REV-19-2356Rev-
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IF
235b
nc�d�'1U�Ill►`�l?9Zc� Miami Shores Village REczlvED
Building Department NO 202 19
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972 ����
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 ��
BUILDING Master Permit No. RC-03-19-539
PERMIT APPLICATION Sub Permit No. REV-10-19-2356
BUILDING ❑ ELECTRIC
❑ ROOFING ❑ RE SION
❑ EXTENSION [—]RENEWAL
F-IPLUMBING ❑ MECHANICAL
PUBLIC WORKS CHANGE OF
❑ CANCELLATION ❑ SHOP
CONTRACTOR
DRAWINGS
1080 NE 104th St,
Miami Shores, FL33138
JOB ADDRESS:
City: Miami Shores
County: Miami Dade
Zip:
11-2232-029-0200
X
Folio/Parcel#:
Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction Type: Flood Zone: BFE: FFE:
SHORES 104 LLC
305-778-8787
OWNER: Name (Fee Simple Titleholder):
Phone#:
POBOX 613248
Address:
MIAMI
FL
33261
City:
State:
Zip:
N/A
N/A
Tenant/Lessee Name:
Phone#:
remy@quilliot.com
Email:
DAVID HESTER INC
786-246-6429
CONTRACTOR: Company Name:
Phone#:
420 NE 115th Street
Address:
Miami
FL33161
33161
City:
State:
Zip:
DAVID HESTER
786-246-6429
Qualifier Name:
Phone#:
State Certification or Registration #: CBC1261342 Certificate of Competency #:
DESIGNER: Architect/Engineer: SCOTT WEINKLE Phone#: _
Address: 400 KINGS POINT DR - STE 1507 City: SUNNY State:
Value of Work for this Permit: $ RW O' `S"D Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
BATHROOM #3 REVISION
Description of Work:
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Permit Fee $
Radon Fee $
786-546-5046
FL Zip: 33160
❑ New ❑ Repair/Replace ❑ Demolition
RAISE FLOOR OF EXISTING BATHROOM N/ PLATFORM IN GARAGE
CCF $ CO/CC $
DBPR $
Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
N/A
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 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 charge
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
� /V day of O V2.M �X ( 20 I q by
F,9ZYhy a u i \1 ! O k- who is personally known to
me or who has produced 'F- t)r►y2r L[Cier1 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: I<e-ylf) I—OwCA 31cK
Seal
d.
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
—C� day of ko yews )o e , 20 1 °l , by
1 lck, o( who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
SSign: N-t - C ail
Print:
Seal:
as
:✓' :�q� KEVIN LAIPCIGIER
Notary Public - State of Florida BETTINASEIFRIED
.•.<:
Commission C GG 364682 =f '
************ *�s%*a>Rt*#t;4`C�H!`°'E7i�lii'• ,l '� i�� � ******************** �* *llt'�'I�SI4?41i:�r�* *************
,= EXPIRE obey 2022
APPROVED BY Plans Examiner Zoning
6 Structural Review Clerk
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: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
RECEIVED
F 14 2020
BY•
FBC 201�
Master Permit No.RC-03-19-539
Sub Permit No.REV-10-19-2356
0 REVISION ❑ EXTENSION ❑RENEWAL
■PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:1080 NE 104 Street
City: Miami Shores County: Miami Dade zip:
Folio/Parcel#:11-2232-029-0200 Is the Building Historically Designated: Yes _._ NO
Occupancy Type: Load: Construction Type: _Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):SHORES 104 LLC Phone#:305-778-8787
Add ress:1080 NE 104 Street
City: Miami Shores , state: FL zip: 33138
Tenant/Lessee Name:
Email: info@quilliot.com
e#:
CONTRACTOR: Company Name: Edward Rojas Plumbing Corp Phone#: 786-443-9846
Address:880 NE 111th Street
City: Biscayne Park state: FL zip: 33161
Qualifier Name: Edward Rojas Phnna#-
State Certification or Registration #: CFC 049431 Certificate of Competency #:
DESIGNER: Architect/Engineer: Scott Weinkle Architect Phone#: 786-546-5046
Address:400 Kings Point Drive City. Sunny Isles State: FL zip: 33160
Value of Work for this Permit: $900 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: bathroom #3 (garage) under REV-10-19-2356 plumbing work
Specify color of color thru tile:
Submittal Fee $ �0 Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ W
(Revised02/24/2014)
a
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 abs f such posted notice, the
inspection will n tion fee will be charged.
Signature Signature ,
OWNER or AGENT
R
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
05 day of February 20 20 by 05 day of February 20 20 , by
Remy QUILLIOT , who is personally known to Edward Rojas . who is personally known to
me or who has produced Florida ID as me or who has produced Florida ID as
identification and who did take an oath.
identification and who did take an oath.
