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RC-12-22-3085 CanceledMiami Shores Village T Building Department DEC 0 9na 10050Tel: (3 5) 795-22 41Fax: (305) 756-897233138 CANCELLED BY. INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No. (2C-IZ-u-�o5 PERMIT APPLICATION dBUILDING ❑ ELECTRIC ❑ ROOFING Sub Permit ❑ REVISION 0 EXTENSION RENEWAL ❑PLUMBING MECHANICAL CHANGE OF ❑ CANCELLATION ❑ SHOP ''11 (J CONTRACTOR DRAWINGS JOB ADDRESS: 7 � N)c- City: Miami Shores County: Miami Dade Zip: 3 3 I3 ? Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: OWNER: Name (Fee Simple Titleholder) e,l,lro«• q Ir 1 S AIL 41,> Construction Type: Flood Zone: �1C>RGh`/ SCI?w/tClt City: fl "L S lil)it('S State: F L Tenant/Lessee Name: Email: SLR+rJ/�i,i� 1 e 00T 400u A- Lllm BFE: FFE: 60t -3Lis -11r1) p: 311)-9 6W 345 -f}11 CONTRACTOR: Company Name: NW-1 C46 Phone#: :-uJ �776tTV Address: 32q�-) /V RJ -94h 746F Email: C>a4/ 03/� & CA1UCyZEC1N , C,6A4 Qualifier Name: CI&/&] X4 Phone#: State Certification or Registration #: C'CL 16123W�o Certificate of Competency #: DESIGNER: Architect/Engineer: Address: City: State: Zip: Value of Work for this Permit: $ y�69 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $ " Structural Reviews $ r Permit Fee $ DCA Fee $ Training/Education Fee $ CCF DBPR $ CO/CC $ Notary $ Double Fee $ P&Z Review $ Bond $ (Revised04/05/2022) TOTAL FEE NOW DUE $ 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 insaection will not be aaaroved and a reinsaection fee will be charaed. Signature N OWNER or AGENT The foregoing instrument was acknowledged before me this day of , 20 27- , by uru .Sc , who is personally known to me or wh9as produced GI- DC, as Signature _ -4 &/ CONTRACTOR The foregoing instrument was acknowledged before me this q day of .4C�*\1�Q-- 20 '�90- by 49 who is personally known to me or who has produced PC-JC0 110'A rA-I•as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: t PSign: Sign: Print: t Print: AJoaA Seal:; MICHAEL ROJAS Seal: ' M1 Notary Public . State of Florida Commission p HH 0786D7 (ti'�' i''• =.i HE6ERT MARTINEZ k1yCAMMISSIOH k HH 323276 ,or "•••' My Comm. Expires Jan 7, 2025 +' � ' EXPIRES: October 18, 2028 ,'1701 M1�, r APPROVED BY Plans Examiner 4 TZoning Structural Review Clerk (Revised04/05/2022) RF;CnIVLD BUILDING PERMIT APPLICATION 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 MAY 0 S 2023 BY:9::�t FFBC 20 Master Permit No. RC — 12 `22- 3089 Sub Permit ER BUILDING Ej ELECTRIC ® ROOFING © REVISION [3EXTENSION []PLUMBING I3 MECHANICAL ® CHANGE OF PqCANCEr_ATION /13SHOP CONTRACTOR DRAWINGS JOB ADDRESS: RENEWAL City: Miami Shores County: Miami Dade Zip: 3,3)36) Folio/Parcel#: 113c2,O(,O 13 N 7o Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titl City: M1aAl" State: Tenant/Lessee Name: Email CONTRACTOR: Company Name:,/ CJII r C_Uff ICL..U/�,7T/vC.TrUY� Phone Address: 3.R/ 7 2 " Air A Curl r 3 3 I3a Email: Lit-uicL D 6p e coia on,G0/h Qualifier Name: CLt%IDS "4-y4 Phone State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone 33139 7f6-7V -87fY Address: City: State: Zip: Value of Work for this Permit: $ --P' Square/Linear Footage of Work: Type of Work: I3 Addition [3 Alteration I3 New ® Repair/Replace ®Demolition of Work: Specify color of color thru tile: Submittal Fee Scanning Fee $ _ Technology Fee $_ Structural Reviews I Permit Fee $ DCA Fee $ IA CCF DBPR $ Training/Education Fee $ P&Z Review $ 0 CO/CC $ Notary $ Double Fee $ _ Bond $ (Rev1sed04/05/2022) TOTAL FEE NOW DUE $ 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 ce rfy that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet :he 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 r, 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 rein ection fee will be chargeed. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of rIt� 20 a3 ,by </eM k who is personally known to me or who has produced identification and who did take an oath. NOTARYPUE Sign: Print: Seal: ************ .;iJ-Y i "•.. z%C ANGELICA BAUTISTA Notary Public -State at Florida ;a• Commission p GG 930159 My Comm. Expires Nov 7, 2027 Bonded through National Notary Assn. APPROVED BY as The foregoing instrument was acknowledged before me this 00 day of 120 23 by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Seal: ANGELICA BAUTISTA g/,•f;°: Notary Public -State of Florida Commission It GG 930159 n°F' My Comm. Expires Nov 7, 2023 ... Bonded through National Notary Assn. *************** Plans Examiner ***************** Zoning (Revised04/05/2022) Structural Review Clerk