PL-12-18-3768, 398 NE 100 StG,
11tr�,� Miami Shores Village
,.VA Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax• (305) 756-8972
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
PZECEI',TED
MA" 1 3 2019
BY:
INSPECTION LINE PHONE NUMBER: (305) 762-4949 !l
FBC 20 I -;�
Master Permit No. PL-12-18-3768
Sub Permit No. -V-
❑ ROOFING FE-] REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 398 NE 100 ST Miami Shores, FL 33138-2421
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 11-3206-013-5410 Is the Building Historically Designated: Yes NO
Occupancy Type: Residential Load: Construction Type: Gas Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): PAUL MAJOROS
Address: 398 NE 100 ST
City: MIAMI SHORES State: FL zip: 33138
Tenant/Lessee Name: Phone#:
Email: PAUL.MAJOROS@GMAIL.COM
CONTRACTOR: Company Name: Garca Group, LLC
Address: 7389 NW 54th Street
City: Miami State: FL
Qualifier Name: Yurek Vigo
State Certification or Registration #: LPG023368
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $
Type of Work: ❑ Addition 0 Alteration
Description of Work: Gas Plan Revision
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
one#: 305-401-5227
hone#: 305-424-8642
33166
Phone#: 305-424-8642
Certificate of Competency #: LPG023368
Phone#:
City: State: Zip:
Square/Linear Footage of Work:
❑ New ❑ Repair/Replace ❑ Demolition
Permit Fee $ CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
CO/CC $
Notary $
Double Fee
Bond $
i n
TOTAL FEE NOW DUE $ _ ---l`
(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
Zip
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 oppCqw4 and a reinspection fee will be charged. , , i
Signatu
The foregoing instrument wasswedged before me this The foregoing instrumenVwas
8th day of May , 20 19 by 8th day of May
Paul Majoros who is personally known to Yurek Vigo
me or who has produced DL.
as
me or who has produced DL
before me this
20 19 , by
is personally known to
identification and who did take an oath. identification and who did take an oath.
as
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Diane ys erez Print: Dianelys Perez
'avLSeal: DIANELYS PEREZ Seal:
DIANELYS PEREZ
2 . Notary Public - State of Florida
Commission a GG 089678 = ? + . - = Notary Public - State of Florida
My Commission k GG 089678
•U9�F; ; ,,AP Bonded hrcuyF m. h2lflCfres d ONOtdry A525R.
9 0 : My Comm. Expires Apr 3.2021
*************IMIR
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)