REV-18-24232�3 ,
..►. 4
BUILDING
PERMIT APPLICATION
❑ BUILDING ❑ ELECTRIC
Miami Shores Village R
Buildin De artm t ����1
g V e n Sep '�F1
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 1 j
Tel: (305) 795-2204 Fax: (305) 756-8972 Oa/B
INSPECTION LINE PHONE NUMBER: (305) 762-4949 (jL
FBC 20 1i
Master Permit No. C`-11 _7kLi
Sub Permit No. faMy1 8 -2H23
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Barry University - 11300 NE 2nd Ave, Miami Shores, FL - Garner - Dunkin Donuts
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Barry University Phone#: 308.899.3995
Address: 11300 NE 2nd Ave
City: Miami Shores
State: FL Zip: 33161
Tenant/Lessee Name: Phone#:
Email: lyao@barry.edu
CONTRACTOR: Company Name:
ne#: 15V 9 3 7-- (- ?�J U
Address: ( t Y /0 57-- Kul! -5— 4F S / K
City: _ b C Vic
L/ State: /�(. Zip: _ 3 3 3 Z1D^
/"� h;� Qualifier Name: -_ Ve v lvrc9 Phone#: 9SLl- q3 7 — 1 &E-b
State Certification or Registration #: C �J C Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $
Type of Work: ❑ Addition
Description of Work:
hone#:
City: State:
Square/Linear Footage of Work:
Zip:
❑ Alteration �" El New ❑ Repair/Replac I .❑ Demolition
Specify color of color thru tile:
Submittal Fee $ V Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ , z, co
(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 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
promise in good faith that a copy of the notice of commencement and construction lien law brochure wil
whose property is subject to attachment. Also, a certified copy of the recorded notice of commen ement
for the first inspection which occurs seven (7) days after the building permit is issued. in th ab nce
inspection will not be approved and a reinspection fee will be charged.
awwSignature_ Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
�� day of AU�Gu�r 20J by
Susan Rosenthal who is personally known to
me or who has produced
identification and who did take an oath.
ni
g 500, the applicant must
be delivered to the person
ust be posted at the job site
of such posted notice, the
CONTRACTOR
The foregoing instrument�w''asaccknowledged before me this
day o � t�-PASA 20 l by
who is personally known to
me or who has produced � `. W uw4 lit CQl1f1/i1Z_as
identification and who did take an oath.
NOTARY PU LIC: NOTARY PUBLIC:
Sign: Sign: G X
Print: ` Print: "VAA vl(,� r
Seal: " Notary Public State of Flonda Seal:
Jeffry J Yao �;y'P& ANAMARIA VILLEGAS RODRIGUEZ
My Commission FF 168481 : i�', o=. NotaryPublc-State of Florida
ex n Expires 11/12/2018 r • ' ' • Commission N GG 066414
Barked thragh rre�ai Nomry Aaen.
�L
APPROVED BY Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)
�yf_2or8a0 -3-3 1l
NOTE: ALL SHEETS MUST BE REVIEWED
MIAMI-DADE COUNTY DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES
�J/-�
Herbert S. Saffir Permitting and Inspection Center L/ ��
14 11805 SW 26th Street (Coral Way) • Miami, Florida 33175-2474 • (786) 315-
APPLICATION FOR MUNICIPAL PERMIT APPLICANTS
THAT REQUIRE PLAN REVIEW FROM MIAMI-DADE FIRE RESCUE
_ AND/OR ENVIRONMENTAL SERVICES CC �7 ;qs
/� o
MUNICIPAL PROCESS
NUMBER HERE
F.
.PR/OVIVIDE
Job Address / 3 o 0 ,y L �Npi
Contractor No.
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Folio �l dU ��
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Last four (4) digits of Qualifie No.
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Contractor Name Rai
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Lot Block
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Qualifier Name
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Subdivision PBpg
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Address .
