CC-17-1110Miami Shores Village E
(p` pp 12017
`� 5 Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 '
Tel: (305) 795-2204 Fax: (305) 756-8972
V INSPECTION LINE PHONE NUMBER: (305) 762-4949
q _ - FBC 2014
BUILDING ,,�„�� 1=�� Master Permit No. 0
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9280 Biscayne Boulevard
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 3 g66 d { L- l q� Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: I FFE:
OWNER: Name (Fee Simple Titleholder): James Dentico Phone#: 305-756-6553
Address: 10055 Biscayne Boulevard
City: Miami Shores State: Florida Zip: 33138
Tenant/Lessee Name: Phone#:
Email: jdentico@bellsouth.net
CONTRACTOR: Company Name: James L. Dentico Contracting, Inc. Phone#: 305-756-6553
Address: 10055 Biscayne Boulevard
City: Miami Shores State: Florida Zip: 33138
Qualifier Name: James L. Dentico Phone#: 305-756-6553
State Certification or Registration #: CGCO13750
Certificate of Competency*
DESIGNER: Architect/Engineer: James L. Dentico, PE 28502 Phone#: 305-756-6553
Address: 10055 Biscayne Boulevard Miami Shores Fl 33138 city: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: N 300 5Qfr
Type of Work: ❑ Addition ❑ Alteration ❑ New U Repair/Replace ❑ Demolition
Description of Work: concrete repair in courtyard approx 300 sq ft
Specify color of color thru tile:
Submittal Fee $ 50 pA ; d 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 $ I ` • 10
(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
0.
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
WNER or AGENT
The foregoing instrument was acknowledged before me this
IZ day of �,t; I 20 17 by
,-J—awcS D 0 �1'cy , who is personally known to
me or who has produced flL 17 L as
identification and who did take an oath.
NOTARY►PUBLIC:
Signature X
CONTRACTOR
The foregoing instrument was acknowledged before me this
Z day of �(X I 120 2 by
r
Jac.-►„�S i?, iL, r , who is personally known to
me or who has produced / L- 7 L� as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: WMM Sign:
Print: lAymy Print:
Notary Public - State of Florida
Seal: °. • Commission I GG 077616 Seal:
My Comm. Expires Mar 31, 2021
Bonded through National Notary Assn.
***************************** **** **** **************************
APPROVED BY I Plans Examiner
1AYMYBENGIO
Notary Public - State of Florida
• ' • `
Commission t GG 077616
'
My Comm. Expires Mar 31, 2021
Wad through National Notary Assn.
Zoning
Structural Review
(Revised02/24/2014)
Clerk