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PL-14-2427 (2) iami Shores Village D uilding Department APR=5 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 0 6 BUILDING Master Permit No. C q —J� —z®3I PERMIT APPLICATION Sub Permit No. KBUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING [:] MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: `3N° o -I© City: pMiami Shores County Miami Dade zip: -JF Folio/Parcel#: 1 132-0' V`3� 1.50 Is the Building Historically Designated:Yes NO '5-GL -FL Occupancy Type. Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):��N 7`'�' + +�' �`l��" Phone#: -; Address: n�3 51A N-t 4q q� s"r� Ci �"I 1 A M% s ® State: L Zi City: � p: a� Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:VgTAX a - ' Nea� 4 � AL Phone#: 9 4 P. [ Address o® W.W, 2-& V - City: State 14 L Zip- Qualifier Name: �A"y� �— f1J+Y �' ��1`J �� Phone#: State Certification or Registration#: Certificate of Competency#L OO / DESIGNER:Architect/Engineer: CLO A� �� ©� � �� 1 1V-ePhone#: ®—1 qq/ Address: TJ®0 IV+ VV= 225114 I /�"G�G 1 ► SU Cite I t 1Am ) State: L zip: 33I ;,Z. Value of Work for this Permit:$ ,�,/ Square/Linear Footage of Work: Type of Work: ❑ Addition LIQ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work:—1 (,0 �! ��`- (iy ' � � �` � i Specify color of color thru tile: Submittal Fee$ Permit Fee$ '715-. y CCF$ CO/CC$ Scanning Fee$ Co<C-) Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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 approved and a reinspection fee will be charged. A Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 1�day of 20 CS ,by 3(% day of y y 'L�` ,20 ,by 40!�Who is personally known to Jai cx�tV i�%Aca>who is personally known to me or who has produced M91\PE9-U s me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: C� -27 Print: Print: %-!"V "11, ORLANDO LEON MEJIA +e� �y Seal: ��nn Notary Public St#t®of Flaflda Seal: . • Commission#EE 175035 s SSlndia Alvarez s,�, �o`g ►4y Commission Expires YCommfsson FF iftjgp ,m�n a� March 30, 2016 �a ena Expires 00/03/2016 3 r� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) iami Shores Village7By:. ilding Department 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 1� U I LD I N G Master Permit No. C — !q-1 PERMIT APPLICATION Sub Permit No. PL-17' 29 2 - ❑BUILDING ❑ ELECTRIC ❑ ROOFING ( REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION [:] SHOP �pp CONTRACTOR DRAWINGS JOB ADDRESS: 39s, q e- q City: Miami Shores // 1+ County Miami Dade Zip: '3x'71 �4y Folio/Parcel#: l I ?; 0 6 ( 0 Is the Building Historically Designated:Yes NO 1/ Occupancy Type:S� Fm Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): _laoNftTHAiv C ' 6 y e'C0wD Phone#: * ®�Z� Address: �Jsn�� ,!^ City: �!'nvYl 25AL)/`'C5 State: 151'' Zip: V531 -3k Tenant/Lessee Name: Phone#: Email: //�� /�. �n CONTRACTOR:Company N�ae: -1 I"1 'fU�M]]�� P L fWA 81'N G ► T N C . Phone#:�o� Address: 2 LAy'-e V f*T(T . , =H•• 1 OL4 City: d/1- State: �L Zip: Qualifier Name: 7006E J'• Ne EWE Phone#• State Certification or Registration#: CFC l y gy Certificate of Competence c- v DESIGNER:Architect/Engineer: Et-otZ PA f�N' 1l 'y�'1 None#: ��,1 9�- Address: �Jr®0 -W• i►"� � ► ,.�y City Li( M( ( State: FL Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition AAllteration ❑ New F-1 Repair/Replace ❑ Demolition Description of Work: M�5 _,_ f��_�!I. . .1 `M'01�� Xi91VAI %Tbi 1 '(" fes® / �( - W �/ 'in vyc Specify color of color thru tile: Submittal Fee$ Permit Fee$ A 15° CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) . 04 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 approved and a reinspection f will be charged. Signature4V Signature6 ` NER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ��2-(� ,20 ,by �_day of_Wt`e�, ,20 t� .by JCLJP `i�.who is personally known to $c,)rC�e a�. r .O�aEr ,who i ersonally kno to me or who has produced7v U "D(Zl lF-P ��"J5'Cas me or who has produced as Identification and who did take an oath. identification and who did take an oath. NOT4PUBLIC, NOTARY PUBLIC: Sign Sign:— z.c � A�—l�' PrintNotary Public State of Fladda arez Print: MiG�e=S\C o l dei My Commiasian FF 186750Seal: Expkw09/03/2018 Seal: My COMMISSION#EE 867546 U APPROVED BY ��'�S Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)