BPP-17-2347\A
�\k Miami Shores Village
L.M Building Department
artment
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
BUILDING
PERMIT APPLICATION
QBUILDING ❑ ELECTRIC
RECEIVED
(OCCT 0 2 2017
c l�
INSPECTION LINE PHONE NUMBER: (305) 762-4949
Master Permit No.}�
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /1300 NE 94 ST
City: Miami Shores County: Miami Dade Zip: I;3 (.-
Folio/Parcel#: u - 32-057- a 1 0- 0 / Za Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): CHRISTIAN BERNARD Phone#:
Address: 1300 NE 94 ST
City
MIAMI SHORES
State: FL
Tenant/Lessee Name: Phone#:
Email:
33138
CONTRACTOR: Company Name: GATOR POOL & SPA CONSTRUCTION Phone#: 30S- Z.Z2 —ZZZO
Address: 13295 SW 200TH ST
City: MIAMI State: FL Zip: 33177
Qualifier Name: MIGUEL A CARMONA Phone#: 3052222220
State Certification or Registration #: CPC1456729
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Z(
Value of Work for this Permit: $Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑■ Demolition
Description of Work:
DEMOLITION OF THE EXISTING POOL AND CONSTRUCTION OF A SWIMMING POOL
Specify color of color thru tile:,
Submittal Fee $ 2.co . 00 Permit Fee $ 1120D • W CCF $ oZ(4 • CO/CC $
Scanning Fee $ IS- 03 Radon Fee $ ( Z • 00 DBPRs$�19 ' QD Notary $
Technology Fee $ 32--' OO Training/Education Fee $ Double Fee $
Structural Reviews $(50.0o go r Gb Bond $ aD' 00
et � Vi i 3rj AGO TOTAL FEE NOW DUE $ 13 (q
(Rev1sed02/24/2014) (, (9 1
a--) , CZ
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) oys after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspecon fee will be charged.
XT =
The foregoing instrument was acknowledged before me this
_ �1 day of Scrv-�e-yn'6IC 20 1 ? by
k,,= ; Q,h who is personally known to
me or who has produced f7`l)L— as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
Signature1 - /V—
TRACTOR
The foregoing instrument was acknowledged before me this
"2—, day of Sera "e t , 20 _� , by
A-cat'�who is ersonally known o
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
NOTARY PUBLIC NOTARY PUBLIC
Seal: g� ESTATE OF FLORIDA Seal: ITICEISW
o e STATE OF FLORIDA
Comm# FF946106 Comm# FF946106
Expires 4/17/2020 Expires 4/17/202.0
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APPROVED BY y Plans Examiner Zoning
Ahw? I Structural Review
(Revised02/24/2014)
Clerk