Application w contractor (signed) RC-07-20-1613Miami 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
FBC 20
BUILDING Master Permit No
PERMIT APPLICATION sub Permit No
■❑BUILDING F-] ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ 5HOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 561 NE 106th Street
Gt . Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-2231-014-0140 Is the Building Historically Designated: Yes NO X
Occupancy Type R-3 Load: Construction Type: Flood Zone: N/A BFE: N/A FFE: N/A
OWNER: Name (Fee Simple Titleholder): David & Angela Benjamin Phonett: 305-332-3812
Address- 561 NE 106th Street
City: Miami Shores Stater Florida Zip. 33138
Tenant/Lessee Name:
Email: davidbeniamin7@yahoo.com; angelafbenjamin@hotmail.com
CONTRACTOR: Company Name: Miran Construction, LLC
ArldrPss- 2640 Hollywood Blvd, Ste 200
City, Hollywood state: FL
Qualifier Name: Julio M. Miranda
State Certification or Registration # CGC 1516201
DESIGNER. Architect/Engineer. Victor J. Bruce Phone#: (305) 310-5030
Address:370 NE 101st Street City_ Miami Shores state: Fl Zip: 33138
Value of Work for this Permit: $ 120,000 Square/Linear Footage of Work: +/- 789 sq. ft.
Type of Work: ❑ Addition 91 Alteration New ❑ Repair/Replace ❑ Demolition
Description of work: 1) Addition of Master Suite with bedroom & bathroom; 2) Garage Conversion into Laundry
& Walk -in -closet; 3) New Terrace & pool (under separate permit)
Phone#
hone# 786 925-0084
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revaed02/24/Z014)
zip 33020
hone#: 786 925-0084
Certificate of Competency #:
CCF S CO/CC $ _
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
r7nnd-nR Company's Narne (If appli(able)
ltursduig Company's Addieti .... .
City Slate Zip
MurtgAge tender's Name (If allphc 1>1c}
Mortg,ipe Iendet s Adiffetscity —
Stall, Z'p
Application is hereby made to obtain a Imimd to do the work and installations as indicated I certify that no work or !nirallaloon ha,
Commenced prtt�r to the Issuance of a permit and that all work will be performed to meet the standards of all tans regulating
Constlilclrorl ir1 this 7u=tsdiction I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS.
1-URNACES, B011 FRS, HEATERS, TANKS, AIR CONDITIONERS, ETC
OWNER'S ArfIUAYiT I Certify that all the foregoing information Is accurate and that all work will be done In compliance wiln all
applrcablc Ipws ouguial,ng construction and toning
"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 it) Appllrant • A; a cond+Iron to the issuance of o building permit with an est!mored volue exceeding $2500, the appf!cant must
prtirrsne in good faith Ihot a copy of five notice of commencement and construction fren fow brochure will be delivered ro the pe,son
whose progrrly is lubfect to attachment Also. a certified copy of the recorded notice of commencement must be posted at the fob sire
for rhs lift( inspection which occws seven (7) days after the building permlr is Issued in the absence of such posted roi,ce the
Inspecfeon will not be avproved and a relnspecoon fee will be charged.
t-kvi1a
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S€gnalure _�'
OWNER or AGENT
CONTRACTOR
was acknowledged before me this
The foregoing instrument was acknowledged before ino they
The foregoing tnslru nenl
►' 20 by
-1 day of u�fern __. 20 _ by
day of tjQrriiu T,
who is petson, p to
Julio M Miranda who Is personally known to
f9or t� IN wG'( It`�� is
as
me ar who has produced
me or who has produced
idi,ntificltinn and who did take ,;n oath
Identification and who did take an oath.
NOTARY PUBLIC
NOTARY PUBLIC.
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