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PL13-2733Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: PLUMBING �+� 0 2013 B Y Q-Q• — ------ FBC 200 Permit No. �FU ;�l Master Permit No b�'p 1:5 '-2�� 32 JOB ADDRESS: 57 3 N E, I" Eared City: Miami Shores County: Miami Dade Zip: 3 3 t 38 Foho/Parcel#: . 320 (P � 011 — i C Is the Building Historically Designated: Yes NO X Flood Zone: eA OWNER: Name (Fee Simple Titleholder): iJl � n J V' Phone#: C40u 4 0 Z " 7 2 Address:_ r- 73 N l02 b't1rP,e'4. City: M i O M i S hgf ep State: F (I zip: 33 13$ Tenant/Lessee Name: N Phone#: 040 4) 4 Z ' %sz 2 Email: (lop fofI . Y ► � Y-0 (a q MQ t I • GO.Yyi CONTRACTOR: Company Name: Address: 129'40 Svi ab (X5-) Z40 -q55 5 City: M i C rn i j, jk% to e: F L zip: 33030 Q (,I Z (3 U tM t� 1 a Phone#: � 30s) 'Upo -4 S 55 ualifier Name: State Certification or Registration #: W Ci 14 5 7 055 Certificate of Competency #: Contact Phone#: 00 24C - RS 55 Email Address: 0 S� @.ge4l if,- R00 S• Ga/'1r1 �i DESIGNER: Architect/Engineer: E'd U QxG%Q baxr� Phone#: (1 S(p-) 239'1 8 02 Value of Work for this Permit: $ l boo Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration XNew ❑Repair/Replace Description of Work: _ new ►pool p p� nol y45 SF Submittal Fee $ Permit Fee $ 2 Z5• `� CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $, Technology Fee $ TOTAL FEE NOW DUE $ L ❑Demolition 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 plicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be deliver d to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must at the job site for the first inspection hick occurs seven (7) days after the building permit is issued. In the absenc f such o to otice, the inspection will not be a roved an a einspection fee will be charged. Signature - -/ U/ The foregoing day of who s person NOTARY P Owner or Agefj V V 2 IS rument was acknowledged before me this ✓ _, 20 3, by &—,Vv1 6 rk',4 "I Ior who has pi As ideliffication aut i r`;ii11Y4 4ABRIEL E. Sign: Print: My Commission Expires: M take ah oath. The foregoing instrument was acknowledged before me this day of C .20 A, by 6.'� wh s personally known t e or whLd has produced as identification who didake a th. NOTARY Sign: QY RIA -� CO N # FF 030W-, Print: U Tr20i7- My Commission E ~a "�"' B `��' Undenrtiters APPROVED BY ��'//�/'f Plans Examiner Zoning Structural Review Clerk (Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) BUILDIG 3I�� Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 PERMIT APPLICATION Permit Type: JOB ADDRESS: BUILDING 573 N E 102 S-Wee-t Permit No. L; d 0 Zui3 �I BY; m__Q&e___®___ FBC 2010 Master Permit No.13 PP t J —2-7 32. ROOFING City: Miami Shores County: Miami Dade zip: 3 3 138 Foho/Parcel#: I I -1J20 (0 - 01 l - 1000 Is the Building Historically Designated: Yes NO X Flood Zone: OWNER: Name (Fee Simple Titleholder): iI obiyn J t r V Phone#: C4 Oy) y O2. — w57 2- Address: 6 15 N E 102 StYeO City: M i Cil M"I shlzre,S State: r- L Zip: 3 3 13 8 Tenant/Lessee Name: 1J (a Phone#: ( u O 4) y D Z " (08? 2 Email: U a s torn. u l CONTRACTOR: Company Name Address: j 2q q c, S" CLEA le l28 St (305) 2(00- g555 City: M I a M I StatUVK zip: 3 318 (O Qualifier Name: �- Z QU d I a lov—Phone#: ( 157 Z%0� 4 5% State Certification or Registration #: q 51 O 55 Certificate of Competency #: Contact Phone#: �305�2(0©"a555 Email Address: �OS`�YO01 S • Lory-I DESIGNER: Architect/Engineer: Fduaw-M B re*O Phone#: 1 8(P-) 2-39- 11608 Value of Work for this Permit: $ tQ ,000 Square/Linear Footage of Work: y 4 a S F Type of Work: ❑Addition ❑Alteration Oiew ❑Repair/Replace ❑Demolition Description of Work: yle' J sv4i mm,n q MCI Color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Technology Fee $ Bond $ TOTAL FEE NOW DUE $ I• k Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address VA t 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 apl promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be poste t for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of s}tcKo sted inspection will not be appr9ved and a reiAs e�;Aqn fee will be charged. ,, / 7 v Owner or Agent The foregoing instiument day of , who i rsonally kno As NOTARY PU LI Sign: Print: My Commission Expires: APPROVED BY Si Contractor was acknowledged before me this The foregoing instrument was acknowledged before me this by 6asmaday of 0 - by o I or who has produce who is ersonally kno o me or who s produced 1 let[ification tho di It o an o th. as ide �17 ation a d who did t e a o tli. NOTA RIEL E. G AADI V"' RI E UARD M COMMISSION FF 'l� My MM k FF 30887 :f XPIRES: Jul 4, 7 •• *P1R : July 4, 17 �awc Sign: + •. Print: o/o y�2o1'� My Commission Expires: vff"Y/,/ - Plans Examiner / /Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)