PL-19-323Miami Shores Village P'F�c Ez
�Oxo Building Department , FEB 12 2 9
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
FBC 20 )�
BUILDING Master Permit No. ?L_" 2-lq-'323
PERMIT APPLICATION Sub Permit No.
❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
®PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 990 NE 92 ST
City: Miami Shores County: Miami Dade Zip: 33138-2911
Folio/Parcel#: 11-3206-006-0140 Is the Building Historically Designated: yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ROSALEEN HOERBER Phone#: 305-205-1117
Address: 990 NE 92 ST
City: Miami Shores State: FL Zip: 33138-2911
Tenant/Lessee Name: Phone#:
Email: coverage4u@gmail.com
CONTRACTOR: Company Name: AAA PROP IG . Phone#: 305-639-8972
Address: 8550 NW 64th St GAN69LLEU
City: Miami State: FL Zip: 33166
Qualifier Name: George Cando Phone#: 305-639-8972
State Certification or Registration #: CFC 1428813 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 4J 1 �'p 0 Square/Linear Footage of Work:
Type of Work: ❑ Addition El Alteration El New F-1 Repair/Replace F-1Demolition
Description of Work: La /nfl ry f 'gx(&_Tbr(MA 4 tot
Specify color of colorJthru tile:
Submittal Fee $ S(}�) V Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $� '
TOTAL FEE NOW DUE $ I (&('9'
666-a
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 9=26EQ c y -
OWNER or AGENT
The foregoing instrument was acknowledged before me this
(2� day of E-! L VV 0,! -J , 20 �l by
`. Ptr-' , who is personally known to
me or who has produced ' f V C/S U cR,-SR - as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
I day of9�:A 20 by
C-1Ive!5�-P 1- Cmc-+ o , who is personally known to
me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
as
Sign: Sign: ;�
Print: �tJ�►l ;� � rC� Print:I e- bV 9-��
�.
Seal: DEBORAH Y. HERNANDEZ Seal: R,� ce.: CortmKssioDEBORAHn # 1HER 4NM11DE�Z
Commission # GG 141559
Expires September 30, 2021 Expires September 30, 2021
`' ft" Thu T mr Fain kwm 800 3L�7019
oe n„• %*d Thu Troy Fain h�aur m 800.3857019 ,
APPROVED BY �Y Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)