BPP-14-1063Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 7952204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUII.DING Cor4facA.0f 15 DonC[
PERMIT APPLICATION
Permit Type: BUILDING
FBC 20
Permit No.
Master Permit No. 8PPZ'/®15
QIZIIM1l4
JOB ADDRESS: —5 0 Al & &- _n W -.
City: Miami Shores County: Miami Dade Zip: J 3135
Folio/Parcel#;
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): ° "/ 1 !j U 6J ,Vd ids- ,% P ,O Phone#:
Address: 50 lades _ !2
F
City:sLf r State: F &_ Zip: 3 j /
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 1 ?61 i ` 0 E) C.5
Phone#: -3�i M5 3 %-5
Address: /33? 50 t ST j t7, o
City: "I nm / State: Ff: Zip:
Qualifier Name:
State Certification or Registration #: 02C 0156113V Certificate of Competency #:
JC51,2_55--5_3i
Contact Phone#: 1-3' --S 3 i _ Email Address:
DESIGNER: Architect/Engineer: ill G e o k_ F�e rt.") co Phone#: ,30,5/2 , 3 es - Fi 6 3 /
Value of Work for this Permit: $�' Square/Linear Footage of Work:'V6
Type of Work: ❑Addition ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: N W .5cu d m m e 4 y A£)O.L- ,®,S P,} V j9eeK
Color thru tile:
Submittal Fee $ _ a . lel Permit Fee $ CCF $ CO/CC $ 60 ' co
Scanning Fee $
Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 1C
' I (, 2-2- .
Bonding Company's Name (if applicable)
Bonding Company's Address
City state
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
rr
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 conditio to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy f the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to a Also, certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which o urs leve 7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approve Fred aro
ection fee will be charged. _ / J .
11`14N1 r or Agent
The foregoin trumem was acknowledged before me this
day of , 20 &, by kk 0
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: ✓
Print: H c
My commission Expires: i�
EXPIRES: January 10, 2016
Bonded Thw Nary Puft UnBwmftm
Contractor
The foregoinjinstrument was acknowledged before me this
day of A4, I 2O L4—, by ',-&hli; Al fiekk
who is personally known to me or who has produced
as identification and who did take an oath.
APPROVED BY % Plans Examiner
A -46q— fly Structural Review
(Revised 3/12/2012)(Reviwd 07/10/07)(Revised 06/10/2009)(Revi ised 3/15/09)
NOTARY PUBLIC:
Print: Z1J&7LW
M Commission Ex =# Nry C0�
Y P _`f� January 10, 2016=
Bonded Thru Nary Public Umlo wtbars
Zoning
Clerk
Miami shores village
NOTICEOF
As
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
I (We) acluumledge that a new svf>Imming pnol, spa or hot tib will be constructed or Installed at
,jd Ata 9G 5r iq)Rg/ ��� , � � 31-39 dgiami Shores, PL, and hereby
affirm that one of the following nWthods velli be used to =d ON requkwmft of ChaPter 515,
Florlda Statues and the Florlde Building Code 84101.17.
ftese Initial the method(s) to be used:
The pool will be equipped with an approved safety pool cover that comp lies with ASTM
F1346-91. (Submit Manufaituurees. Specifications).
A continuous, one-piece (child} barrier meeting the requiremerifs of Roma Building Code
R4101.17.1.15 will protect the pool perimeter. The plans shag show the fence location and method of
attachment, Including one end that shall not. be removable without the aid of took. (Submit Manufacturer's
Specifications).
A combination of non -dwelling walls and fends (screen enclosure, child fence, masonry
fence wags, chain link or wood fence, etc.) will protect t he pool perimeter. The plans must specify t he type
and location of all non dwelling walls. Florida Building Code, RM 01.17.1
� Any combination Of protection which incorporates dwelling walls with openings directly into the
pool perimeter and all windows and doors will be equipped with exit alarms complying lying with Florida Building
Code, 84101.17.1.9 (Submit Manufacturer's Specifications).
Any combination of protection which Incorporates dwelling walls with openings direly into the
pool perimeter and alt doors will be equipped with a seif4atching device with positive mechanical
latching/locking installed a min. 540 above the threshold. if this option is selected, submit pians showing all
types and location of all perimeter protection. The dans must also show the location and type of all
openings, and the hardware type for each location. (Submit Manufacturers Specifications).
In accordance with the Code, the pool may not be filled with water without compliance with the
Private Swimming Pod Safety Requiromb, and upon expiration a permit. the pool shall be
presumed to be unsafe. I understand that not having one of the a ve Installed will constitute a
violation of Chapter 51 , S ., an d will be considered as a rnis r of the second
d
Puml .klqd In Section 775.082 or Semon .083 F.S . s form must be signed
the ant
rw;w
C 'S SIGNATU AND A SIGNATURE AND
CONTI TOR'S NAW REASF PRINT} _ f ' r (� P IT) �
s-
W,tl U.,..,.,,I-- - IVUPkrc�r AA.YNSCHwnrZER
MY COMMISSION # EE 129586 = : ,Y My COMMISSION # EE 1ER
EXPIRES: January 10, 2016
Bonded Thru Notary PubUc Undertvd m, , Rf� ` � Bmded TIou Noby Public U' 20nde ar6f m
Miami shores village
Building.Depaftmant
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
MWIMI dG PGGL CERTIFICATION
Date �/
Miami Shores Village
Building & Zoning Department
Attention: Budding official
t.I certify that t am the legal owner of the property described as /�/ 'B -511""S cyA-'� .
zrt. AloeC -S' - , looted at
.SU '4j q' s o (1i i -V/0'r CS `,,L 31313'f
In accordance with Section 33-12(f), Code of Metropolitan Dade County, l certify that 1
understand and agree that the swimming pool to be constructed at the above address cannot
be used or filled with water until separate permit has been obtained for an approved safety
barrier, and such barrier erected, inspected and approved.
I further understand that this certification, however, does not elimina)6 the need for
obtaining a permit and erecting and approved barrfer prior to final insploon an 'o# the
Em
Legal Owia_
Note: This certification is to be submitted with a swimming pool permit application in duplicate.
In accordance with Section 33-12(f), Code of Metropolitan Dade County, l certify that 1
understand and agree that the swimming pool to be constructed at the above address cannot
be used or filled with water until separate permit has been obtained for an approved safety
barrier, and such barrier erected, inspected and approved.
I further understand that this certification, however, does not elimina)6 the need for
obtaining a permit and erecting and approved barrfer prior to final insploon an 'o# the
Em
Legal Owia_
Note: This certification is to be submitted with a swimming pool permit application in duplicate.