DS-13-948 :r.
Miami Shores Village
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CI s Building Department MAY 062013
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fag:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20 02'
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
Permit Type: BLnDING ROOFING
JOB ADDRESS: to .� �V:Q CA)° q 6 IT, '��
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City: Miami Shores County: 4P: 3: l
Folio/Parcel#:
Is the Building Historically Designated:Yes NO X 7jWoodZone:
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OWNER:Name(Fee.Simple Titleholder): V 1,0 " ® Phone#:
Address:" IcAq j Q /AJ, U-1 S Cl
city:ot--V A-A,--T State: �^ l Zip: �✓" �� ��
Tenant/Lessee Name: P I hone#:,rSo s 7
Email:
CONTRACTOR:Company Name: Construction Developer Group Phone#: 305-9369802
Address: 20381 NE 30th avenue#414
City: Aventura State: Florida Zip: 33180
Qualifier Name Gustavo Asman Phone#: 3052151988
State Certifications or Registration#: CGC1504895 Certificate of Competency 4P
Contact Phone#: /89�'T�^ 6 g 21 Emig Address: asmangus @aol.com
DESIGNER:Architect/Engineer: Phone#-.
Value of Work for this Permit:$ ®00 73— S Footage of Work:
Type of Work: ❑Addition ❑Alteration `FATew ❑Repair/Replace ❑Demolition
Description of Work: /� /4
I
Color thru tile. 9f
Submittal Fee b ' Permit Fee$ 46 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education;Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ .
IIEIEIVED
NOV 1
e 2013
Afimg Navwnber 12 2013
Min Skam Hilage
10050 ME 2nd AmRar
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To Whom It May Con-cem
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the owner Mr Flavio Moy 165 NW % Street Ylb=l Slm A 3A hudecOcd
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