REV-18-17304'‘ °
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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
66
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
El PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS: i 1 fJ ( Icdo'
❑ REVISION
4{,1D
18
FBC 20)1
Master Permit No. 1 C7;1 . \ 1 1
Sub Permit No. Pt))/ l 1130
❑ EXTENSION ❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip: 3,3 Ira
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: eel Load: Construction Type: Flood Zone: BFE: _ FFE:
OWNER: Name (Fee Simple Titleholder): Mtliaa- t44. V'e-✓°€C_
Address: 1 t1/4.1(Ai Ioaf
City: 1" itt wi 511..wState: Zip: S ) /iT
Tenant/Lessee Name: Phone#: g t —b'S 7 " 179
Phone#: gq'r-" 7 -7 ?
Email: /t'i.�L,k&t L� Aarl4e-✓wale e „tat I. (Awl
CONTRACTOR: Company Name: Se, r rronr arl5/-rticf(t0^
Address: 1/ /(,2 % 5c•-.7 /0 ci/ i 51" - yL3
City: /4 State: Fe___
Qualifier Name:
JZ SpefF r1 1
State Certification or Registration #: (.GC. /524rq 3Z
DESIGNER: Architect/Engineer:
Address: City:
Phone#: `20 '217-9`j7-o
Phone#:
Certificate of Competency #:
Phone#:
State: Zip:
Value of Work for this Permit: $
Type of Work: ❑ Addition
Description of Work: i"-- tr-) j 0s
c
:3/ o
Zip: 336%
`30S--2 f.q -11
Square/Linear Footage of Work: S-/ /1;
❑ Alterationeti❑ New
❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ Os:). ' CCF $ 1 • SO CO/CC $ 0
Scanning Fee $ Radon Fee $ C.A. DBPR $ c� Notary $ q
Technology Fee $ 2 ' ' ° Training/Education Fee $ O - ;•6) Double Fee $
Structural Reviews $ Bond $
0
TOTAL FEE NOW DUE $ ) I - 1 O
(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 rein • ection fee will be charged.
Signature
0 NE' or AGENT
Signature
ONRCTOR
The foregoing instrument was acknowledged before me this The foregoing instrut was acknowledged before me this
, 20 f/ 8 , by ? b lday of Tip/ c, , 20 /7 , by
.7114 ! �Ir/� U
o day of
/� rC,� r+. ( /�(/���✓U d<C , wh o is personally known to
, who is personally kno o
mar who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign.
Print:
Seal: • i
I'
,,,.,�' , � rG... KAftEN C.S .Q
mod= Notary Public - State of lorida
• Commission # FF 23 740
4,40 My Comm. Expires Aug 17, 2019
„,,• Bonded through National Notary Assn.
*******************************
APPROVED BY
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
4
*************** **************************
Plans Examiner
COMMISSION 1 FF185472
EXPIRES: December 28, 2018
WWW.AARONNOTARY.COM
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Viiiage
'Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: 07-05-2018
Permit No. 18-1730
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1. According to the aerial view there are several trees within the front setback of the property that
appear to be in the location of the propose driveway. DERM tree section approval is required.
Ismael Naranjo, BO
Building Director
Email: bo(umsvf:.gov
M)c-,-3frkix-r (--(,/t2(117( f'Obt
9 4, f-re-A
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Roberto Abrahante
Engineer III
REGULATORY & ECONOMIC RESOURCES- (RER)
Environmental Resources Management
11805 SW 26th Street
Miami, Florida 33175
T 786-315-2810 F 786-315-2919
abrahr@miamidade.gov
miamidade.gov