Certification or Registration #: I C E CAC— (W10 1 7 Certificate of Competency #: DESIGNER: Architect/Engineer: Cesar M. Cano Address:4906 Campo Sano CT City: Coral Gables State: FL Zip: 33146 Value of Work for this Permit: $ Square/Linear Footage of Work: 528 s.f. Phone#: 305 740 7929 Type of Work: Addition ❑ Alteration Description of Work: AP7(TlE e7 l��►�b-`t' ❑ New ❑ Repair/Replace % :p'P' ' -vt7M ❑ Demolition Specify color o for thru tile: Submittal Fee $ Permit Fee $ D00 GtD CCF $ 0 CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ « ._ © Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ l tK (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 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 CLAA CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this t'F ' day of ,.!C" -t1r'€ - , 20 1 (' • by 2Q't'`A day of , 20 (. , by 'e04,CtrAt, PA , •,who is perso y known ro me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: yg1lIN;11 �'. SANOy1/4Oir. ti \;16sIUN 6,,p • �G2S, 2ofr • • o` • . , who is persona lyknawala. .e.ue or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: *************************** **1;;;;I::°;w- '"#atEetEfigl.tr:e*.%4: ::****************************** i\�CO ,.,a° e Plans Examiner APPROVED BY •cw \SSION�p•, f^, ;ccLc,2o, •2o�Fs. 2 P ; EE8EO& 0 hJ` a ***** Zoning (Revised02/24/2014) Structural Review Clerk