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EL-16-2796 (6)IVIM1111 JI IUI CJ V IIIdgC 5BY: FT�T� i Building Department 1410050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING Master Permit No.z u b— i PERMIT APPLICATION sub Permit No. ❑BUILDING ;Q^�EEECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING [:]MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [::]SHOP //� CONTRACTOR DRAWINGS JOB ADDRESS: l��/ / 1� C���—� "J (l (S_ 7— Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE:/�/� FFE: JI1 // OWNER: Name (Fee Simple Titleholder): �/i ` �/ Q�✓//!�(� Address: 20533 &_r A4V_ S V Iy3 J 2 City: /<1 , State: �� Zip: 331fo Tenant/Lessee Name: 11 Phone#: 305- °l Dy l h tl) f Email: '9� /�p 2W'k%oN"'f - CONTRACTOR: Company Name: FOSTER AND SON ELECTRICAL CONT. Phone#: 786-423-8905 Address: 2498 nw 3rd street miami florida 33125 City: State: Zip: Qualifier Name: JORGE L. FOSTER Phone#: 305 345 3134 State Certification or Registration #: 99E000259 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: .9a Value of Work for this Permit: $ ,� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration �.1N-tNrertw ❑ Repair/Replace ❑ Demolition Description of Work: KW .yz O�L , Specify color of color thru tile: Submittal Fee $ h'�,W Permit Fee $ f y3 � © CCF $ CO/CC $ /W Scanning Fee $ 3 '' // Radon Fee $ DBPR $ Notary $ Technology Fee $ � ' �O� Training/Education Fee $ "YoDouble Fee $ Structural Reviews $ Bond $ a, V� 14.12- TOTAL FEE NOW DUE 9 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. /J ,Signature - OWNER or AGENT The foregoing instrument was acknowledged before me this 23 day of 20 by —Al� ma t- %�(nj"�►a who is personally known to me or who has produced identification and who did take an oath. NOTJP;LIC:Sign:Print Seal: ,..rrrrrrr, ••r r�, �hrnu s**s***s*s APPROVED BY CRISTY A GARCIA Commission # FF 926841 My Commission Expires OCtoher 1 A oni n as The foregoini(instrument was acknowledged before me this — day of �-r.,+ 20 L t , by P??�-}'rle' , who is peSonally known to me or who has produced � as identification and who did take an oath. NOTARY PUBLIC: Sign 0 vl—�g Print: ) CA - 141yay JMICa Olaaels Nvern Seal: JAM44L NOTARY 7UBUC STATE OF FLORIDA . Comm# FF24IN5 s*s**s**:ssss***ssss*s*s**sss s**�Cpklq$t;�p�gss**ssss*s*s Plans Examiner Zoning Structural Review Clerk