REV-19-20899
2s ( Miami Shores Village RECEIVED
�oq Building Department SEP 0 9 1019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 44-1
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 201"
BUILDING Master Permit No. - R3
PE IT APPLICATION Sub Permit No. e� - Da-jq- go99
UILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: % (� `" c 9/ / sT
Folio/Parcel#: Il 32 0,6 D I q Dry /U Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: �FFFE: �r
OWNER: Name (Fee Simple Titleholder): -i i m)'_: s FrL�: ti ( LL Phone#: 3 �% k C� z / 1/ 8
Address: �� =%tr�'�/c &,,4
City: �G � I d / State:
ip:
xt
Tenant/Lessee Name: Phone#: ,
Email:
CONTRACTOR: Company Name: L[ Phone#:
Address: J4 n A � r 0) 34 ST-
City: f Yu
Qualifier Name:
r( Zip: J 3 / 7 Y
Phone#:
State Certification or Registration #: C66) U' �I Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $�1i Square/Linear Footage of Work:
1
Type of Work: ❑ Addition ❑ Alteration /❑ New ❑ Repair/Replace ❑ Demoliti n
Description of Work: G� Ulf �C�c.��
Specify color of color thru ile:
Submittal Fee $' ^%'11_'Perrhit CCF $ "CO/CC'$"
Scanning Fee $ 1 Z Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $ 41 C)
Double Fee $
Bond $
�6
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 areinsctionfee will be charged.
Signature Signature
OWNER or.AGENT 7
CONTRACTOR
The foregoing iris rum nt was acknowledged before me this
_ day of 20 1i by
CIL who is pe n; a y k11 —§n to
me or who has produced—� as
identification and who did take an oath.
NOTARY P
Print:
Seal: rzoz;etrzo se,idx3
HZnr:�f." uoissiwtuo^ Ayq i
zal�:ruo;j i�sa�a � assgarq '
epuold Jo ale1S og4nd tielON
The foregoinglinstrument was acknowledged before me this
day of 20 / by
// who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PU
Sign:_
Print:
Seal: uR* Notary Public atGoFlorida
Ivelisse Teresa Gonzalez
My Cammission GG 30?028
NA Expires 02114/2023
APPROVED BY Plans Examiner
Structural Review
************
Zoning
Clerk
(Revised02/24/2014)
EXISTING ROOF FRAMING AND
SHEATHING TO REMAIN.
LEDGER 'C', SEE ROOF
NOTES.
LEDGER 'C', SEE ROOF
NOTES.
2x10 WOOD JOISTS
9 16' c%.
PROVIDE TWO HURRICANE FLAT
STRAP BY USP MANUF. MODEL STIR,
ONE EACH SIDE OF EACH OPENING,
WITH (3) '/4'0xl'%' LACE SCREW TO
LEDGER AND (2)1i4'Ox 21i4' FLAT
HEAD TAPCONS TO CONC.
EXISTING CONC. TIE BEAM TO
REMAIN,
SECTION A -A
FAUSTO GUERRERO
19552 SW 133 AVE.
MIAMI, FL., 33177
Ph: (786) 443-1685
Florida register:
PE 50465
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