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REV-18-1222VA Miami Shores Village Building Department R ._ 'E0 ' 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAY 0 9 Tel: (305) 795-2204 Fax: (305) 756-8972 � r INSPECTION LINE PHONE NUMBER: (305) 762-4949 r 1 FBC 20F:k BUILDING Master Permit No. RC--3-18-542 PERMIT APPLICATION Sub Permit No.V—E\ je—\222. ❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 1080 NE 92N D Street JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 33138 11-3205-027-0400 Folio/Parcel#: Isthe Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): GUCo Holding LLC Phone#: (786) 712-6806 Address: 2700 Sw 3rd Ave Suite 2F Miami FI 33129 City: State: Zip: Tenant/Lessee Name: Phone#: Email: Juan@cpcoin.com CONTRACTOR: Company Name: Cp Construction & Investment LLC Phone#: (305) 926-0977 Address: 2700 Sw 3rd Ave Suite 2F Miami FI 33129 City: State: Zip: Qualifier Name: Carlos Cortes Phone#: (786) 317-4198 State Certification or Registration #: CGC1508210 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 ❑ Demolition Description of Work: i IG &Ar1 CA-,N 141 S �COJ— Y CIS =At LGSA— New C(0s'A A-iywC"II 1 Specify color of color thru tile: tt ff Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ �� �Jo Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ S - C7O (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 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 Signature D OWNER or AGENT The foregoing instrument was acknowledged before me this CONTRACTOR The foregoing instrument was acknowledged before me this Qq day of `I 20 to , , by _4 day of 6,ta-,4 20 (A by y� who is personally known to 0-61(LS -ice ( NJ(0\ who is personally known to me or who has produced identification and who did take an oath. 1►f0r_1:VA'111-iIrig Sign:_ Print: Seal: ;a*. yams Commissidn # GG077310 =4`= Expires: Feb. 27, 2021 •'•'•a�.,�''� Bonded thru Aaron Notary as me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: ; ��A ' A8 Montero Com ission # GG077310 Seal: Expires: Feb. 27, 2021 °•';?;a�� Bonded thru Aaron Notary APPROVED BY !3� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)