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BPP-18-2957Miami 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 BUILDING PE IT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING JOB ADDRESS: l 44 l RECEIVED OCT 0 9 2018 Q-4 T FBC 201 —1 Master Permit No. 2 ISr- Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR ei2,0„ City: Miami Shores County: Miami Dade Folio/Parcel#: Occupancy Type: Load: Construction Type: &f- / ( El RENEWAL ❑ SHOP DRAWINGS Is the Building Historically Designated: VS% NO Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): L7 4'In'" 2. &C47 -1/11i1'ts—ne� Address: ( 1 6 3 O (f c 0'T 4/)4 City: n 1 State: P L.- Zip: 1(,0 ) Tenant/Lessee Name: die#: Email: Address: CONTRACTOR: Company Name: I t 6co of � 3 City: Yet l evYh ( State: V L Qualifier Name: (. L. L_- . ,7 ' State Certification or Registration #: , _) ? - Z 1,0 Phone Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of,Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace n Demolition Desc�iption�of Work ��.` IL} � "= "r (.,'�!1 �� IF c,�� J 4 P 'PO (16 fi Zip: Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bondirig Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (ifapplicable) A Mortgage Lender's Address :City i are; r N/. _ 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 cerkify4hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating opz ction and zoning. "WARNING TO OWN ER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUPAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICErr ` 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 occur even (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved an illet rpection fee will be charged. Signature 47.43 OWN F AGENT The foregoing instrumerlcknowledged before me this day of , 20 , by , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Signatu CONTRACTOR The foregoing instrument was acknowledged before me this GI /► day of OC* ,20�_by M IGho �jl --co JJAY who is perrson�ally known to me or who has produc�d 'E'{ 1 icon identification and who did take an oath. NOTARY PUBLIC: ssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ‘vr- ofrpoLl o`-) e4' ► 2-`715 P E _ va-, t 6J 40 PC__ L uAT1 a w )\/6 —vim b /1/42 �iS (�?i'isaiT /ut Aor" 6G &,./Ge.• "ee'l Azr 0/, 4-4 /40÷ 6/1/rbe 4 ac4.44,-( 1-;,-,r Pr" MPv%k • vocc'1)0' 1 (� BUILDING vi''`' PERMIT APPLICATION 'BUILDING ❑ ELECTRIC ❑ ROOFING ['PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: ' ((00 NE- 1 01 Sfl2LCT City: Miami Shores County: 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 DC 1 : 2017 BY • !• sL14- FBC 20 I `I Master Permit No. 6 Pt7 I \ `29D Sub Permit No. El REVISION EXTENSION El RENEWAL [l CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR 4pRAWINGS Miami Dade Zip: 3Si Folio/Parcel#: I ( 32 5 02a 050 Is the Building Historically Designated: Yes NO�� 7� Occupancy Type:' Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C n, n, A C eIrtfr Address: I )°9$ 2/sL'11" - 'SvvD City: 011 4n41 546 4-r ' Tenant/Lessee Name: Phone#: State: �' Zip: 331(o i Phone#: Email: 1-11 N-MriA'DNSTTZ()QXl( )t' a•- 'i 1 Lt CONTRACTOR: Company Name: CI 44" "' Address: I I (A$ L-4 gt'V O City: ,ti. iqn.,� Qualifier Name: n" IL"6k- C'14.IL Cork.) oa..1 a3 State: Phone#: Phone#: State Certification or Registration #: I'CZ 310 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $ 3 I7°' Square/Linear Footage of Work: 4 a0 Type of Work: ❑ Addition ❑ Alteration ❑ New Zip: 71 Repair/Replace ❑ Demolition Description of Work: "71- DeLr- A 1- L 4 Lac) r nv4-' C.4." A S1-a o'd E,2 _ C LALC-illr.- arc- C: V C 1L (R- vS c{ EAo Specify color of color thru tile: Submittal Fee $ ES , Q Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (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 commenced prior to the issuance of a permit and that all work construction in this jurisdiction. I understand that a separate p FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information applicable laws regulating construction and zoning. installations as indicated. I certify that no work or installation has will be performed to meet the standards of all laws regulating ermit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, is accurate and that all work will be done in compliance with all "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 exceCdit , h = a; , ant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be e ' PP'' 4: cl I e person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted a e 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 ( The = "-goi : instrument was acknowledged before me this /I OWNER or AGENT day of C" 4 C1_, , 20 CO`Yc,P (4/> , wh me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: e/7/gis,44td •i""_'"'rk;; CHRISTIAN GUTIERREZ MY COMMISSION # GG078303- EXPIRES February 23, 2021 CONTRACTOR The foregoing instrument was acknowledged before me this day of 4L+L__ , 20 by n)fcanc,(- 14PL_ ,whoi •ersonallyk - nto me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: 4.," /S'097-7, tN (7 S" r'' Z CHRISTIAN GUTIERREZ MY COMMISSION # GG078303 EXPIRES February 23, 2021 ****************************************************************************** APPROVED BY Plans Examiner v*w vw*** Zoning (Revlsed02/24/2014) Structural Review Clerk