PW-20-498Miami 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
ENTERED
MAR 0 6 2020
BY.--4'L—
FBC 201-7 c0
Master Permit No.
Sub Permit No. :f?�N L4 q
REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
7� j CONTRACTOR DRAWINGS
JOB ADDRESS:3
City: Miami Shores County: Miami Dade Zip: 33 i ` i
Folio/Parcel#: is the Building Historically Designated: Yes NO
Occupancy Type: :Sj;jL- Load: Construction Type: '%L)L- Flood Zone: 1-Y% BFE: FFE:
4r-kA LTC u
�p
OWNER: Name (Fee Simple Titleholder): f•- P YJ m Syy)ALPN'L Phone#: 30 S
Address: 10 I N E I d �.L <j,
City:
Tenai
Email
CONTRACTOR: Company Name: !�C�'c.46 LA�LDSC �� ��L— Phone#: TA 356 EY01;
Address: i t S '-6 S v Z (U 5--
City:
Qualifier Name: pte x.'T'
FL Zip:
ne#:
State Certification or Registration #: 6 G G 1 S 1 -7 1 _�— Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
5 3 / g�--
Address: City: State: Zip:
Value of Work for this Permit: $ 2, �O� Square/Linear Footage of Work: 3L-7. Z
Type of Work: ❑ Addition ❑ Alteration 9 New I--] Repair/Replace ElDemolition
Description of Work: IN"-�.q ) 1 13C'k'> 40tr e— V'RVt2 fit' iye-%- soSa-
Specify color of c for thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
DBPR $
Notary
Double Fee $
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 c�a reinspection fee will be charged.
OWNER or A4GENT
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
of.... r=VC -. 20 20— -by 2 -day of 1=71, x.�C�' .�...._.Zg....�.........
Zu Sh�alcS�ak.e , n f ,
who ' personally know to �( S F�11 C-O( wh is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: C �l 3 In `VU�3-
Print: LVOS-\iA4-
as me or who has produced as
identification and who did take an oath.
li[•�L'�'11�I.1�L•A
Sign: Lku-VS�-wL
Print: vAS df- WadmoLa
Seal: � " ��# Seal: �ft� W
B�,JI1yy�� mANA s
1fRlAera�t�o�rY , �► #GCW
APPROVED BY Plans Examiner Zoning
/�I�► e� Structural Review Clerk
(Revised02/24/2014) rw
Jun 13 2020 1127 HP FaxCasajr 7865804660
page 1
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: (30S) 762-4949
FBC ZO
BUILDING Master Permit No. _?o;; PA 2-0 C1.7),
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ELECTRIC ❑ROOFING ❑REVISION EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS D CHANGE F CANCELLATIO ❑ SHOP
22 }� CONTRACTO DRAWINGS
JOB ADDRESS: qJ N S
City: Miami Shores County: Miami Dade Zip: 331b (
Folio/Parcel#: i,- ! 5 ELK Z)S NCS Is the Building Historically Designated: Yes NO
OccapancyType: �_ Load: LK Construction Type: Flood Zone: P1 BFE: FFE:
OWNER: Name (Fee simple Titleholder): ��/j�a 1�i Yt !}!~�i) t Phone#. 3o 5 _3d 144X,
Address: �,I N♦� ����>L
City: m i yvrA 1 State: ;'L Zip: 33/ I
Tenant/Lessee Name: 11 Phone#:
Email: 771_19 ., "% L. U, I^'1
CONTRACTOR: Company Name: Phone#:
Address:
City: State:
__Zip:
Quallfier Name: Phone#:
State Certification or Registration #: Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
Address:
Value of Work for this Permit: $
Square/Linear Footage of Work:
State. __ Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ Newer' ` ❑ Repair/Replace El Demolition
Description of Work: C—'�C�t' 'L "� — �� —� �CA
Specify color of color thru tile.
Submittal Fee
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Train Ing/Education Fee $
Structural Reviews $ _
(Revised02124/20141
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
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
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 low 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 CONTRACTOR
Theforegoinginstrument was acknowledged before me this
day of � Uy)L 20 2 U , by
SVVVCtJ LO Vt � , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
day of
as me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC;
Sign: Lt 0-(t, Sign:_
Print: �Vl y I S�tivL� wad tAo c- Print:
Seal: (f1@ WWF1d8 Seal:
Coma#GM 63�6
APPROVED BY
Plans Examiner
as
Zoning
(Revised02/24/2014)
Structural Review
Z abed
Clerk
8AJ-V,Z�, �, a s DOZ
099b0g598L ifese:)xed dH L2:61" 0202 £6 unf
Arlenis Silvera
From:
Sent:
To:
Subject:
To whom it may concern,
Ryan Smaldone <j.and.r@mac.com>
Tuesday, June 16, 2020 10:53 AM
Arlenis Silvera
Cancellation for Public Works Permit #PW-03-20-498
Please CANCEL permit #PW-03-20-498
We will be unable to proceed with this work at this time due to loss of Job from COVID-19.
Thank you
RyanSmaldone
305.301.8266
www.toddmichaelglaser.com
www.jandrdesignmiami.com