RC-12-1029 (2)Miami Shores Village
Building Department APR 16 2AQ
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: 15 210 6'\'!S C
FBC 20 (Z:)
Permit No. ) 3 "'-�
Master Permit No. RL—
ROOFING
Vz.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholder): sA& SO v1
Address: +5 20 1EA5co�y rxR— 6W � .
City: —1A7t& State:
Tenant
Email:
NO X Flood Zone: N0
:�V l
3-31 3C6
CONTRACTOR: Company Name:
1. Address:
Pity: -�ju in nN1Ibe_A
Qualifier Name: C'J,�A t ke-Y ►'ti
State Certification or Registration #: P
• Phone#:
ke-
State: IFI
Certificate of Competency #:
zip: 3 31 (v 6
T75( n —q43--SZjpi
O
Contact Phone#: Email Address: eXWI o • . � V M Al v &O'n,
DESIGNER: Arc ngineer. r� �SC�In Phone#: -3v r (-1-c)
Value of Work for this Permit: $ co Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration 9INew ❑Repair/Replace ❑Demolition
Description of Work: w C�Ylt JCAA-X-�/ iw� 'IYb V► �^� � �
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
&F
CO/CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ l
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
f,
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 . ,g
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 aJll
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.
4 9
Signature
Owner or Agent
%�
The fP**rument was ac wl ed b ore this
day obywho iknown to a or who has produced
identification and who did take an oal .
NOTARY
Sign:
Print:
My Commission Expires:
APPROVED BY
5 o��aa
2 205
s`a
Signature
Contractor
The foregoing instrument was acknowledg before me this 14
day of M 20 lei, by v-Ui Ko
who is personally known to me or who has produced
L t 22-?ZZa -6 n%&Qtification and who did take an oath.
NOTARY PUBLIC:
Sign-:::
Print:
My Commission ExpJP%;!% W=
** MYCOMMIN10N #EE 150323
EXPIRES: January 17, 20th
10°�Mlod Ba edikn8 1 8anesb
�y (� Plans Examiner 9&3 -zoning
Structural Review Clerk
(Revised 5!2/2012)(R6yised3/12/2012) )(Revised 06/10/2009XRevised 3/15/09)(Revised 7/10/2007)
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT #: DS� ✓ �CQ� DATE: 41 Z3
,, C-1X-t4k&I �V)-61
Contractor
Owner
zi Architect
From the building department on this date in order to have
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: 'F
PERMIT CLERK INITIAL:
IYllsslon. Rick Scott
To protect, promote & Improve the health APR 15 2013 Governor
of all people in Florida throu§h Integrated ` a John H. Armstrong, MD, FACS
state, county & community efforts. r State Surgeon General & Secretary
HEALTH
Melon: To be the Healthiest State in the Nation
April 10, 2013
Jason Fevia
9520 Biscayne Boulevard
Miami, FL 33138
RE: Contingency Letter
Application Document No: API 101611
Centrax Permit Number: 13 -SC -1462355
OSTDS Number:
9520 Biscayne Blvd
Miami, FL 33138
Lot:3 Block:75 Subdivision:
Dear Applicant:
This will acknowledge receipt of an application dated 03/21/2013 for a permit to use an
existing onsite sewage treatment and disposal system located on the above referenced
property.
Proposed new walkway (pavers) and and driveways.
From a review of your completed application, it has been determined your existing system is
adequate for the proposed use.
If you have any questions on this matter, please call our office at (786) 315-4444.
Sincerely
Carlos
Enclosures
cc:
Florida Departmental Health www.FloridasHealth.com
In DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St, Opa Locks, FL 33056 FACEBOOK:FLDepartmentofHealth
PHONE: (305) 623-3500. FAX: (305) 623-3645 1 YOUTUBE: fldoh
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
April 18, 2013
Permit No: DS13-769
Planning Critique
1. PAVERS OK
2. SLABS NOT PERMITTED IN SIDE YARD SETBACK.
David Daquisto
305-762-4864
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.
r 4
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
April 18, 2013
Permit No: DS13-769
Planning Critique
1. PAVERS OK
2.
3. SLABS NOT PERMITTED IN SIDE YARD SETBACK.
r
David Daquisto
305-762-4864
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.