ELC-19-1323Miami Shores Village R�Cr-IVED
Building Department SEP23 2
019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 1�Q�
Tel: (305) 795-2204 Fax: (305) 756-8972 w
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 201l �
BUILDING Master Permit No. CC-12-18-3721
PERMIT APPLICATION R-ev ol.- A407� Sub Permit No.ELC-06-19-1323
❑BUILDING (ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
10B ADDRESS: 11300 NE 2nd Ave, Weber Hall
QYL Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER: Name (Fee Simple Titleholder): Barry University Phone#: 305-981-1157
Address: 11300 NE 2nd Ave
City: Miami Shores State: FIL Zip: 33161
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: C. DAVIS ELECTRIC CO. INC. Phone#: 954-432-4334
Address: 1701 SW 100 TERRACE
City: MIRAMAR state: FL Zip: 33025
Qualifier Name: CHARLES E. DAVIS JR. Phone#: 954-275-6004
State Certification or Registration #: EC0001038 Certificate of Competency #:
DESIGNER: Architect/Engineer: Cannon Design Phone#: 703-907-2339
Address: 1560 Wilson Boulevard, Suite 200 City: Arlington State: VA
Value of Work for this Permit: $ /so Square/linear Footage of Work: 45,466
Zip: 22209
Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: - RENOVATION TO WEBER HALL
9-lod4cW wtwi,_ m and u adcld ASK
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ �� CO/CC $
Scanning Fee $ 3 Radon Fee $ �' DBPR $ � Notary $ Sv
Technology Fee $ ( ( ZS Training/Education Fee $ 2 Double Fee $
Structural Reviews $ Bond $ vy
TOTAL FEE NOW DUE $ I '
(Revised02/24/2014)
Bonding Company's Name (if applicable) N/A
Bonding Company's Address
City
State _
N/A
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
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) days after the building permit is issued. in the absence of such posted notice, the
inspection will not be p ved and a reinspection fee will be charged.
Signa_ Signature
tur4OWNER or AGENT CONTRACTOR
The fg instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
_day of ! 20 ICl by 18 day &SEPTEMBER 20.19 by
oh n (r- who is perso ilri�iil�n to CHARLES E. DAVIS JR. who is personally known to
me or who has produced'
`A\W1 M�NE�TA,gr�//iy�� me or who has produced as
identification and who did take an oath : o� oMy 17 F/,c•. identification and who did take an oath.
_ a •'o�• 2
NOTARY PUBLIC: ' * S •.� "' I k _NOTARY PUBLIC:
0 ; rFF 854799 ; p�
Sign: 1 °�' .����i r:::"s�;• ��
Print: 1 l r �%1 I Print °a^•` °y •. DOUGLAS E. BERNARD, SR.
Seal
Seal: ::"ra; Expires July 14, 2023
`.oP!`°• a.,d,d Th, Troy Feln Insurence 880.385.7019
************************************************************************************************************
APPROVED BY % Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)