RF-19-12BUILDING
PERMIT APPLICATION
❑ BUILDING ❑ ELECTRIC
Miami Shores Village RECEIVED
Building Department AUG 13 1019'?
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 0
FBC 201
Master Permit No. -- � I
�OOFING
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores C County: Miami Dade Zip:
Folio/Parcel#: U-37-06 '-01.3 -- J 750 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: ��//Fllood Zone:: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): f 1�� A&&a,/644 M- 1140 PhoneM
'07r -
Address:
City: N6011 54res State: P:6 Zip: ?313,'
Tenant/Lessee Name: w A a a a% a s a' aRhone#:
Email
CONTRACTOR: Company Name: _TLP S��L� 5 . Phone#b
Address: 5q,?)
City: Nk �A M k State: T Laa Zip: Z -
Qualifier Name: C�-���. �C�- - Phone#:
State Certification or Registration #: CC C�o Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: City: State
Value of Work for this Permit: $ Square/Linear Footage of Work: _
Type of Work: ❑ Addition ❑ Alteration ❑ New
❑ Repair/Replace
Zip:
❑ Demolition
Description of Work:
Specify color of color thhr -tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) _
Mortgage Lender's Address
City 1 i - 1 -I 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 com nceme ust be po ed at the job site
for the first inspection which occurs seven (7) days after thefbuilding permit is issued. n th sence of such p ted notice, the
y ie., -j I"
inspection will not be approved and a reinspection fee will/bppe.,chdrged.
Signatu
OWNER or AGENT
Signature
CO
Y
The foregoing instrument was acknowledged before.ri�e this The foregoing instru ent w s a edged before me this
day of 20 + a `` ?, * day of �2 20 by
who is personally known to 4 3`Sa M'C—''�tc-- who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
identification ar}dwho did take a)�oath.
NOTARY PU
Sign:
Print:
MICHAEL MARTINEZ
Seal: seal: : sE :
'" MY COMMISSION # GGD41319
'�;,. EXPIRES October 24, 2020
APPROVED BY
(Revised02/24/2014)
Plans Examiner
Structural Review
Zoning
Clerk
• `- a� ' Reiresh Search. fton . f w Save CanW
- • �+
{dans II Permits Code Cases P acts A Gcatia is R nests (� Licenses &tsirzesses j Pref. La eases �' Remidance Account • Rental Properties i= LandLord Licenses F /
Drag a column header and drop it here to group by that column � V Save Layoud ? � Clear Layout
- --- 1 ------- +I
Permit Numb Permit T Work CI i Status Y Api►ticat E Exprrati+ Q Final Da Descrrpn Q Main Address Q� Lina ttur, Rrojezt
_� _. ........ . ..._.
RF-01-19-12 Roof Flat Expired 103/2019 712/2019 RE-ROOF LOW SLOPE TAPPER TO DRAIN WELL 357 NE 97TH ST
>� r RF-06-19-1293 Roof Tile Approved 6/5/2019 2/3/2020 RE-ROOF 1 LE TO TILE 149 NE 106TH ST
- -
I
BUILDING
PERMIT APPLICATION
Miami Shores Village R8CEiv
ED
Building Department A 43 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 C(}
FBC 201 --
Master Permit No. P, -� 0 I
Sub Permit No.
❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION [-]RENEWAL
F-1 PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
�J CONTRACTOR DRAWINGS
JOB ADDRESS: �� ! /L� q/ ! /(
Citv: 40� Miami Shores Cnunt-w Miami Dwip lin•
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
A\A/AICA• fJ�mo I Coo Cimnlo Ti+loL..,I.J.�.l. �/(� �J rl'� / "`. �d ��%�+� nt....,,.u. �e� n! ��^ S 3V O
Address: 3-5-f /I'F <?0`4 I.Q'-1- ..J
City: 01--4M' / X'P4--� State: / Zip:
Tenant/Lessee Name: A/�� Phone#:
Email:
/�'�. l�� �i� ®`pow. C-)^
CONTRACTOR: Company Name: 'I -G91 'SC.A 1r1��Phone#:
Address:Zi-1�1.�
. City: ✓�t��t State: tL Zip
Qualifier Name: Poly I'f�C F-� - Phone#:
State Certification or Registration #:. ��_ t'3'3O Ito( Certificate of Competency #:
DESIGNER: Architect/Engineer:
one#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: �r� p
Type of Work: ❑ Addition ❑ �Alterattioon ❑New U6 epair/Replace ❑ Demolition
Description of Work: yZ" �L7�'1 �"�'V —�A41 `I -,, 7, t &t IV
1 -
}'t(�.. '"i Si— '�t':r,,I' 1st
color of color...tliru
Fee.$- �......_.., ._..
Scanning Fee $
Technology Fee $.
Structural Reviews $.
(Revised02/24/2014)
Permit Fie $ CCF $ CO/CC $
Radon Fee $ DBPR $ '' " Notary $
Training/Education Fee $ Double Fee $
Bond
TOTAL FEE NOW DUE $O �' 1
gnu,l(o
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 Ocomm ceme t must be osted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. I the abse ce such osted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signatur Signature
OWNER or AGENT ONTR TOR
The foregoing instrument was acknowledged before �me this The foregoing instrument was acknowledged before me this
`/3 day of Ar—t &r 20 d by n,, IG day ofLE)` 20 �by
Ac`�n V1 , who is personally known to k1 -*C b 0-1 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
NOTARY PUBLIC: NOTARY PUBLI(Y.
Sign: ,lr� Sign:_
Print:��Z?3u Print:
Seal: Seal:
Troy Tolentino
NOTARY PUBLIC •!
_STATE OF FLORIDA
' •xpires 7/23/202 '
APPROVED BY �3/ Plans Examiner
Structural Review
(Revised02/24/2014)
1�41
MICHAEL MARTINEZ
MY COMMISSION 0 GG041319
EXPIRES October 24, 2020
ane****
Zoning
Clerk