WS-12-766 (2)S ►� --
fd�/iz. 141
B ILDING
PERMIT APPLICATION
FBC 20
Miami Shores Village
Building Department
?0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit Typ BUILDING ROOFING
OWNER: Name et): J Ocok
Address: 14-1‘ .5t `e,w- 61q c)
mcmzwarit
ti+Y 0 1 2512
Permit No. �I r y�
Master Permit No.
Phone #: 10s- qcS- C4
Zip: 'q7 IS
Phone#: 3Qj "g6ti A64
City: For :I1 State: ST.,
Tenant/Lessee Name: S0rti 1 k J 1 , o0.1`■S 04 0 'y.,^"J
Email:
JOB ADDRESS: CO N £ 10 Li 0'
City: Miami Shores County: Miami Dade Zip: ' 1 i'3
Folio/Parcel#: 11 i.,14) C - 011 ` 0110
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Nail: v' e d-, & j o." A iQCi, 11d41_ 2S� I n G. Phone #:1 06'2(810 0 G
Address: AQ'ZiiQ Ste' ,S� j1/4.4;.---;,r-L, 11 5 SV. k 1Q
City: State: Zip:
Qualifier Name: n VI l n, (.13 Phone #: 3 U- '1S' (17 1
State Certification or Registration #: C6 C Q Q g Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: N/A Phone#:
Value of Work for this Permit: $ ‘00 Square/Linear Footage of Work:
Type of Work: DAddition UAlteration ONew IgRepair/Replace
tICO is
Description of Work: (I,e p l a ct 'Z euhh'e t: o c
ODemolition
* * * * * * **a *** * ** ** x * *** ****x,x *** *****Fees********************************************
Submittal Fee $ Permit Fee $ \ -(.1 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ • ���
af
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOn FRS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S ANrIl)AVIT: 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 approved and a reinspection fee will be charged.
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 9 by Ge1%��S
who is personally known to me or who has produced D fv41 W'/ L
7/o 46 -753- ()As identification and who did take an oath.
D7
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
KAT'HERINA M. TEJEDA
� iS
= Y-TUC • STATE OF FLORIDA
CO DD915194
0/2013
OTARYI
Signature
._) (IN
Contractor
The foregoing instrument was acknowledged before me this
day of ®1811 , 2012, by i, ° 1, aka
who is personally known to me or who has produced "---
as ides' cAit„�ncrw�o c rxa afakeatg
"" ° MELISSA RAMIRE2
NOTARY PUBLICI �1 1 Notary Public - State of Florida
1 = ; My Come Expires Feb 17, 2015
• =- '
s - • -_,•' # EE 65911
Sign:
rmt: ® z
My Commission Expires:
******* *** ****** **:i<**** ******** * * * ** x****:>: * *:t *** ***** ********a *** *+1< *:i<*************
Plans Examiner
Structural Review
(Revised 07110 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk
t 3 :If.
b
M iamShores
Viiiage
Building Department
RECEIPT
PERMIT #: ��� Cam. I J� ,� DATE:
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
IR Contractor
o Owner
o Architect.���'°
Picked 2 sets of plans and (other,)
Address:
v�,
From the budding department on this date in order to have corrections done to plans
And /or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Department to continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE: sD I o
PERMIT CLERK INITIAL:
Permit No: 12 -766
Job Name:
May 11,2012
Miami Shores Village
Building Department
Building Critique Sheet 2nd
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
1) The design wind Toads are incorrect. The design criteria are incorrect. The correct design
criteria for Miami Dade isASCE 7 —10 175 mph exposure C
Plan review is not complete, when all items above as corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Norman Bruhn CBO
305 - 762 -4859
Miami Shores Vivage
Building Department
RECEIPT
PERMIT #: (k&-\ 1(.L2(12 DATE: JCUJ
I, / ('( a b(6:
Contractor
o Owner
o Architect
Picked up se of plans an
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
11
other CIOV€04
Address: W. 1'n26 =+
From the building department on this date in order to have corrections done to plans
And /or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Depart to continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
PERMIT CLERK INITIAL: e.56-
Permit No: 12 -766
Job Name:
May 2, 2012
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
Building Critique Sheet
1) Provide wind Toad design criteria and design wind pressures from a licensed architect or
engineer signed and sealed.
2) The design wind Toads are incorrect.
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Norman Bruhn CBO
305 - 762 -4859