REV-18-3171 (2)Miami 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
BUILDING
PERMIT APPLICATION
BUILDING ELECTRIC ROOFING
PLUMBING MECHANICAL PUBLIC WORKS
RECEIVEL;
OCT 161pp
FBC 20nb
Master Permit No. CC-5-18-1362
Sub Permit No. V'E_y tys t 1 0
REVISION EXTENSION RENEWAL CHANGE
OF CANCELLATION SHOP CONTRACTOR
DRAWINGS JOB
ADDRESS: 9499 NE 2nd Ave., Miami Shores, FL 33138 City:
Miami Shores County: Miami Dade Zip: 33138 Folio/
Parcel#:11-3206-013-3760 Is the Building Historically Designated: Yes NO X Occupancy
Type: M Load: See plans Construction Type: I I - B Flood Zone: X BFE: 81 FFE: OWNER:
Name (Fee Simple Titleholder): Bank of America NA Phone#: 954.541.6773 Address:
101 N. Tryon Street, City:
Charlotte Tenant/
Lessee Name: Email:
Mike.Wedel@am.jll.com state:
North Carolina CONTRACTOR:
Company Name: CAL Development Address:
6850 Lyons Technology Circle City:
Coconut Creek Qualifier
Name: Eithne Catherine Keane te:
Florida zip:
28255 Phone#:
954-292-6007 e#:
Zip:
33073 ne#: (
954)
564-0655 State
Certification or Registration #: CGC1512095 Certificate of Competency #: DESIGNER:
Architect/Engineer: Infinity Engineering Group, LLC (PERMIT CONTACT) phone#: 813-380-6930 Address:
1208 E. Kennedy Blvd., Suite 230 City. Tampa State: FL Zip: 33619 Value
of Work for this Permit: $ J LJ66 3() Square/Linear Footage of Work: j 00 O Type
of Work: Addition XAlteration New Repair/Replace Demolition Description
of work: Mill/overlay and resurface entire lot including Alley. Replacing the ADA parking stalls
with concrete instead of asphalt. Specify
color of color thru tile: Submittal
Fee $ Permit Fee $ //22 3 CCF $ ZO CO/CC $ Scanning
Fee $ [9 ' Radon Fee $ DBPR/ $ 3y
Notary $ Technology Fe&$
w_--i , Training/Education Fee $ I T 0 Double Fee $ jo Structural Reviews $
Bond $ 10 TOTAL FEE
NOW DUE $ Revised02/24/
2014)
i
Bonding Company's Name (if applicable) N/A
Bonding Company's Address N/A
City N/A State N/A
Mortgage Lender's Name (if applicable) N/A
Mortgage Lender's Address N/A
City N/A State N/A
Zip N/A
Zip N/A
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 a proved and reinspection fee will be charged.
142SignatureSignature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of 0C4&Q_ 20 1 1S by
who is personalLyknown to me
or who has produced identification
and who did take an oath. The
foregoing instrume t was acknowledged before me this R1411-
day of 20 by Eithne
Catherine Keane , who is personally known to as
me or who has produced identification
arrd wdo did take an oath. NOTARY
PUBLIC: NOTARY Sign:
y
J`'—" '
Sign:
Print:
Print: Seal: ;'
k",-I ''••
LUCY GUTIERRE2,10005 Seal: o
Notary Public • State of Florida commission
11 GG 22209 t My
Comm, Expiroit Juh 1, b22 f Bonded
through National Ntltar Assn APPROVED
BY Plans Examiner Structural
Review TARYN
L REIS Notary
Public - State of Florida Commission
M FF 997689 My
Comm. Expires Jun 11, 2020 Bonded
through Natian2i Nntw„ a... as
Zoning
Clerk
Revised02/
24/2014)