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BPP-15-844 (2)
� / 1 Midi 111 JI IUI CJ V 111dgC RECTUVED Building Department JUN,1 a 2015 10050 N.E.2nd Avenue,Miami Shores, Florida 33138BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 )0 BUILDING Master Permit No J PERMIT APPLICATION Sub Permit No. BUILDING [--� ELECTRIC ROOFING REVISION EXTENSION RENEWAL PLUMBING r--j MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP �j'�J cCONTRACTOR DRAWINGS JOB ADDRESS: l" I rte' ` / 5r— City: Miami Shores , !fir County: Miami Dade Zip: Folio/Parcel#: k I •3? t�h' C),�[ ' 0"t�0 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: riooa cone: bi-t: �(1-1-t.' -r : t �j �1WNFQ• Namo i as:....... -.,.._......._. . eC/�C V��pr �� _--. - _- `�/` L �v/ Address: City: �/M�-c S - � State: ft Zip: Tenant/Lessee Name: �lf�-- Phone#: Eman. CONTRACTOR:Company J�� to Name: C)�INt �rl/� Phone#:�� 6�' Address: 1�kgk--)% P City: '-k'L A--A-a State: 12 Zip: 1 Quaiitier Name: ©QVt-f' 6 " R;C(--2 i� ejJ Phone#: sedLd i.ef uucduurr ur negis�rduon ff: Cmc�2�I �� -1 Lei uiicdLe of Lortipetency fr: uwwr�etc:r+rcnnecyc(Igrneer. rnoneff: value vi rwiw lug 0.616a rat 11114..q �O.�C�O � +yuac�auicoi rvvaa�c v. wv.n.!�� L• �` .yrc W. vvv.— u --u— L-J I LTJ vc.v LJ vcu wuu�n uescrrpuon or worn: ee r^c-)"x t7r1►-�,�a.,s7 ��.i TGA - - Submittal Fee S Permit Fee$ CCF$ CO/CC$ aLdmems rrn.? nauuri rec.? vDrn i Ivulal y i i ecnnoiogy ree> i raining/taucatron ree> uouoie ree> vira.rcc wrr vaic 3'�tM, l i 41 Bonding Company's Name(if applicable) Bonding Company's Address City State Zip 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,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 posted notice, the inspection will not be rov and a reinspection fee will be charged. Signatr Signature u a OWNER or AGENT CONTRACTOR The foregoing instr Ment was acknowledged before me this The foregoing instrument was acknowledged before me this �Q day of 20_1';;'- by _�day of oxN� 20 15 , by JC AL,el'y\ Q6CC, ,who is personally known to �A& : ke�o.S ,who is ersonally kno 0 me or who has produced �1.. i`�e as me or who has produced as identification and who did tak an oath. identification and who did take an h. NOTA PUB C: NOTARY P IC: Sig 1 _Z Sign: OL Print: 1 Print: Old- Seal: ` REBECA M.PASTRANA Seal: REBECA M.PASTRANA _h1F COMMISSION#EE872624 MY COMMISSION#EE872624 xr4 :XPi RES:February 07,2017or EXPIRES:February 07,2017 ############################### ############################################################################ �W APPROVED BY ►� Plans Examiner Zoning Structural Review Clerk SHORES G Miamiz shores Village "' Building Department .�" FLORIDA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT PePermit N.Gr p �Li 4 Owner's Name (Fee Sim le Title Holder)lf Q- �'I�w �6cezgA- Phone#: I Owner's Address: O 1 /,—)(: S City: J"ktAMti( C(LCV=C- S State : f'Z_ Zip Code: SI Job Address (Of where work is being done): City: Miami Shores State:—Florida Zip Code: I Contractor's Company Name: &L�'C' - Phone#: 32j_ ?IS }' Address: City: �^iV�_\ State: r—L_ __ Zip Code:--7,,,,, 1-25J__. Qualifier's Name : 7L*Pc1�Co klrvSj Lic. Number:C(04, j)2 4tb Architect/ Engineer of Record Name: Phone#: Address: City: State: Zip Code: Describe Work: (Sopw Com- , hereby certi hat the work has been abandoned and/or the contractor/architect is unable o Ill Willi 1' to complete the contract. I hold the Building Official and the i Sh res harmless of all legal inv vement. Signature Signature wn or Agent Contractor or Architect The foregoing ins u ent was aknowledged before me The foregoing instrument was aknowledged before me this ja day of 201-5,by e( this 9 day of Vie 2015 by Ill eosf` Who is personally known to me or who has produced who i ersonally known t me or who has produced as indentification. as indentification. Notall Public: Nota Publi �E�OpHEN 911852 Sign-. Sign- oPu 'O 0YCOMMISSION25 2017 o� A�dtpruBud9e�NoCatY ices Seal: REBECA M.PASTRANA sTATE�F«� MY COMMISSION#EES72624 ' � ` EXPIRES:Fc uary 07,2017