REV-19-1011BUILDING
PERMIT APPLICATION
Miami Shores Village
IV
Building Department M Y 0
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 BY:
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
Master Permit No. S0q- 10/- 001
Sub Permit No. V- S-o
❑BUILDING ❑ ELECTRIC ❑ ROOFING EKEVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [::]CHANGE OF ❑ CANCELLATION ❑ SHOP
'I CONTRACTOR DRAWINGS
JOB ADDRESS: 1) '7 A 1D6 5ilyQt l
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: 112 * 6 D D 5Z 0 -?0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple 1 titleholder): J (,1�(;(j ye;�y- "N/ t/u Phone#: qjq- S88" V Z 4 1
Address:_ 11q pd'�y/ �sd f4e7t
City: m lh wl S �'4QJ' . 1 State: JAL Zip: 33
Tenant/Lessee Name: -I /n� Phone#: Y- 5'99- BZ6 1
Email: I i r W `� ?y44 @ a,0j. eoM
CONTRA(
Address:
one#: 491-Rql-3oclo
City: Vk-Mk&A(A State: P-L Zip: 3340 J8
Qualifier Name: 'T0S.F 5-044,0 E Phone#: '7arb-iq;-3090
State Certification or Registration #: C sC- 6s Z Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State
Value of Work for this Permit: $ Square/Linear Footage of Work: _
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
' f v1 1 V�4- Sodr.nf Ci
Zip:
❑ Demolition
I N
rv�t✓� S owns
Av
b� v�rE� � �o�,nS'• n� ,,� '*„�M ,t; �..c�.,arM.�ar..v..«+�-:A�..,F...�,.,,•�.� w. a...,
Specify color oltrtcnlar th .01� e..
I T K
Submittal Fee $ Permit Fee $ CCU S CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $
Structural Reviews $
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ K , Ell
(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
Zip
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 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 reinspq'Non fee will be charged.
Signatu
OWNER od AGENT
The forhaoing instrum�t s acknowledged before me this
O day of Pikl j- 20 11 —by
3 4CQGeune 1iQV�Ai', YI `,,who is personally known to
me or who has produced IVe w L#Y-k Sh+k lri al as
identification and who did take an oath.
NOTARY PUBLIC:
Seal: FLNotary
AREN M BATTISTA
ublic - State of New York
0.01BA6029060
d in Westchester County
ssionExpir s Dec 11, 2021
APPROVED BY
Signature
The foregoing instr ent was acknowledged before me this
2 /A day of I 20 by
Y_OSIC,%1QfY(Z•J(Q`LO ,who is personally known to
me or who has produced, 57"-".%-74 - KC,41' / as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Mane Mack
Seal: My Comon GO 299369
AM
missExpims 021071=3
*************************************************************
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
H
Typical Cross Section of Paver installation.
Mix I
A- Sub -Base: Existing stable compacted soil.
B - Base: 6" to 8" Inches of leveled and compacted limerock
C - Curb edge hestraint.
D - Curb: Optional height.
E - Pavers: By Gem Paver Systems.
F - Joints: Filled with masons sand.
G - Bedding: 1 '/2" screening sand.
Cross section
of standard
concrete edge.
9845 N.W. 118th Way. Medley, FL. 33178 • Tel: 305-805-0000 • Fax: 305-805-0004
Easy to Install:
Pavers can be installed in just
about any weather condition
and require no grouted joints,
no mortar, no concrete sub-
base, and no curing time.
Long Lasting:
Individual paver units are
more resilient than poured
concrete and more durable
than aspha4.. They are long-
lasting wilth : e7Cttle
• g o • rrtdintenance. ""; •
Good L00%s:'.'; •
• ••:'Ile many %nape? and color• • o •
""'i ambinationsavailable with .
•' ••'pavers wili add• value aiii�
• • • •appeal to 4w property..... •
• • • •.Recyclab6ei, . • e; o o •
.. �..In the event 6W under;round
.....repair, paveryl can be removed.
• td replaced with ease. They.
• .can also be.in4alled at aa*
• • iifferenilocation. • •
Safety:: . • • . • •
Pavers hd" 4h'hon-skid surface
even when wet. Contrasting
color banding or edging can be
used to delineate certain areas
such as pedestrian crossings,
school zones and hazards.
Fdcil de Instalar:
Los ladrillos pueden ser
instalados en casi cualquier
clima. No requiere cemento
entre sus juntas /grietas o en la
base y no necesita tiempo para
curar.
Dura mucho tiempo:
Cada ladrillo es mds fuerte que
el concreto y mds duradero que
el asfalto, con poco
mantenimiento.
Buena Apariencia:
La variedad de disenos y colores
disponibles, puede agregar valor
y elegancia a su propiedad.
Reciclable:
Si hay que hater alguna
reparation, serd fdcil de
remover y reponer a incluso
instalarlo en otro sitio.
Seguridad:
La superficie del ladrillo es
antirresbalante. Combinando
colores y maneras de instalar, se
pueden demarcar cruces
peatonales y zonas escolares.
1.4
GEM PAVER
SYSTEMS, INC.
MANUFACTURERS OF INTERLOCKING BRICK PAVERS