FW-13-866j- I
Miami Shores Village
✓�a Building Department
1, 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
r� Tel: (305) 795.2204 Fax: (305) 756.8972
Q 1
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit Typ : BUILDING ROOFING
Ownet's Name (Fee Simple Titleholder) Bary Universitt
Owner's Address 11300 NE 2"a Ave
City Miami Shores State
Tenant/Lessee Name
Email 41
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JUL 17 20B
_, �° o 0o aoo°ooa0000 / d
Permit No.
Master Permit No.
Phone # Sas— ?49 4(bsy
Zip 33138
Phone #
Vr
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Job Address (where the wor a 306IVOe�T c�
City Miami S ores County Miami -Dade Zip 93%(01
FOLIO / PARCEL # 11-213 000-0050
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name _eN4&Z &Wr&C41; C) �,uG Phone #
Contractor's Address S Sr 4(/e CfAd�+
City fe)j / �Q.u�Ic�orare State t�,Gi Zip
Qualifier Name eR�Eel- e] 6eL Phone # 90-5.FifI/ df
State Certificate or Registration No. 1X0 0 /5"F 73 Certificate of Competency No.
Contact Phone E-mail
Architect/Engineer's Name (if applicable) NIA Phone #
Value of Work For this Permit $. J/ ?%O,QO Square / Linear Footage Of Work: oy
Type of Work: * �ddition
❑Alteration 2lew ❑ Repair/Replace ❑ Demolition
Describe Work: od5,Q Zn S r;�rw.S f. �� .,7
L -
r
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $.
Scanning $ Radon $
Double Fee $
Structural Review. $
DPBR $
CCF $ CO/CC $
Technology Fee $
Bond $
Violation date: 141 , c_
Total Fee Now Due $ (��gp3
See Reverse side -�
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
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, BOILERS, HEATERS, TANKS and 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 post d notice, the
inspection will not be approved and a reinspection fee will be charged. A / ,I �
Signature
Owner or Agent .�
The foregoing instrument was acknowledged before me this
day of •79 , 20 a by �. in "o n L fc 44o
who is personalk know or who has produced
V Contractor
The foregoing instrument was acknowledged efore me this—// /
day of (/ "20/
8 , by
who is personally known to me or wbo has pr-odused
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
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Sign:Sign:
Print: Print:
\o\v�N icy`,®
My Commission Expires: 8//b Il ```\���P�OpRA J.•CODBo®�� My Commission Expir s: ,,, rI,IO
.....
` . ��asswa .•�' ," r s�,y LAUIPIE A CHAPMAN
_; ! te,� s =.: Condeslon # EE 054039
j _ : Ex ms M&U, 2015
6'Yrly 7
APPROVED BY ki ` ' s�Nlarr miner Zoning
Engineer Clerk checked
(Revised 07/10/07)(Revised 06/10/2009)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No: FW 13-866
Job Name:
July 29/2013
Building Critique Sheet REVISION
1. Show the fence layout on the survey.
2. Remove the second type of fence details.
3. Why are equipment layouts provided.
Mehdi Ashraf
Building Official
Page 1 of 1
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.
STOPPED REVIEW
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No: FW 13-866
Job Name:
July 29/2013
Building Critique Sheet REVISION
1. Show the fence layout on the survey.
2. Remove the second type of fence details.
3. Why are equipment layouts provided.
Mehdi Ashraf
Building Official
Page 1 of 1
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.
STOPPED REVIEW
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