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REV-19-1168t Miami Shores Village Building Department MQ zd1� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No. RC -01-19-214 %22J ('1 `q5o PERMIT APPLICATION Sub Permit NoTzW ❑BUILDING [k ELECTRIC ❑ ROOFING [� REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL E] PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 750 NE 97 St City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: _ Load OWNER: Name (Fee Simple Titleholder): Address: 750 NE 97 St City: Miami Shores Tenant/Lessee Name: Email: Construction Type: _ Flood Zone _ State: FL BFE: FFE: hone#: Zip: 33138 hone#: CONTRACTOR: Company Name: Sal Electrical Contracting Corp Phone#: 786-344-4762 Address: 7803 NW 199 St City: Miami State: FL Zip: 33015 Qualifier Name: Ramon Salazar Phone#: 786-344-4762 State Certification or Registration #: EC13006377 Certificate of Competency #: 03E000224 DESIGNER: Architect/Engineer: Phone#: Address: City: Value of Work for this Permit: $ dhoo, i?0 A___ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New a Repair/Replace Description of Work: Specify color of color thru tile:, Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ DBPR $ ate: Zip: ❑ Demolition Co/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ ` W 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 low 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 OWNE GEN The foregoing instrum nt was acknowledged before me this day of a� \ _, 20J by 1(0q--4SA'LL _`Guho is personally known to 1u 1 me or who has produceA�)0<"w, CCA�1 identification and who did take an oath. NOTARY PUBLIC: Sign: Notary YU011c Q` — , 3f 0" ANDRES ARROLIGA My Commission GG 160879 Expires 1111512021 _ Signature �,04i TRACTOR The foregoing instrument wa acknowledged before me this -0 day f r — 20 J'9 by °CAtd 0 -641 ZA,L __who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: 'N Print: Seal: r APPROVED BY vJ l Plans Examiner Structural Review (Revised02/24/2014) MO,4 as NI1 tU�iUCAC91 `het: ANDRES PALAGOS MY COMMISSION # GG 203282 EXPIRES: Apra 3, 2022 Bonded ft Noesry Pubic tlndeswrt s Zoning Clerk 1 Miami Shores Village RECEIVED Building Department MA, 22 2019 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 („ C FBC 20th BUILDING Master Permit No.RC-01-19-214 ' % 19 _CT ID13 PERMIT APPLICATION Sub Permit Nova -V t(:�` ! 16 ❑BUILDING ❑ ELECTRIC ❑ ROOFING d REVISION ❑ EXTENSION F—] 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#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: _ _ Construction Type: _ Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Address:750 NE 97 St City: Miami Shores Tenant/Lessee Name: Email: State: FL CONTRACTOR: Company Name: SLAZAR CONSTRUCTION INC Address: 10381 SW 138 Ct City: Miami State: FL hone#: Qualifier Name: ERIC SALAZAR Phone#: State Certification or Registration #: CFC1427198 Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: p: 33138 305-412-6355 Address: ____City: State Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New LVI Repair/Replace ip: 33186 Zip: Demolition Description of Work: l HAN JGE 0f :A CDZ45 i TA()C6T t+ZOf{ '< A)60C ?© I.1kifJ(0c otlo. Ce 'CiIE SUJIG. Specify color of color thru tile: Submittal Fee $ _ Permit Fee $ Scanning Fee $ _ Radon Fee Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $473-. 07 IL;43; I 5 i i 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 Int must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is u d. In the absen of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature :,? __ Signatu OWNER or AG C Theforegoing instrurrwnt was acknowledged before me this The foregoin i strumen�t was acknowledged before me this Jam/ day of �s 20 i"1 r''�by �� day of -{ DR'i l 120 ,19 by �hck \C,((-W�ho is personally (, SQyknown to IgAIL who is personally known to me or who has producedT(pA\-16t44_ - -CL me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: / V NOTARY PUBLIC: Sign: 1714 X Sign: % i ` `� • •`�.� r Print: �ysPrint: vA Seal: ,�..,, Notary Publle State of Flodda Seal: ANDRESPALACIOS .01 41tANDRES AR ROLI GA MY COMMISSION O GG 2=2 1011J H� My Commission GG 160879 o`,r EiES•Apri 3, 2022 �. ���� Expires 11/15/2021 '+, i;p�'' Bamnallotery � APPROVED BY ��-� �� Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk