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RC-17-2422 (4)i"h,.: ��'!�l '"`� :11j • , �(`� h..v'� �k1�� �,`� ����. �� i.j��;sy � } � R�.,5}�A y�,��, r, :� S��4j � r _ i��x"�' '�a ��j[• ! �'KS�, ♦ , 1 ��j ��T�,`�"f�..� �tr. + �� f1j !i�- �yy ^t �i M'1 {�` �pN' �it�" ri/ ��d � �.y�1���y�r � � �� Certificate of Completion Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Building Inspection Department Description: GARAGE ENCLOSURE, KITCHEN REMODELING AT NEW LOCATION, NEW GUEST BATHROOM. Permit Type Building (Residential) Bldg. Permit No. RC-10-17-2422 Owner CHRISTIAN LANSER Contractor HOME OWNER Subdivision/Project Date Issued 02/07/2020 Construction Type V-B Occupancy Single Family Square Footage Location 175 NW 100 ST Miami Shores, FL 33138 Type 609.00 Flood Zone X If the building is located in a special flood hazard area documentation of the as -built lowest floor elevation or lowest horizontal structural member has been provided and is retained in the records of Miami Shores Village. This certificate issued pursuant to the requirements of the Florida Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the jurisdiction regulating building construction or use. 0 Building Officials Approval Not Transferable POST IN A CONSPICUOUS PLACE Ismael Naranjo, CBO ��� h� p..t�� �'?��e�•� • • ^rj t' ~ ..r-r � ��i,^.'_'<i+1;� ����«�` 'S�„i:rifi �f�'(.��` !7 � "-'� �a .., � � ;,��f r �y -� �;��'` r•ti ��t �!'1� 5f�•�r} x�Y ti '.e�1, � ,•,^t,.�j�ir�� • �y �riy;�1' ^4 � .-i(� • r'r � i �S{�a+ '�✓i' Lam' A��,�'.�' ..�i- � 1 S .vN. �t Ma �:3.��'�T��� w r�7 .�}� 3� �.+ �'.��' ��• ry.�i�`{ i•�Hti• liF�- 4f ,•,[y�r .'� � .�_.:L:r..�� ._��� _ ..t �:�...:.--t./`•.Y It �:1�' Jdf�.. �`�3._ t rr./.�i A-. tiY �!����`�..�Gt.�� �ORio Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores FI.33138 Permit nio. RC-10-1.7-2422 Type: Building (Residential) Ilmorkc/ass: Garage Encloture Perlis Status: A r±dyed Issue Date: 7/6/2018 Expires: 05/04/2020 INSPECTION REQUESTS: (305)762-4949 or log on at https://bidg.msvfl.gov/energov—prod/sel%ervice POST ON SITE Requests must be received by 3:30pm WORK IS ALLOWED: MONDAY THROUGH FRIDAY, 6:OOAM-7:OOPM 1131010230320 SATURDAY B:OOAM - 6:OOPM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY . NO INSPECTION WILL BE MAD UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED . PLANS ARE READILY AVAILABLE. IT IS THE PERMITAPPLICANTS RESPONSIBILITY YO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES: NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION . Owner's Name: CHRISTIAN LANSER Owner's Phoney (305)772-4313 Job Address: 175 NW 100 ST Total Square Feet: 609 Miami Shores, FL 33138 .'I, dotal Job Valuation: $ 35,000.00 Contractor(s) Phone Address HOME OWNER Description: GARAGE ENCLOSURE KITCHEN REMODELING AT NEW LOCATION, NEW GUEST BATHROOM . 06-27-2018 This property had a approved demolition permit issued on 05-09-2017. Also please see County records of review on file. No work without permit was performed. WY{lV�� �s>v . ti WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Page 1 of 1 INSPECTION RECORD Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit NO. EEC-1 0-17-2422 Issue Date: 7/6/2018 Permit Type: Worts Classification:, Garage Enclosure INSPECTION REQUESTS: (305)762-4949 or Log on at https://bidg.miamishoresvillage.comlcap REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY. Requests must be received by 3 pm for following day inspections. Expires: 01/02/2019 Residential Cbnsrruction Parcel0131010230320 Owner's Name: CHRISTIAN LANSEP, Owner's Phone:. (305)772-4313 Job Address: Bond Number: 3819 AP WELDING AND STEEL MANUFA` (305)824 /VGw CJXa1/a/0J/ 7y `-f f c¢�ry;elf Total Square Feet: Total Job Valuation: 609 $ 35,000.00 WORK IS ALLOWED: MONDAY THROUGH FRiDAY, 8:OOAM - 7:OOPM. SATURDAY 8:OOAM - 6:00PM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. j, 4--6 - - NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS THE PERMIT APPLICANT'S RESPONSIBILITY -f0 ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN :ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. INSPECTION RECORD STRUCTURAL INSPECTION DATE INSP Foundation j Stemwall Slab Columns (1st Lift) Columns (2nd Lift) 4Of Tie Beam Truss/Rafters Roof Sheathing Bucks Interior Framing Insulation Ceiling Grid Drywall Firewall Wire Lath Pool Steel Pool Deck Final Pool Final Fence Screen Enclosure Driveway Driveway Base Tin Cap Roof in Progress Mop in Progress Final Roof Shutters Attachment Einal Shutters Rails and Guardrails ADA compliance DOCUMENT Soi713e�arring Ceff Soil Treatment Cert Floor Elevation Survey Reinf Unit Mas Cert Insulation Certificate + Spot Survey Final Survey Truss Certification STRUCTURAL COMMENTS WINDOWS & DOORS INSPECTION INSP Attachment PUBLIC INSPECTION WORKS DATE INSP Excavation ELECTRICAL INSPECTION DATE INSP Temporary PO 30 Day Temporar'V� Pool Bonding P"6ol'Deck Bonding Pool Wet Niche Underground Footer Ground Slab Wall Rough Ceiling Roug440e6U IX: Telephone Rough Telephone. Final IU U{ Ill TV Rough TV Final Cable Roug Cable Final tp 6 Inte om Rough Intercom Final~ Alarm Rough Alarm Final Fire Alarm Rough Fire Alarm Final Service Work With ELECTRI I1 1 aj COM E TS AW t D 2`P 9 Final Sprinkler Final Alarm .190 INSPECTION DATE ;INSP Rough .c.,.,A c Water Service 2"d Rough 3c � Top Out Fire Sprinklers 1 Septic Tank Sewer Hook-up Roof Drains Gas LP Tank Well _.. Lawn Sprinklers Main Drain ` Pool Piping Backflow Preventor Interceptor Catch Basins , Condensate Drains HRS Final. PLUMBING COMMENTS INSPECTION DATE INSP Underground Pipe Rough J � Ventilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater Final•Vacuum 421 MECHANICAL COMMENTS V 40 3i �jel,, l Na to L'" may i1� 14o17� 12.0. yA n D ID 20 LOT 4 ( LOT 9 LOT - 10 SCALE' I' ---20 I _BLOCK NN 1. 1 ( BLOCK 4 I BLocrc 4 I I FOLw%� IRON PIPE I I FO1110 y- I E '_ PTI - - - - - WaNt PIPE - - i� 7 E 7 25 FEET OF LOTS 5, 6, i AND B. BLOCK 4, BONMAR PARK /J ION ACC TO THE MAP THEREOF, AS RECORDED IN PLAT BOOK 24 PAGE 71 OF 75• ZrJ• 25 0 ` „� A... T*fuBLIC REC G F MIAMI-DADE CWNTY. FLORIDA. DO* 89�6.* O \�Q • / /•%9. N A •\•yh� 0.5'WEST �� SIF•EYOR'S REPORT"AND GENERAL NOTES �B. 6' q0 LVO VALID W.T.ONT THE ATTACIED SIPIEY Mu) IN REMAIN of LDT - 5 N / N LEGAL DESCRIPTION HAS BEEN FUPMISR BY THE CLIENT. BLOCK - L EAST 25' of / LOT 5 AMga1XDe I 2. REFERENCES Tn DEED RECOPO OR PLAT REFER TO MCUMENTs AND INSTRUMENTS OF RECORD As BLOCK - 4 PART OF THE PERTINENT INFORMATION USED FOR THIS SURVEY WORK. MEASURED DISTANCES, DIRECTIONS 4rtR TANK AID ANGLES ALONG BOUNDARY LINES ARE IN CONSISTENCY WITH CORRESPONOIS VALIIEgFROM RECORDS, I, I UNLESS OTHERWISE SHOWN • 00000 _ LOT - 16 3. THEM LANDS ARE SUBLECT TO ADDIT o AL RESgtCTIDNS O•RECORD THAT - �- - - - - - - - - r•.RE NOT FURNISHED TO rHE• 000 @ • \OQ ``�/ ,/ 1. BLOCK - L OD I UMERSWNING REGISTERED SurtVEYOR. A TITLE 5@ARCI 1W NOOKEN PERFORMED. • }\ L. NORTH ARROW DIRECTION IS BASED ON AN ASStM� �ERroIAr BEARINGS �F•B45ED �•+ 4ry ASSLMED • "AST 25' OF •,11 / j�" \\ MEWDIAM ON A WELL -ESTABLISHED LINE, SAID LINE IS BEING NOTED AS CR Or THE6JRVEY�IAP. • ID REMAIN OF LOT - 6 .� LOT - 6 /VI I M1 5. ONLY ABOVE GNtMO IMMOVEIENTS ARE SNOT* SE•.• `.1t+DATgeR, U*ERGR0*Qo ATURES AND• • • • • • N BLOCK 4 \\ BLOCK - 4 �6. �D, L- UT ILMIES HAVE HOT BEEN LOCATED • /N O / I b. FENCE OWNERSHIP HAS NOT BEEN DETERMINED `.�gfV'(RgM EXISTING FENCES W BUtMDARY LINES• • /• CID ) 9. ARE APPROXIMATE FENCE/WALLS WIDTI AID CONDITIONS MIST BE CONSIDERED TO DETERMINE TRUE• • • • • • / 2B 16.5, 11 12' K I LOCATION LAMS LOCATED BEYWD PERIMETER 6Fk F% *,GMT OR MIGHTO NOT BE j-ING USED BYO • _ ? ADANERS HAWING PARCELS NAVE NOT BEEN+ VESTIGFTED@ • • • • • - 75'_ J % - 16.$' 10 7 THIS SURVEY MAP b INTENDED TO BE DISPLAYED LE SHOWN NEP 'N S S -ESSED IN - U.SSURVEY FOOT ; • @ • @ • 1 9.78. /C _ 8. THIS SIIRIEV MAP 15 BEING PREPARED FOP i F ARTYIPARTIES Jrjli 5 tERTIFIED TO n 2O.B' � AND DOES Mi EXTEND TO ANY UNNenEO NglvrouAL, t1TY ASSIGNEE. REMAIN OF LOT 7 \O 0 9. FLOODPLAIN INFORMATION. AS SCALED FROIiFE9ER� ySIRANCE RATE MAP (Fll t COnnIMITr N EA T 25' OF N I ONE STORY - - N0. 120652 (PILLAGE OF MIAnI $HIES). PANEL lu302, SUFFIX L. RE V15E0 ON SEPT ITTI, 2009, iI15• • • • • • (� BLOCK - 4 OT - 7 LOT - IS REAL PROPERTY FALLS IN ZONE -X' • RESIDENCE N0. 175 • • • B OCK - 4 BLOCK - 4 10. HORIZONTAL ACCURACY ACCURACY OBTAIN• TM'J•EAS• MENTS AND CALCULATIONS HEFTS ANO F.F.ELEv =13.30' I o pt•� O I EXCEEDS THE nINInUn HORIZONTAL FEATURE Ac uRAGY `R A URBAN ARE BEING EDUAL i0 FOOT IN • 9.76 w V4J I VERY CAL CONTROL AND ACCURACY THE EYATIONS AS SHOWN ARE 0101APTA ARE NATIONAL • • • • • 1.1L' GEODETIC VERTICAL DATLM OF 1929 (NGVD 1 9) T �LOSIIRE IN FEE1�A5 COMPUTED. MfE's inF• E 1.3'EAsi 13.5' 15.6' 0.2'WESr �+ o STANDARD OF PLtS OR MINIS 0.05 FEET TIME? THE SARE� ROOT OF THE LOOP DISTANCE IN MILES.:-! • • \\. ELEVATAM ARE BASED ON A LEVEL LOOP FROM A 614THE F 1LUWING OFFkAAL BER&OIA: S. Z •Dy aD \\b I S O. BENCH MARK B I: MIAnI-DADE COLMTY PUBLIC WORKS DEPARTMENT BENCH 'M RKA-56' _ NT # w 1 O • �l. ELE VATroN = 10.5E FEET 0900 } r� m W BENCH MAIM R 2: MIAMI-DAM CWNTY PUBLIC WORKS DEPARTMENT BENCH MARK N-568, _I J P REMAIN of LOT - 8 \�Q E4 T 25' OF -- - �O ELEVATION = 9 65 FEET W LL Z N BLOCK - 4 OT 8 1 0. > Z W I ✓) B ocK - 4 H B9 BD. a t6.�S. }1,(.s L NO CD "I DO 11 qp° K\O. 9.K aCC G� 1 HEREBY CERTIFY TO. 0 L 75 CIBRISTIAN LANSER. Z O h 3 Z - - V THAT THIS SURVEY CONFORMS TO THE STANDARDS OF PRACTICE AS SET FORTH BY THE FLORIDA J N FWMi< 74.96' M. 7S.O9' M. BOARD OF PROFESSIONAL SUR'/EYORS AND MAPPERS- IN APPLICABLE PROVISIONS OF CHAPTER 5117. G IRON PIPE 75. 00, P. 75. 00, P. IROU1 P FLORE)A ADMINISTRATIVE CODE PL.RJUANT TD SECTION 172027 FLOPTA STATUTES THK SURVEY IS O LL 0 3 FOUND " @ SE CORNER ACCLrATE AND CORRECT TC THE BEST OF MY KNOWLEDGE MID BELIEF J I Dignalyugnedby J z IR ON PIPE OF THE WEST 25' Oday,C Mi. Z b b CIS SOUTH 0.45 LOT IL Date Z0191Z 17 Lu o Jo N \O' \p, 10.36:27-os'W 15ASPHALT PNEMENT ODALYS C BELLO�IZNAGA Q - _ PROFES..,JNAL :.fVEYOR AND MAPPER LS6169. STATE OF FLORIOA - € 50' TOTAL R/W 1 PER PS 2L - PG 71) - - FIELD WORK DATE .2"212C'9 LL O 3 M z N.W. TOOTH STREET J N W n zo a E ADOITIpS AND DELETIONS TO THIS SURVEY MAP ARE PROHIBITED THIS $JIVE• MAP eND O] N d w REPORT ARE HOT VALID WITHOUT THE SIGNATLRE AID OPGINAL RAISED SEAL OR WITHOUT THE WTIENTICA TED ELECTROHIC SIGNATURE AND SEAL OF THE UNDERSIGNING FLORIDA LICENSED SUNEYOR AID III - LEGEND III ABBRE-TIONG MAP OF BOUNDARY SURVEY • ,e .W, .,.,.. W,. PROPERTY ADDRESS: � �•..•..• ® • SE '�• • •--,.• ,K.K• - .,„, - 175 N.W. TOOTH STREET, MIAMI SHORES, FLORIDA 33150 �i-`� .�WW.. ... "` • T e•ffe s.R. • - +..+•�.• • �" _ ..-....- ..., ._ _. _ f • y PROJECT N0. 20336 PAGE I OF I �s 1 � � �� t`i r � �:> � � a;: �I / /. .5 . r z:' .. �; . <, ', c`' , 'i � < i '� 1 1 S � 1 _,' ' rr 3 u>1 � {, � a s T :r a � � t _. ...__� .,.. . .. ..a <� .,. v.iff _. vR: �.. .. .. ...f ... ri.�.�.�.; 1��i Yy.,��yy .. _ia:'`... .f Ri. �': Yk� .1� ,. S. [. ... .lu RP. ..'�aM:i:•� ti Miami Shores Village 10050 N.E. 2nd Avenue NW ( Miami Shores, FL 33138-0000 Phone: (305)795 2204 CORioQ Permit No. RC-10-17-2422 Permit Type: Residential Construction err it Work Classification: Garage Enclosure Permit Status: APPROVED Issue Date: 7/6/2018 1 Expiration: 01/02/2019 Project Address Parcel Number Applicant 175 NW 100 Street 1131010230320 Miami Shores, FL 33138- Block: Lot: CHRISTIAN LANSER Owner Information Address Phone Cell CHRISTIAN LANSER 175 NW 100 Street (305)772-4313 MIAMI SHORES FL 33150- 175 NW 100 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone AP WELDING AND STEEL MANUFACI (305)825-4511 Valuation: $ 35,000.00 Total Sq Feet: 609 Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Construction: Occupancy: Single Family Stories: Exterior: Front Setback: Rear Setback: Left Setback: Right Setback: Bedrooms: Bathrooms: Plans Submitted: Certificate Status: Certificate Date: Additional Info: GARAGE ENCLOSURE, KITCHEN F Bond Return : Classification: Residential Fees Due Amount Bond Type - Owners Bond $500.00 C C F $21.00 CO/CC Fee $50.00 DBPR Fee $15.75 DCA Fee $10.50 Education Surcharge $7.00 P&Z Review Fee $35.00 Penalty Fee $0.00 Permit Fee $1,050.00 Plan Review Fee (Engineer) $160.00 Plan Review Fee (Engineer) $90.00 Plan Review Fee (Engineer) $90.00 Preliminary Plan Review $200.00 Scanning Fee $39.00 Technology Fee $28.00 Work without Permit Fee $0.00 Total: $2,296.25 Pay Date Pay Type Amt Paid Amt Due Invoice # RC-10-17-66310 07/06/2018 Credit Card $ 1,736.25 $ 560.00 10/11/2017 Credit Card $ 200.00 $ 360.00 10/27/2017 Credit Card $ 360.00 $ 0.00 Bond #: 3819 mvauaoie ins Inspection Type: Review Planning Review Planning Review Electrical Review Electrical Review Electrical Review Building Review Structural Review Structural Review Structural Review Mechanical Review Mechanical Review Building Review Building In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. July 06, 2018 1 y� Miami Shores Village �sHO1s 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Map Permit No. RC-10-17-2422 Permit Type: Residential Construction Pen Work Classification: Garage Enclosure Permit Status: APPROVED Issue Date: 7/6/2018 1 Expiration: 01/0212019 Project Address Parcel Number Applicant 175 NW 100 Street 1131010230320 Miami Shores, FL 33138- Block: Lot: CHRISTIAN LANSER Owner Information Address Phone Cell CHRISTIAN LANSER 175 NW 100 Street (305)772-4313 MIAMI SHORES FL 33150- 175 NW 100 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone AP WELDING AND STEEL MANUFACI (305)825-4511 Valuation: $ 35,000.00 Total Sq Feet: 609 Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Construction: Occupancy: Single Family Stories: Exterior: Front Setback: Rear Setback: Left Setback: Right Setback: Bedrooms: Bathrooms: Plans Submitted: Certificate Status: Certificate Date: Additional Info: GARAGE ENCLOSURE, KITCHEN F Bond Return : Classification: Residential Fees Due Amount Bond Type - Owners Bond $500.00 C C F $21.00 CO/CC Fee $50.00 DBPR Fee $15.75 DCA Fee $10.50 Education Surcharge $7.00 P&Z Review Fee $35.00 Penalty Fee $0.00 Permit Fee $1,050.00 Plan Review Fee (Engineer) $160.00 Plan Review Fee (Engineer) $90.00 Plan Review Fee (Engineer) $90.00 Preliminary Plan Review $200.00 Scanning Fee $39.00 Technology Fee $28.00 Work withoLt-Permit a $0.00 Total �--� $2,296.25 Pay Date Pay Type Amt Paid Amt Due Invoice # RC-10-17-65310 