Loading...
PL-16-2797 (2)Miami Shores Village;c,I Building Department PR o Zoos 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 T INSPECTION LINE PHONE NUMBER: (305) 762-4949 � ` t FBC 20 BUILDING Master Permit No7vQ- (6— I)) JI—] PERMIT APPLICATION Uih Permit NnC_ I A ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ R ISION ❑ EXTENSION [:]RENEWAL E2/CHA LUMBING ❑ MECHANICAL ❑PUBLIC WORKS GE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I Z'�� n 1 r J v r 1(� 6 O �z t City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: -32 oG - ,c> i `f 63z) Is the Building Historically Designated: Yes NO Occupancy Type: rZ- Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �ot' ke Phone#: _20E, _q9O2-763 Address: /% C>1 PC c -�G 4 City: 9IOtt "A i' �J�cState:zip: 33) 3 Tenant/Lessee Name: Phone#: Email: Q ZC1Z_In1yznt!'- M-W CONTRACTOR: Company Name: Address: Phone#: -1 66 .2S I -`k L7 City: �j? �� LtA tA'c90 � �� ( State: � Zip: Qualifier Name: )UCH` lv \_a 0 ✓t Phone#: -78c �S iB (5 State Certification or Registration #: Gi-C z 6Z2J( Certificate of Competency #: DESIGNER: Architect/Engineer: �t 1 a Phone#: 3 b5 -2S 3 - S-7 ,6 Address: ��(�(�� Jew _)-} C_ City: I 1 State:' Zip: ? ; (6> G Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace Description of Work: ]11-�:� L,-k V-)— I r 0'j— S , b-- Specify color of color thru tile:. Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $ ❑ Demolition CO/CC $ DBPR $ Notary Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address: - na.i City State Mortgage Lender's Name (if applicable) Mortgage Lender's 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 c mencement must be posted at the job site for the first inspection which occurs seven (7) days t e i 1ding permit is issued n he absence of such posted notice, the inspection will not be approved and a reinspectio ee will be-cJrtfged. _ A OWNER or AGENT The foregoing instrument was acknowledged before me this day of i 1 GrtrC.� 20 16 by CL�G who is personally known to me or who has produced as identification and who did take an oath. i Sign The foregoing instr ent was acknowledged before me this day oA ov> 20 16' , by U(,tn a- v LA 'who is personally known to me or who has produced T� �� as identification and who did take an oath. NOTARY PU C: NOTARY PUB C: Sign: Sign: Print: �n�n 1 r - Paint: -V� \� Seal: Seal: 1d� ° =o � NotaryPublic State of Florida oar °�y Notary Public State of Florida `(� Dennis Lefton ? �% Dennis Lefton My Commission GG 073635 '7 � My Commission GG 073635 of t� Expires 02/15/2021 gip, Flog Expires 02/1512021 ************* ************************* **** 4A7 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 6 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. PL12172913 Owner's Name (Fee Simple Title Holder): BKT HOLDINGS LLC Phone #: 305-904-1608 Owner's Address: 2694 E. OAKLAND PARK BOULEVARD SUITE 201A City: FORT LAUDERDALE State : FL Zip Code: 33306 Job Address (Of where work is being done): 1201 NE 96 STREET City: Miami Shores State: —Florida Zip Code: 33138 Contractor's Company Name: ALDAN PLUMBING INC Phone #: 305-829-3031 Address: 2527 AMBASSADOR AVENUE City: COOPER CITY State: FL Zip Code: 33026 Qualifier's Name: ALFREDO CARMONA JR Lic. Number: CFC1428171 Architect/ Engineer of Record Name: SEBASTIAN EILERT AIA,LEED Phone #: 305-253-5786 Address: 13063 SW 133 CT City: MIAMI State: FL Zip Code. 33186 Describe Work: GAS LINE ADDITION hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to comp e t contract. I hold the Building Official and the Miami Sho es h less of all legal involvement. Signature o 7—c4t71 Signature Owner or Agent Contractor or Architect The foregoing instrument was aknowle ed before me The foregoing instrument was aknowledged before me this 15 day of MARCH ,20 by 2G, r -1 t this 15 day of MARCH 2O18by �� Q �� CU rntia+► Who is personally known to me or who has produced who is personally known to me or who has produced ALEXANDRE BURKI tRDT A as indentification. ALFREDO CARMONt Jq as indentification. Notary Pu ri c: Sign: Seal: :eY °oe Notary Public State of Florida `h Dennis Lefton My Commission GG 073635 1� OF n°° Expires 02/15/2021 Seal: ; ,,.` '= Commissio g'GG 161158 or: My Comm. Expi s Mar 13.2022 ,,,,,, fiorxled:hrojghNa na No:aryAssn, 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 or Engineer A change of contractor, architect or engineer must be done under a permit number. There is a $75.00 charge for a change of contractor. The owner will submit a Change of Contractor Form completed with notarized signatures. If the signature of the previous contractor cannot be obtained the owner must send a certified letter/return receipt notifying the previous contractor, architect or engineer the reason for the change. The owner must allow 10 business days for the contractor, architect or engineer to respond. A permit application must accompany the change of contractor form, with the information and signature of the new contractor. The new contractor must be registered with the Village or must submit the required documents to register with the Village. I. Change of Contractor form completed, signed and notarized. 2. Permit application by new contractor. 3. Required fees. 4. Copy of original letter sent via certified mail along with the returned receipt. In addition to the requirements above the architect or engineer of record must authorized the new architect or engineer to reproduce his documents. The authorization must be in writing and must be signed and sealed. �..fa.,�'• „f i»S.'..sd_v. �r,.rf `•--:.,�,�g r.�.�d,.•�....'�...rx 1.