REV-19-1085Miami Shores Village
v � MAY 4 2
19
Building Department i )>
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY'
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit Novi-y C
PERMIT APPLICATION Sub Permit No \, (ol�l �
❑BUILDING Q ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
JOB ADDRESS:
��
DRAWINGS
City: Miami Shores County, Miami Dade Zip:
4
folio/Parcel#:. // Z G - fil ) + Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: C �)S . Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): t SO �kk Phone#: 3'139
Address: Ll G(c M L / J 2 St
City: State: Zip: 3 3 1 3
Tenant/Lessee Name: (. l Phone#:
Email: — —A t-1. Co
CONTRACTOR: Company Name: /`-/l,/ "WIMe 4
Address: Lkj_
City:
Qualifier Name:
/.
State Certification or Re strati
DESIGNER: Architect/Engineer:
hone#:
Address: City: State:
of,Work,for this.Permit: $- am &A yr " W Square/Linear Footage of Work:
rS,; e'dWork: E ]"Addition ❑ Alteration ❑ yNew ]Repair/Replace
Description of Work:` �11 �\ �� n A 1—,4 ,C A 0 n \ a , . ,, n
Zip:
❑ Demolition
Specify, co/or.o , color thrutire: r :,
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
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
OWNER or AGENT
The foregoing instrument w acknowledged before me this
day of 20 19 by
v who is personally known to
me or who l as -produced 2%& as
Signature
CONTRACTOR
The foregoing instrument was knowiedged before me this
/ day of 20, by
//UJ 4 who is personally known to
me or who has produ(;ed _-'e;&_ as
identifi tion d
ho did take an oath.
identification and wh
d to a an oath. r
ODUMO
NOTAR U LI
NOTARY PUBLIC:
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er�yo` Expires Matd125, 2021
,7441;
Sign:
Sign:
Print:
Print:
Seal:
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Seal:
Comrnission GGOTSM
+� W. Expires March 26.2021
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AVFf
APPROVED BY
Plans Examiner
Zoning
Structural Review
Clerk
(Revised02/24/2014)
FWV�
ENGINEERING SERVICES
4/23/2018
Village of Miami Shores.
Building Department.
Plumbing Division.
Re: 466 NE 102ND ST. Miami Shores, FL 33138.
Dear Building Official:
I, Roberto Barreiro, P.E., with registration in the State of Florida, engineer on record for the job at the
above -referenced address, hereby attest to the best of my knowledge, belief and professional judgment,
that:
_ It is acceptable the replacement of copper material for CPVC for the water lines.
23 011
lBarreiro, P.E.
No. 68383
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As a routine matter, in order to avoid possible misunderstanding, nothing in this report should be
construed directly or indirectly as a guarantee for any portion of the structure. To the best of my
knowledge and ability, this report represents an accurate appraisal of the present condition of the
building based upon careful evaluation of observed conditions, to the extent reasonably possible.
AW041- C
l5053 SW 57th Street
Miami, Florida 33l93
TEL.- 786.473.5813
F4401
ENGINEERING SERVICES
4/23/2018
Village of Miami Shores.
Building Department.
Plumbing Division.
Re: 466 NE 102ND ST. Miami Shores, FL 33138.
Dear Building Official:
I, Roberto Barreiro, P.E., with registration in the State of Florida, engineer on record for the job at the
above -referenced address, hereby attest to the best of my knowledge, belief and professional judgment,
that:
16[
It is acceptable the replacement of copper material for CPVC for the water lines.
011
Roberko Barreiro, P.E.
License No. 68383
Y •
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••••
••••••
•
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• •
• • • • • •
• • • • •
As a routine matter, in order to avoid possible misunderstanding, nothing in this report should be• •
construed directly or indirectly as a guarantee for any portion of the structure. To the best of my
knowledge and ability, this report represents an accurate appraisal of the present condition of the
building based upon careful evaluation of observed conditions, to the extent reasonably possible.
M&OL 01 ' t� 4Cra&&t'="
l5O53 SW 57th Street
Miami, Florida 33993
TEL. 786.473.5813
EMAIL: rbarreiro peOgmall com