REV-10-19-2455, 716 NE 92 StBUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
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
❑ ROOFING
F-JPLUMBING ❑ MECHANICAL EIPUBLICWORKS
10B ADDRESS:
ores
q2- 5-t-
FBC 20 i--+ ]Pc.-- 01- ia- 3o
Master Permit No.,,
Sub Permit No. -Rt\l-
REVISION
❑ CHANGE OF
CONTRACTOR
❑ EXTENSION ❑ RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
Folio/Parcel#: Is the Building Historically Designated: Yes NO.
Occupancy Type: Load: Construction Type: Flood Zane: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 6ameA Phone#: )78'cs^o�Q�7`��S0
Address:
City: State: �C'L Zip: 2 3 / .3 8
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: V,/rOCRf IVOC Phone#: j%-q O (0—q �i
Address:3i�0 S. oc-e n C A--1109
City: Liam Q ,J-f, State: -�� Zip: aax)
Qualifier Name: C lands %E�! r ncE�2 Phone#: `(c-Ldfp -qO41K--
State Certification or Registration #: 151��.5 `E�- Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ '.00 404 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ��❑ New ❑ Repair/Replace ❑Demolition
Description of Work: 1J151 ijiit�t�•TG.��Ir7 �lT
Specify color of color thru tile:
Submittal Fee
Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee•$ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $ ry
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 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. l the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signatu
ER or AGENT
The foregoing instrument wa acknowledged before me this
day of 20 0/1"� by
who is personally known to
me or who has produc as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Public State of Florida
The fo egoing instrument was acknowledged before me this
day of 20 ! — + by
who' rsonally kn
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:N
Print:
as
Seat: My Comm Expires Nov 7, 2020 Seal: `sue,commission # GG129380
''°.� `�''Bonded'hrow1r, Nat ' Ai N , i1v AS,- 30, 2021
Bonded thra Aaron Rotary
+pwua
APPROVED BY ! Plans Examiner Zoning
Structural Review Clerk
(Reviseda2/24/2014)
ELECTRICAL REVIEW/�p-ter--/Fi
APPROVEAR�9?__DATE
FLORIDA BUILDING CODE 201-41?
FBC LEVEL 2 ALTERATION
COMP_Y WITH SECTION 107 OF THE
20 FLORIDA BUILDING CODE AND
CHAPTER 8-10 OF THE MIAMI DADS
COUNTY CODE
SCOPE OF WORK
1. REPLACE EXISTING KITCHEN CABINETS WITH NEW CABINETS
2. REMOVE & REPLACE TILE FLOOR IN BATHROOM
3. REFINISH EXISTING WOOD FLOOR, W/ NEW BASEBOARD
4. NEW INTERIOR PAINT EXISTING WALLS
5. REMOVE & REPLACE PLUMBING FIXTURES AS SHOWN SAME LOCATION
BATHROOM RECEPTACLE ON 20 AMP i
AND 1311 PROTECTED
--p" 44
PLUMBING PLANS
Approved Date
Disapproved Date REMOVE AND REPLACE EXIST.
WATER CLOSET AND LAV.
?t' /1'.' NG' COUNTER TO BE MORE THAN
-F , .Pr)!-" in , ; PROTECTED RECEPTACLE.
�I CEP(ACLE UNDER SINK.
; t�r- r) AGPI lahirp.q nNi nFnJrcTrn rl(TC
IN I .111\lr i MUL I I RV I L%a IIVIV
GROUND
FLOOR PLAN
eavarchitect
Eduardo A. Vazquez, R.A.
8425 WAcwm OW.. #103
Mioml. norWa 33138
=711 8�2n-4S12366
.•vreMbM06•IN•ra,.nN
Etk�or6fVOZWU. ,:A
#T4389
.wimwf •er.Atrw.
PROPM FOR:
70NEs2sr
Ll mi More, Ronda
;•a• s
e••• 1 t took
•
• s ♦ •
•
i • • • I a f
rwaEarru.
a r •
• •4 • •
EMMING DERREV. 09/24/19
3GYd: As SHOWN
OMTE: 9EPTEMSM 26. 2016
SCALE: 1 /4"= I '-O"
A-1