NOTARY P
LIC:
NOTARY PUBLIC:
Sign:
Sign:
/
NOER WENDEL
Print
Print:
?•: .-
Seal:
�'yv'P� -.,.
EMMAA. RJUEIit
Seal:
-1 o: ,,.' EXPIRES August 23, 2020
Notary Public • State of Florida
iam> age o�s3 'N'pry C° 0011
Commission # GG 268386
"•• °w
My Comm. Expires Oct 23. 202i
**************** ******** 1 `/y�***********************************************************
APPROVED BY Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)
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: (305) 762-4949
FBC 20 9
BUILDING Master Permit No.aG_0 3 _) / - �3
PERMIT APPLICATION Sub Permit No. REV"i y 23S-�
6 ( -
❑BUILDING ELECTRIC ❑ ROOFING XREVISION ❑ EXTENSION [—]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION [:]SHOP
/ Cj , CONTRACTOR DRAWINGS
JOB ADDRESS: / O� . � 1//
City' Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder)): n ��bdt__ � /(OGPhone#: 30�—
Address: ?o32X g;13 2—
1it�b �+
City: �* State: PA Zip: 3I
Tenant/Lessee Name: ��) �A— Phone#:
Email: &rol p ( wo CPr-
CONTRACTOR: Company Name:
Address:
Qualifier
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Add
Certificate of Competency #:
hone#: 50�'6
_State: Zip: 33)
Value of Work for this Permit: $ _S1s2'j Square/Linear Fiotage of Wor
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Repla
Description of Work:
Specify color of color thru tile:
Submittal Fee
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
❑ Demolition
- 2.35-b
CO/CC $
Notary $
Double Fee $
Bond $ ?? ''�
TOTAL FEE NOW DUE $ //W
�J '
(Revised02/24/2014)
1
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 jse In the abs ce of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
-r
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of t�v 20 by
vxvy ��U1 who is personally known to
me or who has produced - 72( lF-a- U-C�)S`t as
identification and who did take an oath.
NOTA PUBLIC:
Sign:
Print:
Seal: ;a► SINDIA ALVAREZ
MY COMMISSION # GG 238273
EXPIRES. September 3, 2022
• Bated Thru Ndm Pubk Undswft
*******************
The foregoing instrument was acknowledged before me this
_ day of P NVPf-q� 20,96 by
rl 1—C S Ul t who is personally known to
uC'—
me or who has produced r�-�(2d Teoas
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: ;, SINDIA ALVAREZ
V.
MY COMMISSION # GO 238273
EXPIRES: September 3, 2022
�� • Bonded Tluu NoM Public UnderWters
APPROVED BY : Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)
ErTirRED
Miami Shores Villa F j20
1 o zozo e g
BY:
BY:__(� 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 e7A4�1' -02 -a
'Master Permit No.RC-03-19-539
PERMIT APPLICATION Sub Permit NO.REV-10-19-2356
BUILDING ❑ ELECTRIC ROOFING ❑■ REVISION ❑ EXTENSION RENEWAL
F-IPLUMBING ❑■ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:1080 NE 104 Street
City: Miami Shores County: Miami Dade Zio•
Folio/Parcel#:11-2232-029-0200 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):SHORES 104 LLC Phone#:305-778-8787
Address:1080 NE 104 Street
City: Miami Shores
State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email: info@quilliot.com
CONTRACTOR: Company Name: i- &U C• VQ,ML Ali Phone#: 7 R
Address: v 2,1 1`1-1-st,
City: f , )V, State: } Z Zip:
Qualifier Name: b 3 t- 6 1/42a Phone#: /,oG
State Certification or Registration #: Certificate of Competency #: G S S $ r%G irrF+
DESIGNER: Architect/Engine . Ott Welnkle Architect I Phone#: 786-546-5046
Address:400 Kings P nt Drive
Value of Work for
City: Sunny Isles State: FL zip: 33160
Square/Linear Footage of Work:
Type of Work: eration L1 New ❑ Repair/Replace ❑ Demolition
Description of work: bathroom #3 (garage) under REV-10-19-2356 mechanical work
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
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
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature) Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
05 day of February , 20 20 by
Remy QUILLIOT , who is personally known to
me or who has produced Florida ID
identification and who did take an oath.
NOTARY
Pri
Seal:
EMMAA.ORJUELA
'y' Notary Public • State of Florida
e,F®�i Commission # GG 268386
APPROVED BY
as
The foregoing instrument was acknowledged before me this
D to day of .20 1h by
A-D;S$- N who is(fiersonally knowrrito
V IV
me or who has produced Florida ID as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
.
J
tA0
Notary Public • St1ta of 110Hd1
21411111
Seal: My Comm. Expirs S@p t, 2021
" Bonded through National Notlry AIJA,
_ Plaxamin Zoning
Structural Review
Clerk
(Revised02/24/2014)