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REV-19-2245Building Department 10050 N.E2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 RECEI VED SEP 2 51019 a (/L FBC 2017 BUILDING Master permit lVo #05-10-1079 PERMIT APPLICATION Sub Permit No. BUILDING 0 ELECTRIC ® ROOFING REVISION ® EXTENSION RENEWAL 7PLLIMBING Q MECHANICAL 7PIIBLIC WORKS [:] CHANGE OF CANCELLATION Q' SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 420 NE 95th Street Qy: Miami Shores Countw. Miami Dade Trn 33138 Folio/Parc eig-11 `3206-014 0461 4 the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OW, NEIt: Name (Fee Simple Titteholder):Alberto and Marla Carvalho Phone-754-234-4235 Address:420 NE 95th Street City: Miami Shores state. Florida Zip:33138 Tenant/Lessee Name: Phonet#: Email: I't'tadaam iachic.c©m CONTRACTOR: Company Name: Phone#- Nil Address: -7 7db NeAf City: Qual State Certification or Registration #: mil✓ /,1 LQ Xk Z 2 Certificate of Competency #: DESIGNER: Architect/Engineer. Phone#: Value of Work for this Permit: TyPe of Work: a Addition Q Alteration Zip: 33c3 lk State: Tip: Square/Linear Footage of Work: New ® Repair/Replace ❑ Demolition Description of Work: Outlets added in roaster bedroom, second master bedroom and kitchen. Specify color of color t%ru We; Submittal Fee $ C?Y-- Permit Fee $ 1 2-8 - `3 ccF $ 2 . co/cc $ Scanning Fee $ .3 Radon Fee $ 2 I�DBPppR.. $ _ Notary $ _ Technology Fee $ • 2 Training/Education Fee $ �! .CJ Double Fee $ Structural Reviews $ Rend $ TOTAL FEE NOW DUE $ I ! 4 2 = 0 (ReWSed02/24M14) Bonding Company's Name (if applicable) Bonding Company's Address city State Mortgage Lenders Name (if applicable) Mortgage Lenders 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 $25W, the applicant must promise In good frith 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 appAvead and a reinspect ion fee will be charged. Signature IL 4 Signature OWNER or AGENT The foregoing instrument was acknowledged before me this day of September 2019 , by f-vOak who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC, QAN A GUEVAM Print. ` Hot= 21-*.u' � ICUW 49 Rokia Coawssian i GG 271971 Seal: MY CO(M. Ezpdres fan 4, IM Swded thra uniorw NKM Aso. f;1 The foregoing instrument was acknowledged before me this day of . P 20 i c' , by who i ersonalfy kno to me or who has produced as identification and who did take an oath. sssss::*::ssssssssssassss**s*****sss�ss:s*ssss*::ssss*ssss*:::::::ssss*****:::sacs*sass*::ssss*s*::::::ssss* APPROVED Bell/ 7' ,X �r/7 Plans Examiner Structural Review Zoning Clerk (RevisedOU24/2014)