DGT-3-18-626 CanceledMiami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 Nov 0 118
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20t`t
BUILDING Master Permit No.t)61 t�-- 371
PERMIT APPLICATION Sub Permit No.T)bll I V-- G2(4=
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF .CANCELLATION ❑ SHOP
/ // CONTRACTOR DRAWINGS
JOB ADDRESS: �7 1"I�// 0,)
City: 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):
Address: � r /6�lw �"o c
C �%49��4Cii� Phone#: a"---'S
City: o� b�l Zip:
Tenant/Lessee Name:%%�A]�* Phone#:
Email
CONTRACTOR: Company Name:Phone#:
Address:
City:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:. _
DESIGNER: Architect/Engineer:
Address:
City:
Phone#:
Zip:
Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: [C=5 G-0-W4C4r-q>61Z4-V%1. T D6—[ 18 (DLjce 'V""
-nGn-T t I. -- 33 l 1
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(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
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 inspectiory 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 chtarged.
Signature - .
OWNER or AGENT
The foregoing instrument was acknowledged before me this
S day off �i�1C�� 20 L by
7Uefo(� l''"i1i'kz�who i erson kno to
me or who has produced
Signatu
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of
as me or who has produced
20 , by
who is personally known to
identification and who did take an oath. identification and who did take an oath.
as
NOTARY PUBLIC:
IIIIIIIII/�l�� NOTARY PUBLIC:
�y i
Sign:
�.'`Y'e r � : ,Sign:
Print:
o•�� =Print:
Seal:
ono•°, o2oti o�: �� Seal:
************************************************************************************************************
APPROVED BY
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk
Miami Shores Village,
Building Department - 'e
10050 N.E.2nd Avenue, Miami Shores, Florida 33138'9'tp
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 �P
FBC 20 l� l
BUILDING Master Permit No.-b
PERMIT APPLICATION Sub Permit No " -1
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING
❑ MECHANICAL
❑PUBLIC WORKS ❑ CHANGE OF
-ANCELLATION
CONTRACTOR
DRAWINGS
JOB ADDRESS:
_ % '' �(✓
r�r S-5
City:
Miami Shores
County: Miami Dade
-�
Zip: co)
Folio/Parcel#:
Is the Building Historically
Designated: Yes NO
Occupancy Type:
Load:
Construction Type: Flood Zone:
BFE: FIFE:
OWNER: Name (Fee Simple Titleholder): 162 1Z w1E '�' Jz!lJ�ns f�/U Phone#: )J s 9- Y1 32*1
Address: L�3' � IV � 6 S-i
City: �����% �1 %f�7� State: rL Zip:
Tenant/Lessee Name: _..... Phone#:
Email: t l(✓ 14—, CV—CV-r !VL
CONTRACTOR: Company Name: -�n �� - d^`�C Phone#:
Address:
City:
p:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ _i �9 3 Square/Linear Footage of Work: Z T K
Type of Work: ❑ Addition ❑ ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
{L�IZr�lr �s i
Specify color of color thru the:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $ _
DBPR $ Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $ _
(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 $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 4e approved and a reinspection fee will be charged.
Signatu
TheefforregoMg instrument was ac�knno�wledged before me this
y % day oof� ,.�'� � ` , 20 by
—50ZA6X- l %6 '` , who is p a y k owp4o
me or who has produced
identification and who did take an oath
NOTARY PUBLIC:
Sign:_
Print:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of , 20, by
as me or who has produced
, who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
@lli�I��PP
Sign:
III C1"-:9� s Print:
as
Seal: Seal:
--io�`a � rnc_n•
t; -A • "'t
11111111��O
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
BUILDING
PERMIT APPLICATION
Miami Shores Village 17 .
AR
Building Department 12 018
i
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FRC 2i0 I--
Master Permit No� `� J 0
Sub Permit No
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
/ ( CONTRACTOR DRAWINGS
JOB ADDRESS:��
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: 1Construction Type: Flood Zone: BFE: FFE: 2
OWNER: Name (Fee Simple Titleholder): a ICJ1�i �� � s� v IN U Phone#: �5�92—c>Z
Address: ';� 7 /t)Cj /�p �-
City: X/State: C -o 4 Zip: -33 4 So
Tenant/Lessee Name: Phone#:
Email: TIFF
CONTRACTOR: Company Name:
Address:
Phone#:
City: State:
Qualifier Name: Phone
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
p:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: 1/ LUrSSL
Type of Work: ❑ Addition Alteration D New ❑ Repair/Replace ❑ Demolition
Description of Work: 2— ELL Gz-) Cta4 , ,f Ad— A11 AC N-Z") qSD o 1
Alva ` i -- e--)art- grr/i5-- -tip Ljf2 L 6 /J Pb)G
ji�� � LUA S -Du 'C-'-T+WE � FLt'Lr'c ! lRA-7/J
Specify color of color thru tile:
Submittal Fee $ � + � Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
DBPR $ Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(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 $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 tie approved and a reinspection fee will be charged.
Signature _._ _..________
Signature
r
OWNER or AGENT
The foregoing instrument was acknowledged before me this
da o =&jw 20 � by
ONP, 1 who is personally known to
me or who has produced 1v -uVE(— U-C F—NJ st—:�
identification and who did take an oath.
NOJPBLIC:Sig
Priv
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Fb9
Seal: {} Seal:
spar Aver. Notary Public State of Florida
Sindia Alvarez
OF F�Lxpires 09103I2018
.'x..:W #.:,A .F. JA.,R..> .R. li...nh.!;�
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)