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
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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
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012XRevised 07/10/07XRevised 06/10/2009)(Revised 3/15/09)