REV-19-1588Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
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BY:
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FBC 20( A
BUILDING Master Permit No. CC -11-18-3517 fZ_EV�
PERMIT APPLICATION Sub Permit No. TV-�o- (q- IGO
F-IBUILDING F-1 ELECTRIC 7 ROOFING K REVISION F-1 EXTENSION RENEWAL
PLUMBING F_� MECHANICAL PUBLIC WORKS F-1 CHANGE OF F-1 CANCELLATION F-1 SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9801 NE 2nd Ave
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3206-013-4380 Is the Building Historically Designated: Yes NO X
Occupancy Type: A-2 Load: 150 Construction Type: III Flood Zone: X BFE: FFE: 10.35'
OWNER: Name (Fee Simple Titleholder): 9801 Park LLC
Address: 4141 NE 2nd Ave. Suite #204A
City: Miami State: FL
Tenant/Lessee Name: AMARANTHINE RESTAURANT
Email: yiannikg@gmail.com
CONTRACTOR: Company Name: A -Gov
Address:
City: Miami
Qualifier Name:
C A4A-%-j
FL
Phone#: 305 455 1800
zip: 33137
hone#: 9543944140
hone#: 305 219 0427
State Certification or Registration #: Ci�C. 2 L � Certificate of Competency #:
DESIGNER: Architect/Engineer: The Architects Group Phone#: 305 740 0150
Address: 8000 NW 7 Street
Zip: -J 5/.� .s-
--, s Zg>' •73t7
Value of Work for this Permit: $
City: Miami State: FL
Square/Linear Footage of Work: 2410 SF
Zip: 33126
Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: Revisions to plans including MEP to
Proposed new corner Restaurant in existing Shopping Center, all interior improvements.
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Specify color of color thru.tile: r
Submittal Fee $"":` `?, ---—Permit Fee $ CCF $ • CO/CC'$
Scanning Fee $
Technology Fee
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 00
Bonding Company's Name (if applicable) N/A
Bonding Company's Address N/A
City State
Mortgage Lender's Name (if applicable) N/A
Mortgage Lender's Address N/A
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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
The foregoing instrument was acknowledged before me this
dray of 20 0_, by
day of 20 by
-b�
7 (%L who is personally known to
K/„1 who is personally known to
me or who has produced as
me or who has produced as
identification and who did take an oath.
identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
Sign:
Sign:
Print:
Print:
,1 �e .• ANAYS LAGO
Seal: _ • �;1c .
�. Nota Public -State of Fiorica
: 'yr :� • ANAYS LAGO
Seal: ...
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>�; Notary Public . State of Florida
=Rg; Commission = GG 2116553 ye,
`,fps My Comm. Expires Oct 26, 2022•
^.: pi ? �; Commission k GG 2 16553
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�t fti. My Comm. Expires Oct 26, 2022
Bonded through National Notary'Assr.
•
$lr ded through National Notary Assn.
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)