REV-19-2437'�ti� 4 IOIZS)ZU(�
BUILDING
PERMIT APPLICATI
Miami Shores Village ENTERED
Building Departm t OCT 1 5 Zo
10050 N.E.2nd Avenue, Miami S Flo�d�3�38 BY:
Tel: (305) 795-22;U.6iij3Ati�A4��
: ('05);356�8972 INSPECTION LINE 117lFBC 2011
Master Permit No. `/
1A Sub Permit No.� V to—
i �r -Z 7 3?
QBUILDING ❑ ELECTRIC FING FE-] REVISION ❑ EXTENSION ❑RENEWAL '
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
62 NE 109 ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-2136-011-0350 Is the Building Historically Designated: Yes NO
Occupancy Type: Residential Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Address: 62 NE 109 ST
City: MIAMI SHORES,
Tenant/Lessee Name:
Email: david@harrisoncrane.com
DAVID HARRISON Phone#: 305-984-9481
State: FL Zip: 33161
CONTRACTOR: Company Name: Goldin Solar LLC Phone#: 480.208.4688
Address: 3447 Percival Ave
City: Miami State: FI Zip: 33133
Qualifier Name: Daren Goldin Phone#: 480.208.4688
State Certification or Registration #: CVC56965 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ ® Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: C h anneS Ir7 La�OU�
Specify color of color thru tile:
Submittal Fee $ _ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ — (� • w
(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
Zi
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 on 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.
Ll /5 h----
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 0 C+O be r , 20 1 Ct by
L7av►d -Harr-t 5pn 'who is personally known to
me or who has produced
✓Dnv¢r (.�cerse
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: f Florida
wren bolano
SeaMy Commission GG 339437
o'J"QF Expires 05r2812023
Signature
CONTRACTOR
The (foregoing instrument was acknowledged before me this
—1 dayrrof OC.� O b er 20 N 9 by
'Dwe.�n V 6 d 1 n who is personally known to
as rn r who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
V I f0rfti-,'022�0�3
tall of FbriM
% My C6924
Seal: awe Expir
as
APPROVED BY Plans ExaminerZoning
I Structural Review Clerk
(Revised02/24/2014)
0 bQ
kiES N `'
�IORI0
PERMIT ADDRESS:
62 NE 109TH ST PARCEL: 1121360110350
Miami Shores, FL 33161
APPLICATION DATE:
10/15/2019 SQUARE FEET: 0.00. DESCRIPTION: CHANGES IN LAYOUT
EXPIRATION DATE:
04/12/2020 VALUATION: $0.00
CONTACTS
NAME COMPANY ADDRESS
Contractor
RUBEN BLAYA GOLDIN SOLAR LLC
Owner
DAVID HARRISON
DAVID HARRISON
, FL
REVIEW ITEM STATUS REVIEWER
Building v.1 Requires Re -submit Ismael Naranjo email: naranjoi@msvfl.gov
Review item used to allow building to comment during a plan review
Comments: 1. Solar panels should be a minimum of 3 feet from the roof edge on low slope roof systems.
Electrical v.1 Approved
Comments: NEED ELECTRICAL REVISION PERMIT.
MAD SR.
Structural v.1
Approved
CARLOS SOSA email: EL@MSVFL.GOV
Orlando Blanco email: null16
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October 25, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1
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PERMIT ADDRESS: 62 NE 109TH ST PARCEL: 1121360110350
Miami Shores, FL 33161
APPLICATION DATE: 10/15/2019 SQUARE FEET: :0.00 DESCRIPTION: CHANGES IN LAYOUT
EXPIRATION DATE: 04/12/2020 VALUATION: $0.00
CONTACTS NAME COMPANY ADDRESS
Contractor RUBEN BLAYA GOLDIN SOLAR LLC
Owner DAVID HARRISON
DAVID HARRISON
FL
REVIEW ITEM STATUS REVIEWER
Building v.1 Requires Re -submit Ismael Naranjo email: naranjoi@msvfl.gov
Review item used to allow building to comment during a plan review
Comments: 1. Solar panels should be a minimum of 3 feet from the roof edge on low slope roof systems.
Electrical v.1 Approved
Comments: NEED ELECTRICAL REVISION PERMIT.
MAD SR.
CARLOS SOSAemail: EL@MSVFL.GOV
Structural v.1 Approved Orlando Blanco email: nu1116
October 25, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1