PL-18-930 (2)Miami Shores Village
Building Department
100SO N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (30S) 79S-2204 Fax: (30S) 7S6-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
■❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS:
C l 6 ,,, Can CG v rLsC
f FF BC 2}0� q
Master Permit No. �
Sub Permit No.?L I 0 `-5 0
❑ REVISION ❑ EXTENSION ❑ RENEWAL
2"EHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 3G06 -G 17 - d d- 30 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): o 13ci Nad Tp 7c, 6,-; h Phone#: G5N- C09 95V 3
Address: 401 (;ron Cor Cc�ft-S -
City: { o r„ S 1Y., State: �t Zip: '3 31 38
Tenant/Lessee Name:
Email
Phone#:
CONTRACTOR: Company Name: . �ld��s �'r&'::6 Phone#: '3O5 = 5 Z 5 Z 1 r
Address: -/719� Fg .C,uJ <Z_
City:i'�J.les�s State: Y Zip:
Qualifier Name: �Q icJE �c v � �� A-;' Phone#: ---O 'C-- '6 - S
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Certificate of Competency #: 0 3 -U O CC) ?
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ - r— Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Demolition
Description of Work:
ha'T►, ,item
e
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
,r cc,
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
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 on 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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
1 day of J Q' , 20 J2 by
Mad *w Z who is personally known to
me or who has produced 0 L o ►� T�'lL as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
2-5 day of 20 1 � by
�.r,E 6 dZ.ai4ti who is personally known to
me or who has produced J)I bA7�— as
identification and who did take an oath.
identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
Sign:
Sign:
�—
CC
Print: �-�i�
V�.?.�
Print:
A
Seal: Vie• �66y,,
Suy*T. asqueZ
Commission # FF942611
Seal: 2 P =
uyap Vasquez
Commission # FF942611
Expires: December 9, 2019
Expires: December 9, 2019=o—a�c��
Bonded thru Aaron Notary
Bonded thru Aaron Notary
APPROVED BY
Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR / ARCHITECT
Permit N. PZ- 4- t8- r 3 )
Owner's Name (Fee Simple Title Holder): G ap:4 z 6,;k Phone #: ct54 " 6&B- 95 �13
Owner's Address: -4-a 1 G; t, r � cc, Se —
City: 1-41 a/,,; 5bt I-e. State Zip Code: 33 1 3Y
Job Address (Of where work is being done): Cc n C'or Cc,,,, Ye
City: Miami Shores State: —Florida Zip Code: "- 5 CV
Contractor's Company Name: MPS c-F crn i Phone #: !�f6 g�56 446'90
Address: `a-q 5s t,, , 4S i4v
City:4,.lt4l! State: Fy Zip Code: 5 3-(&
Qualifier's Name:. ti t9kt ! t-1 A 359n0i Lic. Number: C FC 14 d6 'f-
Architect/ Engineer of Record Name:
Address:
City:
Describe Work:
State:
Phone #:
Zip Code:
hereby certify that the work has been abandoned and/or the contractor/architect
is unable or unwilling to complete the contract. I hold the Building Official and the
Miami Shores harmless of all legal involvement.
Signature Signature
Owner o Agent Contractor or Architect
The foregoing instrument was aknowledged before me The foregoing instrument was aknowledged before me
this 25 day of Ja_,201$,by O c % this 2-5 day of,�_, 201� by 14a ssa^
Who is personally known to me or who has produced who is personally known to me or who has produced
D Lyv,\ -4 7 a as indentification.
Notary Publi :
Sign: L,
�,un
Seal: 2 c�XP %,� uyap T, squeZ
Commission # FF942611
"- Expires: December 9, 2019
„°;���`
Bonded thru Aaron Notary
Notary Pub
Sign:
Seal: ;�W (/i Suyapa T. Vasquez
_ Commission # FF942611
Expires: December 9, 2019
Bonded thru Aaron Notary
as indentification.
Miami Shores Villa a ' �'�'Ivr
g A R 1 18
Building Department f
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 11
BUILDING Master Permit No. Rc- l e — -` 29
PERMIT APPLICATION Sub Permit No. P L 1 B_ 9S O
BUILDING ❑ ELECTRIC ❑ ROOFING REVISION EXTENSION RENEWAL
AP
PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: �±o 1 6Arga OL—:1,UC-d N2��
City Miami Shores County: Miami Dade Zip:
Folio/Parcel#: ��`�-�� �' Zi �l� Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: /FFE:
OWNER: Name (Fee Simple Titleholder): 6144 M OU-82OH Phone#: trOO�T'.
City: &4.&1 / S�o �� State: V-L Zip: _IV 3 6_
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: °/`'�
City: 14"IeG14 State: Zip:
Qualifier Name: IAr�� h'f�SSt9r Phone#: 7off- d S�- clu,1e1°
State Certification or Registration #: Of;-- Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ D lit
Description of Work: 0`11
t4 1
Specify color of color thru tile:
Submittal Fee $ SO Pa Permit Fee $ ,�CCF $,
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews S _
CO/CC $
DBPR $ Notary $.
Double Fee $
Bond $ O
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lenders Address
City
State
Zip
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 20J by
rX CL who is personally known to
me or who has produced A 6� ras
identification and who did take an oath.
NOTARY PUBLIC:
Sign: 6
4A-a Ole
Print: L--4f -Q
Seal:
Ole
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
Zq day of AQ/ZCLi . 20 /, , by
, A4,r f who is personally known to
me or who has produced L At!) Al as
identification and who did take an oath.
NOTARY PUBLIC:
'-' Sign:_ LS�fl.c
Print: 0 /a1—a
Clara Capote Seal: Clara Capote
Commission # GG17667v ����-
Expires: January 18, 2022 _rl
__ Commission # GG176675
Bonded thru Aaron Notary ;Expires: January 18, 2022
', to .:$padedRttuu aptar)
L� �nu%
APPROVED BY
Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk