REV-19-1494RECMr.,, IE)
Miami Shores Village Ju 2 y JA
Building Department By;
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
FBC 20 (--� 11 Q I
Master Permit No. j2z��j I�i
Permit '5"� P I C) Sub e t N o� �
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF
p� G� �CONTRACTOR
JOB ADDRESS: 3 /IVE / & / "j `S
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: toad: / Construction Type Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): C 1 d7 �%�f� •/ ?� Phone#: ' j6 - 4�d -' 30I
Address: I'lS /V
City: Y A1(A1 ptl S►A(7' +UHF
Tenant/Lessee Name:
Email:
CONTRACTOR: Company N.a`m : 4
Address: ` f�/V� N.
City:
Qualifier Name: �,�/ Q
State Certification or Registration #:
DESIGNER: Architect/Engineer: _
Value of Work for this Permit: $
Type of Work: ❑ Addition
Description of Work:
QAlteration
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Permit Fee $
Radon Fee $
State: Zip:
3313
Phone#:
. 7ib -21 /
State: f�' Zip: ---97 -3: / E 7--
,),I Phone#:
Certificate of Competency #:
hone#:
City: State:
Square/Linear Footage of Work:
❑ New ❑ Repair/Replace
Training/Education Fee $
CCF $
DBPR $
Zip:
❑ Demolition
Co/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ Li 3 • CP
(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 wilt 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.
r
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of 20 by
GaK),al� who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seal: ro�►"r°4�_ Notary Publc Slate of Florida
Michelle Perez
My Commission GG 084089
OF <t Expires 04/08/2021
ThWyV
oing instru fmWt was acknowledged before come this
day / of vim& 20 / by
celh who is personally known to
me or who has pybduced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
ip'""' ' Notary Public State of Florida
Seal: Michelle Perez
a P` My Commission GG 084089
or r o° Expires 04/08/2021
APPROVED BY/Plans Examiner Zoning
Structural Review
(Revised02/24/2014)
Clerk
i_
Miami Shores Village
RECEIVED
,
JU 15' 2019
Building Department
$Y: - ` 0
.14
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
Master Permit No.—LI-�--/
-OS-
PERMIT APPLICATION
Sub Permit NoW.-d-'1-(9 -- Id (74
BUILDING ELECTRIC
ROOFING REVISION EXTENSION
RENEWAL
PLUMBING MECHANICALPUBLIC
WORKS ❑ CHANGE OF CANCELLATION
M SHOP
CONTRACTOR
DRAWINGS
JOB ADDRESS:
City: Miami Shores
County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO
Occupancy Type: Load:
OWNER: Name (Fee Simple Titleholder):
City:
Construction Type: Flood Zone: BFE: FFE:
State:
Tenant/Lessee Name: Phone#:
Email:
"3 3 /T e
CONTRACTOR: Company Name: SPECTRUM RENOVATIONS, LLC Phone#: 561-291-8350
Address: 12985 TANGERINE BLVD
City: WEST PALM BEACH State: FL Zip: 33412
Qualifier Name: EZZARD C MATUTE Phone#: 561-685-1024
State Certification or Registration #: CFC1427616 Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#: _
r
Address: City: ° 1 State:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ^
Zip:
N 11-
Description of Work:
. a
Specify color of color thru We:
Submittal Fee $ 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 $ 43 - ct)
(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
tTl
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 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 Nyd.
0 R or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
7V -
_ day of 10 9 . by
wh� p y kn wn toy
me or who has produced
andvho-did take an oath.
':[@il_[ X1
as
The foregoing instrument was acknowledged before me this
day of 20 C by
Zfil who is p sor pally known to
me or who has produced — as
identification nd who did take an oath.
Print: 1 .-� 1 Print: I ILA I t '
Seal: MAI RAPHAEL
Cl
a�a '�,
.�. Notary.Public - State of Florida
• �` Corrrrissior = GG 171005
My Comm Expires Dec 26. 2021
Bonded :hraagh Nmna No:ary Assn.
###ii## ##### ######i#####
APPROVED BY Plans Examiner
MAI RAP
Seal
Commissior a GG 171005
HA
: : �• � 4%:_ Notary.Pubtic -State of Florida
• �" •
�• hly Comm. Expires Dec 26.2021
,'•,�pr BOn48d :hr0dgn NaaCna No:ary A68n.
Zoning
(Revised02/24/2014)
Structural Review
Clerk