PL-16-2755OWNER: Name (Fee Simple Titleholder): Investinghouse, LLC
Address: 2061 NW 112 Ave., Suite 131
City: Miami State: FL
Tenant/Lessee Name: N/A
Email
CONTRACTOR: Company Name: SC'A'tu-'CLC— us,
lnr t.- n r
one#: 786.521.2276
P: 33172
Address: 141
— t'
City: bi Q4a \ State: �4 Zip:
Qualifier Name: rn : `` �L C- Phone#:
State Certification or Registration #: 0a, 1l� ( Certificate of Competency #:
DESIGNER: Architect/Engineer: N/A Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ f • UZI Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New A Repair/Replace ❑ Demolition
Description of work: install kitchen sink and dishwasher, install new shower, toilet, and vanity in
main bath and master bath, install new shower and vanity in pool side bath
Specify color of color thru the:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Permit Fee $ ;;?gr CCF $ CO/CC $
Radon Fee $ DBPR $ Notary'
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
Miami Shores Village7BY.--
CEI�r D
Building Department
T�12( 2016
` `
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
T
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 204
BUILDING
Master Permit No.
P, C I(V - 2.x-5,3
PERMIT APPLICATION
sub Permit No.
P( -10 - 2-4 55
❑BUILDING ❑ ELECTRIC
ROOFING REVISION ❑ EXTENSION RENEWAL
❑■ PLUMBING ❑ MECHANICAL
❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
DRAWINGS
JOB ADDRESS: 750 NE 97 St.
City: Miami Shores
County: Miami Dade
Zip:
Folio/Parcel#: 11 -3206-014-2220
Is the Building Historically Designated: Yes NO X
Occupancy Type: SF Load:
Construction Type: Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Investinghouse, LLC
Address: 2061 NW 112 Ave., Suite 131
City: Miami State: FL
Tenant/Lessee Name: N/A
Email
CONTRACTOR: Company Name: SC'A'tu-'CLC— us,
lnr t.- n r
one#: 786.521.2276
P: 33172
Address: 141
— t'
City: bi Q4a \ State: �4 Zip:
Qualifier Name: rn : `` �L C- Phone#:
State Certification or Registration #: 0a, 1l� ( Certificate of Competency #:
DESIGNER: Architect/Engineer: N/A Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ f • UZI Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New A Repair/Replace ❑ Demolition
Description of work: install kitchen sink and dishwasher, install new shower, toilet, and vanity in
main bath and master bath, install new shower and vanity in pool side bath
Specify color of color thru the:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Permit Fee $ ;;?gr CCF $ CO/CC $
Radon Fee $ DBPR $ Notary'
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable) N/A
Bonding Company's Address
City
State _
Mortgage Lender's Name (if applicable) N/A
Mortgage Lender's Address
City
State
Zip
Zi
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 reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregping instrume -was acknowledged before me this The foregoing instrument was acknowledged before/ me this
%da y of+- (/ilfl e 20 by day of 20 10 by
who is personally known to S who ispersonally known to
1ame OS who has rod ed � —Gz� ��—f
p e or who has produced as
identification and who n oathJSA9EL MV0R
identification and who did take an oath.
NOM hmic - sat• of Harm
my fwm Nov. a' �
� � ��
L13AA BF S
11
NOTARY PUBLIC: e �3
N
NOTARY PUBLIC:
* "
WMMMISSION#FF225e
EXPIRES: ApniI 29, 2^"•
8w4vdThNBWptNoWY6eM4
Sign:
Sign:
1
Print:
Prin .
Seal:
Seal:
APPROVED BY /0/16 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)