REV-11-19-2634, 335 NE 101st StMiami 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
FBC5
BUILDING Master Permit No. ��?- -02
PERMIT APPLICATION Sub Permit No��
[Z/BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
JOB ADDRESS: 335 N E 101 Street
City: Miami Shores County: Miami Dade Zip:
DRAWINGS
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Federico Rojas Phone#:305-484-7714
.,.,_ --335 NE 101 Street
City. Miami Shores
Tenant/Lessee Name:
Email.. federico.rojas@yahoo.com
State: FL Zip: 33138
�` 1\����� `\�.. Phone#:
CONTRACTOR: Company Name: �-`.�C Ni'� 1� 'C� �-�-
Address: I U? 110 U 17_ S-C
City: 1f��QG P11.1-� Stater— Zip:
Qualifier Name: 6 rw'(_ - Phone#: `" 4 - I t=
State Certification or Registration #: C c- Certificate of Competency #:
DESIGNER: Architect/Engineer:
ne#:
Address: City: State: Zip:
Value of Work for this Permit: $ �3,G G U Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 7c, 4-f C:C'-N C-wy) C Nk'�E-r �hj
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $= - ` CO/CC $
Scanning Fee $ Radon Fee $ s 1 40 DBPR $ i 0 Notary $
Technology Fee $ • e �t 1 Training/Education Fee $ �! ' '` > Double Fee $
Structural Reviews $
Bond $
(Revised02/24/2014)
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
0
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 fast inspection which opear seven (7) ys after the building permit is issued. In the a Bence o s posted notice, the
inspection will not bye-d'ancya einspec or fee will be charged.
Signat
OWNER o`r AGENT
The foregoing instrument was acknowledged before me this
i day of Or_ r css V-- 20 !"A by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: Q
Print: i+Podli'% Mari
Commission # GG099300
Seal: -IN= Expires: April 30, 2021
Bonded thru Aaron Notary
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of O-E—T-F`ff �-- 20 \"1 by
who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: oAl"tc11,_ ILA-4,.1....,...IAI—
Seal: Commission # GG099300
Expires: April 30, 2021
Bonded thru Aaron Notary
as
APPROVED BY l Plans Examiner Zoning
Structural Review Clerk
tp—i in') I M hni A