The URL can be used to link to this page

MC-13-1514 (2)i Permit Type: JOB ADDRESS: Miarin Shores Village LBY:i Building Department �� pn 0050 N.E.2nd Avenue, Miami Shores, Florida 33138Tel: (305) 795.2204 Fag: (305) 756.8972 SPECTION'S PHONE NUMBER: (305) 762.4949 FBC 20 '. Permit 'CATION Master Permit No. r lop City: MMiami Shores County: Miami Dade Zip: Folio/ParceW 11- 320(p"O13 --3t_AQ � Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): ��rrl-ems one#: Address: 13-7 N G CL;� -=-r ' + City: r-niOVY)t State L Zip:.331-30, Tenant/Lessee Name: r—^ Phone#: Email: CONTRACTOR: Company Name: _ Address: - F00 _5 (>s.*-> cl a V Nq1 O t3 ( A& a Phone#: 305 - 5 q9— 11 / Z City: m 1 am i State: r-11 Zip: -3L3)—f( g Qualifier Name: , Phone#: State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: � 0 Qt?�Ple DCS_ iiGti'1 C ° � Phone#: 79 o 29 ©!R& I �D Value of Work for this Permit: $ Squam/I.inear Footage of Work: Type of Work: ❑Address OAlteration ONew DRepair/Replace (Demolition Description of Work: 044 «&4 Tom-- Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ ogle Fee $ Structural Review $ \� I TOTAL FEE NOW DUE $ 0 o l v� Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Zip Mortgage Lender's Address City 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 EUPROVEMENTS 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 e good faith that a copy of the notice of commencement and construction lien law brochure will subject to attachment Also, a certified copy of the recorded notice of commencementmust be po occurs seven (7) days Oer the building permit is issued In the absence of such posted n c reinspection fee will be charged Op4& $,gala Signature _ of or A gding $2500, the applicant must promise in delivered to the person whose property is at the job site for the first inspection which `hp Inspection will not be approved and a A Contractor The foregoing instrument was acknowledged before me this __31 The foregoing instrument was acknowledged before me this day of 0 by_ �� day of 20 by -� who is sonally�l l U who has produced who is personal! a or who has p aced As identification and who did take an oath. NOTARY PUBLIC: Sign: C Print: dN Nuulra My Co MY COMMISSION #FF079719 '+aZor .•� EXPIRES December 29, 2017 APPROVED BY?0 1 q Plans Examiner Structural Review Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10MN)(Revised 3/15/09) as identification and who did take an oath. NOTARY PUBLIC: iQ LAURA B FERNANDEZ Q. 86SSION #FF079719 EXPIRES December 29, 2017 398.0153 Pt.JA. ___ — Zoning Clerk