BPP-10-18-3218 Canceledz;0
�_.M
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
OC 19 2018
FBC 200
BUILDING Master Permit No. 61P? 10. - 3ZI8
PERMIT APPLICATION 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: '33j -0.
Occupancy Type: Load: Construction Type:
OWNER: Name (Fee Simple
Address- — /t! Llj
City: SAk,CSF-$ State:
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
Address:
the Building Historically Designated: Yes NO
Zone: BFE: FFE:
�$3%�L�.
City: Ni f wi State: 74. Zip: J.3 /815-
Qualifier Name: ALoc ROZ)Z6(lei Phone#:�4�'F70^'$eW3
State Certification or Registration #: < PC ,LDS i8 44 S" Certificate of Competency #:
DESIGNER: Architect/Engineer: V lG-r(2� � Phone#:�- ]�4/_ ZOZi�i
Address: /_? 6?;7 !S & /6-6 -� j City: ! l% /Lf State: J:L Zip: &3/ 7 7
Value of Work for this Permit: $ Z 1.cam✓ Square/Linear Footage of Work:_
sp
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work: N J_ iA) S k/ I M ivl I m C� POOL A0 -6FfA
Specify color of color thru tile.
Submittal Fee $ J Permit Fee $
Scanning Fee $ _
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $ T50 J ,
TOTAL FEE NOW DUE $ 62�
11 I Zoo. 30
Af
Bonding Company's Name (if applicable)
'Bonding Company's Address
City State
Mortgage Lenders 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appI and o reinspection fee will be charged.
Signature Signature
OWNER or AGENT ONTR R
The fo going instrument was ackn wledged before rIp'e,this
day of v: 20 /� , by
tse/o s who is personally known to
me or who has produced (-)01 — as
identification and who did take an oath.
NOTARY PUBLIC:
Print: G/2 fJ TN LLO (-)P— LI
Seal:
... CRISTINA RODRIGUEZ
y,�,n; Notary Public - Rate of Florida
_r COmmRs,on: PG 105164
L°6'•=`0. My Comm Expresl'Aay16, 2021
+..:x.+�swrr rw r$#rtyt!;td?r'F.S#tfi R'h�'eff )#si.'
APPROVED BY
L-
The foregoing instrument
was acknowledged before /m is
7F day of ! I Y"''�°)s I 20 by
/ .
� �-0, L / &1'1 shiris eerrsce nown to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
4ian•
Print:
Seal:
Plans Examiner
Structural Review
(Revised02/24/2014)
CRiSTINA RODRIGUEZ
Notary Public - State of Florida
Commission - GC 105164
ncnrr t"-
as
Clerk
Miami Shores Village
1Bo ildinguDepartme, Miami Shores, 'entda $
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
SEP 0 7 Z323
By J f
FBC 20?-0 -
BUILDING Master Permit No, BPP- 32 I
PERMIT APPLICATION Sub Permit No.
MBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF �4 CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBADDRESS: 3Cj WV 10 iI
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BEE: FEE:
OWNER: Name (Fee Simple Titleholder): -1j2h ';Z `VC/OS Phone#:
City: !o/� R A& a - v State: ^/ G Zip: Z 7 ,'TZ c
Tenant/Lessee Name: Phone#:
Email: // f�J[/ �
CONTRACTOR: Company Name: /V1'0jq ,� l cP—e$rQn Phone#: 305-470-g88?,
Address: Zy 73 15W /� ] avgy+?i
Email:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: _Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 1-4
Specify color of color thru
Submittal Fee
Scanning Fee $ _
Technology Fee $_
Structural Reviews
Permit Fee $
DCA Fee $
Training/Education Fee $
DBPR $
P&Z Review $
Co/cc $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
(Revised04/05/2022)
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 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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
-7 -7� day of 20 23 by
•JU C"-% PTV-eo-a s who is personally known to
me or who has produced i—�L as
identification and who did take an oath.
NOTARY PUBLIC:
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:
as
Sign: vr w\-"" Sign:
Print: V l V t -e-n✓ -o--4a-0 Print:
\`��P'��// Vivienne Yao
Seal: �r.....1 PSeal:
9;;F� `1% Comm.:HH222410
Expires: Jan. 31, 2026
°;0"` NotarryyPublic•State ofFlorida
ublic*s***************************************************s**************************
APPROVED BY
Plans Examiner
Zoning
(Revised04/05/2022(
Structural Review
Clerk
Z 3
0
OZ3
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