City Stat ip333z
Metes and bounds
[ ] New Construction on
[ ] Demolish
Current use of property 1 ✓er-Sr
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Vacant Land
[ ] Shell Only
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Iteration Interior
[ ]Alteration Exterior
[ ] Addition Attached
[ ]Addition Detached
Description of Work
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[ ] Relocation of Structure
[ ] Re -Roof
--
Sq. Ft. Units Floors
a.[
]Enclosure
[ ]Foundation Only
_
[ ]Repair
[ ]Tent
[ ] Repair Due to Fire
Value of Work
BLD'
Chg. Contractor
Owner X-Sl
Address
[ ] MELEory
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[ ] Re -Issue
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[ ] Re -Stamp
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City
[ ] MPLU
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Revision
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Phone
Last four ( digits of
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] MLPG
[ ] MMEC
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[ ]Not Applicable for
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FIRE
Fire
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Owner's Social Security No.
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Name CAA. L_o S /Fd/ Nt; 5
Owner
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Address %�% d
Address
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I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible. There is a minimum charge of
a g it
one -hour. Please contact the Fire Department for current rate.
Vacs
w
t st Request: Date:
can w
Le,>>
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2nd Request: Date:
LL
31 Request: Date:
If the applicant is a known named violator with: unpaid civil penalties; unpaid administrative costs
of hearing; unpaid County investigative, enforcement, testing, or monitoring costs; or unpaid liens,
any or all of which are owed to Miami -Dade County pursuant to the provisions of the Code of
Miami -Dade County, Florida, a hold on the review may be placed on this application.
123 01-192 5/17
I
BUILDING PERMIT CATEGORIES
CATEGORY DESCRIPTION PERMIT TYPE
BUILDING
01
_ , GENERAL BUILDING -COMMERCIAL
MBLD
02
SUB -GENERAL BUILDING -RESIDENTIAL
MBLD
08
CANVAS AWNING
MBLD
10
COMMUNICATION TOWER
MBLD
15
DEMOLITION
MBLD
29
METAL AWNING & STORM SHUTTER
MBLD
48
SCREEN ENCLOSURES
MBLD
51
MURAL SIGNS (NON -ELECTRICAL)
MBLD
55
SWIMMING POOL
MBLD
56
TENNIS COURTS (SURFACE PAVING)
MBLD
86
TRAILER TIE DOWN
MBLD
88
WALK-IN COOLER
MBLD
91
MARINAS
MBLD
92
LOW SLOPE APPLICATIONS (GRAVEL, SMOOTH
MODIFIED, SINGLE PLY)
MBLD
95
SHINGLES (ASPHALT, FIBERGLASS)
MBLD
96
SHINGLES (METAL ROOFS/WOOD SHINGLES & SHAKE)
MBLD
97 r
STAGE 2 VAPOR RECOVERY SYSTEM
MBLD
99
SOIL IMPROVEMENT
MBLD
0100
BULK STORAGE PROPANE TANK
MBLD
0101
REMOVABLE STORM PANELS
MBLD
0107
TILE ROOF
MBLD
0110
WATER MAIN
MBLD
0111
SITE PLAN
MBLD
0112 -
INDOOR EVENT/EXHIBIT ,
MBLD
ELECTRICAL
04
FIRE ALARM SPECIALTY
MELE
16
SPECIALTY WIRING
MELE
38
GENERATORS
MELE
40
BUILDING PUBLIC RADIO ENHANCEMENT SYSTEM
MELE
PLUMBING
0020
SEWER CONNECTION TO PUBLIC SYSTEM (THIS CATEGORY
„ .
IS USED WHEN NO BUILDING PERMIT EXIST)
MPLU
0024
INTERCEPTOR/GREASE TRAPS (REPLACEMENT OR
INSTALLATION THAT IS NOT PART OF A BUILDING PERMIT)
MPLU
LPGX
01
LIQUEFIED PETROLEUM GAS
MLPG
02
MISCELLANEOUS
MLPG
04
LIQUEFIED PETROL. GAS/STATE
MLPG
MECHANICAL
09
ABOVE/BELOW GROUND TANKS/PUMPS
& POLLUTANT STORAGE SYSTEM
MMEC
38
COMMERCIAL HOODS
MMEC
43
FIRE CHEMICAL
MMEC
46
SPRAY BOOTHS
MMEC
48
SMOKE CONTROL
MMEC
52
RESIDENTIAL ELEVATOR
MMEC
FIRE
32
FIRE SPRINKLER
FIRE
V
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of