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RC-14-968 (2) Miami Shores Village Building Department J 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No..4-( 4 ` Permit Type: BUILDING ROOFING JOB ADDRESS: / City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name(Fee Simple Titleholder): N Phone#: 6 Address: /3 City: ` State: Zip: 1� Tenant/Lessee Name: Phone#: Email: (^ CONTRACTOR: Company Name: 14 11 e(4S611'S Phone#: ")�(_' 3'�? 7 -y 0 S Address: S S L N '7 U't� S City: G Y-1"''nn tate: � (d r t d c' Zip: 33 I (o Qualifier Name: y�ker,'4r) Q J ev1C�'v�c'I Phone#: State Certification or Registration#: C G C 1`S 1 (02W Certificate of Competency#: Contact Phone#: Email Address: C+ t r\S d C C Cd rvCuS 4 DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Lb O o , O Square/Linear Footage of Work Type of Work: ❑Addition DAlteration ONew dkepair/Replace ❑Demolition Description of Work: CN q4n \j VN - Color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 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 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 posted notice, the inspection will not be approved and a reinspection fee will be charged. Sign r - Signaturyg Owner or gent Contractor T re oing ms me was acknowledged before me this �r The foregoing instrument was`acknowledged before me thisX� day o _� LV by��/)_ � P l day of ,20 J by IISC �P who is personally known to me or who has produced who is personally known to me or who has produced A( if i2LC f As identification and who did take an oath. L460)C6 as identification and who did take an oath. NOTARY PUBLIC: MARISOL MARISOL PEREZ NOTARY P MAR180L PEREZ ••e MY COMMISSION 0 EE843681 e MY COUMI q EE843691 EXPIRES Oclobw 15.2016 E r 15,2016 Sign: 407; , Sign: .am Print: se peZ- Print: &�Ia1 iSol e6' 1=1 My Commission Expires: 6,4 �> �� �� My Commission Expires: CC4 /5., �(e APPROVED BY l Plans Examiner Zoning Structural Review Clerk (Revised 5/2/2012)(Revised 3/12/2012)XRevised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Miami Shores Village _ BuildingDepartment •x�c pmenMAY � 12-014- 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 <g INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 20 BUILDING Permit No. .4�1 /A/— 96� PERMIT APPLICATION Master Permit No. 1 "1 Permit Type: Electrical JOB ADDRESS: ' City: Miami Shores County: Miami Dade Zip: 3 Folio/Parcel#: Is the Building Historically Designated: Yes NO �� Flood Zone: `-- 7&3 OWNER:Name(Fee Simple Titleholder):� 'n V11M �r Phone# a 6� Address: City: State: Zip: �133 � Tenant/Lessee Name: Phone#: Email: a "WintCONTRACTOR: Company Name: c�/ mice Phone#: Address: 2//SZ City: State: A_Z471 sc1 Zip: 33/77 Qualifier Name: Phone#:3 OS'--3/8=7005 State Certification or Registration#: Certificate of Competency#: Contact Phone#: 3 OS_�/� —7�OS Email Address: 'c���c«c e 65"Z" /ce. Co m DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 1,300. c7:)0 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New , epair/Replace ❑Demolition Description of Work: dc Submittal Fee$ Permit Fee$ f r"p,eyd CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 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 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 posted notice, the inspection will not b approved and a reinspection fee will be charged. Signatur Signature —T Owner or Agent Contractor The f oing instrument was acknowledged before me this The foreg ' g instru ent was acknowledged before me this--Q3 day of _,20 J� by t <<a. is't�, day of ,20�,by who is personally known to me or who has produced who isperso ally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY LrC 3 Sign: Sign: Print: Print: -1/ EREZ M Commission Ex ices: (p My Commission Expires: osP,O PU8, LUIS FERNANDEZ Y p , . ay COMMISSION#EE843881 2 I;4Y COMMISSION#EE 838180 EXPIRES October 15,2018 * * Pir[S:November 7,2016 Ex 140y)""153 FW"N0WgSMvke.Oom Bonded 1hru Budget Notary SerAces dr***9e**otY it*at 9c*F#***fie�e 9e�t**9c*9edc�'e*ic*ic�citet 9t9t*ic 9t 9tic 9c**Yie is 4c**�cie*dr9c*ic9eetic�c*ie icie 9c 9c9c a'c�e�t9ttF ie 9eRet eY*F ekie ie�e4c irak***F�e�e*9e ieet 4e9e9e ieiraY* a��y APPROVED BY 1524 y:t/Yta Y Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Miami Shores Village �-- , --_- Building Department MP 12 ' 014 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 BY INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 201p 110 BUILDING Permit No. `'l / PERMIT APPLICATION Master Permit No. J L4^d►G� Permit Type: PLUMBING JOB ADDRESS: el)':�:) LIE ' City: Miami Shores County: Miami Dade Zip: < L Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: At OWNER:Name(Fee Simple Titleholder): ko�'✓O VY7Zt Oetlj Phone#: 7qS'7 11S3a3 Address: City: 1-1� j State: Zip: Tenant/Lessee Name: Phone#: S ] Email: CONTRACTOR: Company Name: p kRX) /i 1W54 Phone#: 7cy�o Address: ��--• City: � !( l� l�PiY i-� State:/'' zip:3,3056� Qualifier Name: J .PiY! na avage i rnPhone#: State Certification or Registration#: 01V-7904AINU IffiWompetency#: Contact Phone#: 99 6 1�7 Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ c7/C>00 .o b Square/Linear Footage of Work: t_Type of Work: ❑Address ❑Alt/eration ❑Ne Iw 31 epair/Replace ❑Demolition Description of Work: aQeO+G CQ -e 1-, d f-,2 It (.1'c��-r �� n� �6Y t4P �Vi iii rG � lir Submittal Fee$S Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 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 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,$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence oX such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signatur h` Signature Owner or Agent Contractor The fa g instrument was acknowledged before me this The foregoing instrument was acknowledged before me this�3 day of t'1 ,20 L4,by ay of / ,20�,by A"02 . &-1)J4 who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: CRINoeARclA rs MY COMMISSION N FF 03M EXPIRES:July 22,2017 Sign: A214,11A60 Sign: 7hru*Wy Pu*uncle Print: f1 C Print: e, /aQ[q MY COMMISSION M EES43691 My Commission Expires: tail� ��• My Commission Expires: ', P1V1 EXPIRES October 15.2016 ��07!198-UiS3 Flerld�NoWy$�rvk�.00m ***ie*ic***9e*�F de*�:dtir is*9e eYicet 9eetataFs'cue**�e�e****9e*9e9e9e 9e�e�'e***9r*****at**de**�k***9eie 9e9:4e*9c*9c**ie�'e*ic*,t*i�*et******ic*�k*iC�t*ie*�e�c9c**�t�c* APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised3/12/2012XRevised 07/10/07XRevised 06/10/2009)(Revised 3/15/09)