PLC-19-1339Miami Shores Village R. SCSI ID
Building Department 201s
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. CC-12-18-3721
PERMIT APPLICATION ���-,� �X'1 ub Permit No. � LC— 6
-
[—]BUILDING ❑ ELECTRIC ❑ ROOFING Q REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
10B ADDRESS: 11300 NE 2nd Ave, Weber Hall
City: Miami Shores County: Miami Dade Zia•
Folio/Parcel#: d z% 36 0oye'o.S0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Barry University Phone#: 305-981-1157
Address: 11300 NE 2nd Ave
City: Miami Shores State: FL Zip: 33161
Tenant/Lessee Name: Phone#:
Email: f�
CONTRACTOR: Company Name: l—� w�/ �b1 CO. Phone#:
Address: P044,
City: 5LUIHie State: EL- Zip:
Qualifier Name: P"Weil Phone#:
State Certification or Registration #:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Cannon Design Phone#: 703-907-2339
Address: 1560 Wilson Boulevard, Suite 200 City: Arlington State: VA Zip: 22209
Value of Work for this Permit: $ Q Square/Linear Footage of Work: 45,466
Type of Work: ❑ Addition Alteration ❑ New ❑ lace Re air Re p / p ❑Demolition
Description of Work: Renovation to Weber Hall VVrJ(k C&41,04`Lt
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 1 V CCF $_
Scanning Fee $ 13 Radon Fee $ DBPR $
Technology Fee $
Training/Education Fee $
CO/CC $
Notary $
Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ 3
Bonding Company's Name (if applicable) N/A
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) N/A
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) 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 Signat
OWNER or AGENT CONTRACTOR
The foregoLiDseulrnent
twwas acknowledged before me this The foregoing instrument was acknowledged before me this
day of 5fL2k DWi/ , 20 n by 12 day of September 20 19
0110 A4LA "jU who is personally known to Da: Iel JCOtLrAce , who is personally kn a to ,
me or who has produced as me or who has produced LLasg
identification and who did take an oath. \����QSN;�NE TRg44%�// identification and who did take an oath. '
1�
.;��SSION
NOTARY P BLIC: ;�� �oa�y �'oAo� : �J11OTARY PUBLIC: £ o
0.0Ea
Z�od
Z* vJQ.-
#FF 99799 : Q 00 w
Sign: �o •. . o0 Sign:
4.
Print: �0� Print: /
tI/IIIt11111N� vc
Seal: Seal:
APPROVED BY � 9 %3 (.9 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)