07/06/2018 Credit Card $ 1,736.25 $ 560.00 10/11/2017 Credit Card $ 200.00 $ 360.00 10/27/2017 Credit Card $ 360.00 $ 0.00 Bond #: 3819 Authorized Si naturer"Cw—ner / Applicant / Contractor / Agent Building Department Copy Avauaoie Inspection Type: Review Planning Review Planning Review Plumbing Review Plumbing Review Electrical Review Electrical Review Electrical Review Electrical Review Building Review Structural Review Structural Review Structural Review Mechanical Review Mechanical Review Building Review Building July 06, 2018 July 06, 2018 A �-fo k\ 11\w \SP.- wv� S? ��\a et BUILDING 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 7-PER APPLICATION B MING ❑ ELECTRIC ❑ ROOFING LV6tq1 12017 BY: F BC 20 it Master Permit No. C i1—iA ZZ ❑ REVISION Sub Permit No. ❑PLUMBING ❑ MECHANICAL [-]PUBLIC WORKS [] CHANGE OF CONTRACTOR ❑ EXTENSION ❑RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS Folio/Parcel#: 11. 3 )// - 0 2 3-03LO Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (fee Simple Title AddrPcc- I '�r' C_ �-j w - Grp I nse►- City: to I G I'- ) 1 .5 State: I I i Tenant/Lessee Name: Phone#:_ Email: CONTRACTOR: Company Name:` �` Ih °1 qh� 7 'f"ef? I (Phhoon M _ Address: W ` I J City: t4 1 At LIB State: - 1 Qualifier Name: w " � �L(" Q o N-ro Phone State Certification or Registration #: Lr l 1 .4� I 6 2 SS Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: 13313�_''> Address: City: State: Zip: Value of Work for thi ermit: $ s �0 Square/linear Footage of Work: 09 Type of Work: Addition ❑ Alteration ❑ New 1' ` ❑ Repair/Replace ❑ Demolition M� Description of Work: ( 6C e f\C �L)vrC_ , f� i + CkOv\ VC fY10 & 1 1 f n Gk w , ►Jew .6ucSA- (�G-levi c, Specify color of color thru -tile: ((�� Submittal Fee $ 200 .01 Permit Fee $ 1 0 J l / CCF $ CO/CC $ Scanning Fee $ Technology Fee Structural Reviews $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ � oao + t a.), Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 6n . �2�_; 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 Y UR PROPERTY. JF YOU INT ND 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. 11 Signature tk��— OWNER or AGENT The foregoing instrument was acknowledged before me this day of J lJ ►) C .20 1 ­7 by La ,)1 e Y, who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: �---� Sign: Print: i0- Seal: W "'R' r"o"" EI'STATE OF FLORIDA Comm# FF098337 '4 E 18 Explres 5/3/2018 sssssssssss*ssss*sssss*sssssssssss�#ess APPROVED BY as Signature _-4W4:�:D CONTRACTOR The foregoing instrumen was acknowledged before me this ac� day of Girl 20 /i - by f- Alollso who is personally known to me or who has produced C 4'(Sa -.'fd ( identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ssssYssssssssssss:sss rlPlans Examiner Structural Review NotaLPub11cStft FloddeBeatMy C32710 Expir s ss s ssssssss sssss}�s*s s*ss �****s*** Zonin g Clerk (Revised02/24/2014)