DS-19-1794�1\ZCV
BUILDING
PERMIT APPLICATION
Miami Shores Village
c
Building Department AUG 2 201
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 t
Tel: (305) 795-2204 Fax: (305) 756-8972 BY:
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
Master Permit No.
Sub Permit No.
F-1 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder)" \ �l u ALA Phone#: , 0I
Address: _-1 63 Z A/6 i) ' _' A,,,— (La
City: I,U/kf S a( S State: R— Zip: 3
Tenant/Lessee Name:
Email: /t 14, I p � I , 6 ' p, -kA- (0 el -7
CONTRACTOR: Company Name:-�nii�i� 1 t uiku V Phone#:
Address:
City:
Qualifier Name:
State Certification or Registration #:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City:" " State: Zip:
Value of Work for this Permit: $ ��� Sq.tiare%linear=Fobtage•of�Work:
Type of Work: F-1AdditionElAlteration ElNe_w El" epair/Replace ❑Demolition
Description of Work: ✓� lI/l �r.� C�Jct; o'd — ' T � ckikyC"'-Ouea
Pro SG 4�et " A....h
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CU?"4" 4 2
(Revised02/24/2014) ,
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
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
OWNER or AGENT
The foregoing instrument was acknowledgedtefcee this
day of F— 20 by
�V ci "v who is pgrsonally known to
me or who has produced I JIIIW i I I (UfV>%" as
\`\%AtIIIIr11Tl l
teond did take an oath 0,��N, �aDY !•/Zj�c fizz
clN24 {��%NAGG 287268•
Print: sAdYIto, _ •'.i'lpa►dedd`��'
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: STA `` Seal:
as
**:***s*****.***::****s:**rs**ss**•****************.****•***.**:***:**::**: **:**:*:.:(:,,s*:**s*s*s**:**�*
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Q
0Arlenis Silvera
From: David Halabu <dhalabu@hotmail.com>
Sent: Thursday, August 29, 2019 3:29 PM
To: Arlenis Silvera
Subject: Re: permit information DS -08-19-1794
Arlenis
I would like to cancel this permit application for the artificial turf
Please let me know that it is canceled
Thanks
Sincerely,
David Halabu, CAIA
♦j THINK BEFORE YOU PRINT.
Confidential: This electronic message and all contents contain information from David Halabu which may be privileged, confidential or otherwise protected
from disclosure. The information is intended to be for the addressee only. If you are not the addressee, any disclosure, copy, distribution or use of the contents
of this message is prohibited. If you have received this electronic message in error, please notify us immediately and destroy the original message and all
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From: Ismael Naranjo <Naranjol@msvfl.gov>
Sent: Friday, August 16, 2019 9:20 AM
To: David Halabu <dhalabu@hotmail.com>; Arlenis Silvera <SilveraA@msvfl.gov>
Subject: RE: permit information
Good morning David,
Attach please find the Ordinance for the artificial turf with all the requirements.
Thank you.
Ismael Naranjo, BO
Building Director