DEMO-18-3409P
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
BY•
NlVc08018
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FBC20 (�
BUILDING Master Permit No. QL44t 1E Z .5
PERMIT APPLICATION Sub Permit No. J� .1\4O I 8-3 kf
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
IZIPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 1t 1 !J -en s r
City: MiamilShores t� County:
Folio/Parcel#: 1/' *OT1.t'W90
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Dade Zip: SS' (a210
Is the Building Historically Designated: Yes NO I<
Occupancy Type: 13 Load: 4 Construction Type: YP
OWNER: Name (Fee Simple Titleholder): Vireo
la/�d o%► 5)//4
State:
Flood Zone: !�
BFE: FFE:
Phone#: 13‹ 0' 2 ZSS
Address: ,O'/ Mr 444" s% r
City: /l/4141 �� Zip: 33/3 e
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address:
City:
,./c‘'/ 47 5e I/
Phone#: s'? 9.6 `7230 y
Qualifier Name: ie-0
State:
6C2
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address: City:
Value of Work for this Permit: $ 2 Square/Linear Footage of Work:
Phone#:
Zip:
Certificate of Competency #:
Phone#:
State: Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
• Veht kik, hi 13 K=-, G4)0 ► w * e "2 fokr,
Specify color of color thru tile:
Submittal Fee $c30 • C.A. 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)
r
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 commenceme t must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the abjnce 04'uch posted notice, the
inspection will not be ap roved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
pC0 day of .32•46% ,20 it ,by
Ots-t!_ i "4 f ' , who is personally known to
me or who has produced as
identification and who did take an oath.
N
MI,'
•
Print:
S
***
JULIA SALA
'r°,•8��'= Notary Public - State of Florida
'Qt "a Commission # GG 242596
'? off' My Comm. Expires Nov 21, 2022
'''''' Bonded through National Notary Assn.
********
APPROVED BY
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
s //dayof /0O�"'�rl ,20 /IG,by
d_ 17 C-? " ' , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
*****************************
%( /3- 71 Plans Examiner
MEILYS AIMEE RODRIGUEZ
f ? • ,•, % MY COMMISSION # GG 255464
zz;;-�� EXPIRES: September 5, 2022
Zoning
(Revised02/24/2014)
Structural Review Clerk
-D-emo c6 -3u0�
— HectoY Tarray 0
eV\o,ed
t\\1511Feo
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pe
Parcel
73 NW 108 Street
Miami Shores, FL
Owner Information
f
Address
1121:
Block
JOAN ROMERO
73 NW 108 Street'
MIAMI SHORES FL 33
73 NW 108 Street
MIAMI SHORES FL 33
Contractor(s)
ESSIG POOLS INC
Phone
305=949-0000
CeII Phc
Type of Work: NEW SWIMMING POOLAND DECK
Type of Piping: •
Additional Info: NEW SWIMMING POOL AND DECK;
Bond Return :
Classification: Residential
Scanning:,1'