REV-19-1698r
Miami Shores Village RECEDED
g JUL 2 4
Building Department - 2°n
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 2011
BUILDING Master Permit No.RF-01-19-151
PERMIT APPLICATION Sub Permit No. 2.fz�j,W—t—((0g�(
❑BUILDING ❑ ELECTRIC ROOFING ❑E REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 39 NW 101 ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1131010180210 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Benisoi Pierre Phone#:
Address:39 NW 101 ST
City: Miami Shores State: FL Zip: 33150
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: NATECON Corp Phone#: 7863894968
Address: 435 NE 164 TER
City: Miami State: FL Zip: 33162
Qualifier Name: Wilbert Fader Phone#: 7863894968
State Certification or Registration #: CCC1329000 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ —VO Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: Permit revision to change small roof section from Concrete the to low slope
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $ _
Technology Fee $
Structural Reviews $
Permit Fee $ CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
CO/CC $
Notary
Double Fee $
Bond $
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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
F1
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 $1500, 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 Signature
OWNER or AGENT CONTR
The�regoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of V1 20 � by day of 20 /, by
ho is personally known to who is personally known to
me or who has produced �f 1 d S 1! iG as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:=�
Print:
v
Seal:
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APPROVED BY
Print: _�� = Commission # FF964172
RAPHAELA ST. AUDE Seal: expires: February ,
Notary Public • State of Florida M Bonded ft Aaron Nl
Commission # GG 051620
My Comm Ex fires Nov 30, 2020 °
§ 4
111I / Plans Examiner
Zoning
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ROOF ASSEMBLIES1AN A00 OF
U(2 4 ?alrcz= q r%
dition (2014) ; `t; �\� X ; 7
High -Velocity Hurricane Zone Uniform Permit Application Form\
Section A (General Information)
Master Permit No. 1 — l� S) Process No.
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Contractor's Name_ L�l r" , 1 r W V 3 tea \A
Job
'' ROOF CATEGORY
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Low Slope ❑ Mechanically Fastened Tile 6410rtar/Adhesive Set Tiles �\ 1/
❑ Asphaltic Shingles ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes vA
I
❑ Prescriptive BUR-RAS 150 1
ROOF TYPE
❑ New roof ❑ Repair ❑ Maintenance C Reroofing ❑ Recovering
ROOF SYSTEM INFORMATION • • • •
Low Slope Roof Area (SF) Steep Sloped Roof AREA (SSF) al (SF) •"•
•• .�....
Section B (Roof Plan) 0
: 1 •. •
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuooers and AvPlf1-Ak% irainc 1!,lltu.le Jimen- •I. • • •
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FLORIDA BUILDING CODE — BUILDING, 5th EDITION (2014) 15.97
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Copyright to, or liccnacd by, ICC (Ald. RIGHTS RFSERVED); accessed by Elicmr Palacio on Jun 8, 2015 10:32:12 AM pursuant to License
Agreement. No further reproductions authorized.
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