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REV-12-21-3363 i i �ares iII� � �=���� � ����.t ��� � uildir� pa er�� 1005t}N.E.2nd Avenue,Miiami Shores,Flarida 33238 �'��Y' �,` �re�:(�os)7�s-z2o��a�:(sos}�s�-s��2 _ _ �_. . ��� lNSPECTI�N�BPIE PHQP�E PIUMBER:(3A5)762-4949 �� � � E �� � ��S��t"���`t7F1'�NO ���f�'�.� � a � �...� � `� „�. � PERIVIIT A►PPL.l�,�4"Tlt�tl� sub P�rnnit No. ����n����� � � ��.� � � �������°��� �au1�.���� ❑ ���e���c � R�a����� ���vis�o�v � ��rr��s�o� ���r���A� ❑��uM�a�� r��cHa�oc�� ❑�u����wa�Ks (� cH�n��� �fi � ca�c���,nT�c�n� ❑ s�a� �t}(�T CT�ft DRAWINGS JAB A��RESS: � �„� �= � Citv: M�ami She�res C�untv: Miami Dade Zi�, A-'� � Folia/Paree�:�1�."��� � � �'� � � ��� Is tfie Bui�din�Histor�call}t Desi�nat�d:Yes NO Qecupancy Type: E.�ad: C�nstruction Type: Flc�od 2ane: BFE: FFE: �WME�a N��te(Fee Simple TitlehoEder�.�-1re �� °� . �ti �, �- Phone#:��a`� ~° �'�-�l� Address: �ity: �. Stat�° � Zip:� _ ..� • TenantJ��ssee Name: Phor�e#: r,ra� �,w "��� Email; � � �-�� � ��,� CANT �"1`�R:Campany Name:__�_ �� i2- "�e-� �' � Phane#t. Address: City: � �� St�te: �..- Zip: � _ C��.`� Qualifier Name:� �t ��' Phone#: State Gertific�tian ar R��istration#: C.�,1�c`�.�\��a���. Certific�te of Competen�y#; DESEGWER:�rchiteet�Engin�er: Phone#: ,4ddress: City: State: Zip: Yalue of W�rk for thws F�rmit;$�� SquareJLinear Footag�of Work; Type ofi l�Vork: ❑ Addition ❑ AEteration New [� t2�pairJReplae� � (JemaEitis�n Qescripti�n c�f Wark: �«�"��°�i�a� � � `""" `-a� � .�� �- � � � � � � � �� �. � �r � � S�ecf c�lor of cvl�r thru tit�e s��m�tt����e S Ferm�t Fee$ ec�� ca/ec� S�ann3n�F�e$ Rad�n Fee$ OBRR$ Notary� T�ehnology Fee� Tr�inin�f Educatlon��e$ Double Fee$ Structural Reviews$ Bc�nd$ TOTAE FEE RIC�W DUE$ � P � (Revised�2(2�t12014} � � � Bondin�Company`s N�m�(if applie�ble) �or�ding GQmp�a�y's Address �€ty State 2ip �i�rtga�e Lend�r's Name(€f appiicable} Pt�e�rt�a�e L�nder's Address City Stat� Zip Applicafiion is hereby made to abtain a p�rmit to d�a thg wc�rk and install�tions as mndic�ted. 1 cerkify th�t no work or instaElation h�s carnmenced prior fi� th� issuar�ce a# a p�rmit and that all work �ill b� p�rform�d to m�ei the standards of all laws regulating construction it� this jurisdictic�n. I und�rstand that a s�parate p�rmit must b� s�e�ared fcar E1.EGTRl�, PLUMBIN�, SI�NS, ROt}tS, Fl1RN,ACES,�UI�ERS,HE�ITERS,TANKS,AIR C�N�IT1C}NERS,ETC..... OWNER'S AFFICtAVIT: 1 eer�ify that all tF�� far��oin� information is accurat� and that all inrar� will be dor�e in campliane� with all applicable laws re�ulatin�construction and zonin�. `•W,4RNING TC! C?WNER: YC1l1R FA►ILURE TC} R��QRE3 ,� Nt�TtCE t}F C4MMEN�EM�NT MA�Y RES�U�T IN YQUR #�AYI�IC ICE Ft)Ft I�tl�RC}VEME�[TS TQ YQUR PR�3PER . IF 1fQE� I�V1'END TO t�B1'AIN FtRIAN�tNG, �C�NSt�CT WITH Yt7►E�R E.EM�EFt 4R AN ATTt�RNEY �E��?RE RE�QRC�II�G Y�t1R IVQTICE t�F Ct�MMENCE ENT." N�tic�go,4pplicant: ,Qs�conditfon tsa the tssuance of a bur'lding�ermit with can es€imat�d value exc�edlrrg.$25t10� the��pdieant rnr�st prorraise in gaod faftir that a c�py of tt�e ncatice�f comm�ncerrrent�nd��nstruction lien law brachure wrll be detivered tsa th�persan whvse pro;�erty is su6,�ect to c��tachrnent. �ds�,a ceriified copy c�f the rec�rci�d nc��ice caf ccaa�nnmencement must be��st�d at tlae 1�b sfte for the frrst insp�ctic�n whlch �accurs s�ven (7) days aft�r th� 6uifding p�rmli rs issued. in the absenc� o}`such post�d ncafiice, the lns�ae�tr`an 4vftd nc�f b�appresve��nd�reinspectr'on fee wi11 be chtrrg�d. .- � _ Si�n�tue� `' Si�nature _-~C} NER c�r A�ENT COtdTR�CT�R �� The f�c in�instreament was acknowledged befc�r�me tl��s The foregcain�instrum��t�as aekr��wl�dged befor�me this �-�� d�y of ~- ,.c�,����;�. ,20 ��,. by �.`�" day�f " c:� e � � 2t? � , by �.� �� ho is pers�naliy known t� � �c� - ,who is persor�ally known to m�or wha h�s pr�dueed as me car xrh�has produGed �� as id�ntification and wha did take an oath. identification and who did take�n�a�h. f��TARY C: NOTARY Si�n. _ � � Sign: � ,�.. _ �x; a �.kGVANaMA� � Pflfl�i ��" �''�� � �v P�u a� Print: w���;,., .�.�--__ � �'. �Casr=miss � � � �, ;..� � � �� �,i�t�� �� � �„', � �,�121�. .... Se�l: �����` `�`� n�t otafY���o. � Seal: � .�: C�mm�ssier,� g �� ��ym ..xPires Ott t�,2Q25 �c�fl�eG throuR��� � `�' a���� � t4�n� Noc��^?dssr,. ' `3oPCeG tht�.� �� �kk�F�k�Rak�k�ks�k�k�k�k�k�+kAc�R�k*#dR�k�R�k�k�k�k�k�k+R*�k#�k*�k�k�k�k�k�k#�kl�k#�k+Rdt�k#�k#�k�k�k�ak�k�k�R�kk�ls�k�b##�k*�k*�k#�k�k�k#�k+!#�k�k�l:�kzk�k�R+k�f�k�le�k#�!s###+k�k�k�R�kak�k�k�k�k�k# APPRC?VED�Y Plans Examin�r 2�nin� Structural Review Clerk (R�v���ao2f2alxo�a}