PL-12-18-3768, 398 NE 100 St (2)BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department R F rP,V -,,o
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 F
Tel: (305) 795-2204 Fax: (305) 756-8972 1 2019
INSPECTION LINE PHONE NUMBER: (305) 762-4949 F
FBC 20 1-7-f
Master Permit No. PL-12-18-3768
Sub Permit No. V_t N q .. ,
❑BUILDING ❑ ELECTRIC ❑ ROOFING Q 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#: 1 1-3206-013-5410 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 Phone#: 305-401-5227
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 Phone#: 305-424-8642
Address: 7389 NW 54th Street
City: Miami state: FL Zip: 33166
Qualifier Name: Yurek Vigo Phone#: 305-424-8642
State Certification or Registration #: LPG023368 Certificate of Competency #: LPG023368
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ ( Square/Linear Footage of Work:
Type of Work: ❑ Addition N Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Gas Plan Revision
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $ Notary
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ I (j`'
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 comqAencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. the absence of such posted notice, the
inspection will n e a roved and a reinspection fee will be charged.
Signatu
ER or AG
The foregoing instrument was acknowledged before me this
11th day of February Zo 19 by
Paul Majoros who is personally known to
me or who has produced DL
identification and who did take an oath.
NOTARY PUBLIC:
Sign: zmg�=
Print: Dianelys Perez
as
Signature
The foregoing instrumerlt?as acknowledged before me this
11th day of February 20 19 by
Yurek Vigo
me or who has produced DL
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: Dianelys Perez
as
Seal: Seal:
DIANELYSPEREZ DIANELYS PEREZ
Notary Public -State of Florida `
Y ram. `` Notary Public - State of rorida
Commission # GG 089678 • . Commission # GG 089678
Bordedthrough National NotaryAyr. °,`�•' Bordedthrough NatioralNotaryAssr.
APPROVED BY<'-�`---�� /� �� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)