RF-14-129 t 1_.` M Miami Shores Village
Io8-- �9 OCT 1-0 014
Building Department
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No.�+
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION VANEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 8C7 A/1"Li l06, S !1z'E-T
City: Miami Shores County: Miami Dade Zip: 33150
Folio/Parcel#: fd 21 3&QQ 6 0/-?o Is the Building Historically Designated:Yes NO �
Occupancy Type: &6b' Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): GV V/1-t-OZ-MC? 46"4614 Phone#:
Address: 3'r 6 6 Pfi-P.A�' &Ew U L
City: /-1/4-M r State: Zip: 33133
Tenant/Lessee Name: •Phone#:
Email:
CONTRACTOR:Company Name: i /L—H Phone#:(3®-5) 6:?-7 z so
Address: 202-00 A,40 Zr?d 4Va-&V F � �c/� ne 40
City: /'moi A P-[ i Cal2DEdV 5 State: �L- Zip:
Qualifier Name: P-co eem 7-o7w � t Phone#: 3'0 5 22
3 3� �P
State Certification or Registration#: CC.c 1 .3 2 4411
4 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
dscription of Work: Re - Ro®w 12e4 ae Si7'i I
Specify color of color thru tile: c�
Submittal Fee$ Permit Fee$ p CCF$ �(D CO/CC$
Scanning Fee$ Radon Fee$ �4 DBPR$ �4 • 1_ Notary$
Technology Fee$ Q Training/Education Fee$ e2_ Double Fee$
Structural Reviews$ S Bond$
TOTAL FEE NOW DUE$ 2?>O l ' G
(Revised02/24/2014)
r
a
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.
Signature r Signature
1'0� NER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,0 20 1' ,by day of_ /C� 20 `T ,by
V►') who is personally known to who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
t
Sign: ;a. `YP`ey�` DAV( J ERNANDEZ Sign:
MY SION#EE054428
Print: ' ' P'` S lanuary 11,2QU Print:
MKNANULL
O4c:
(407)3980153 aF 6 �oridallotaryservice.com :*: *" COMMISSION#EE054428
Seal: Seal: -
EXPIRES January 11,2015
(407)39 ,153 FloridallotaryServloe.00m
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APPROVED BY �`� c Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
1
STATE OF FLORIDA
a , DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
TOTH, ROBERTO CARLOS
BILANTAR, INC.
17814 NW 74 COURT
HIALEAH FL 33015
Congratulations! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation.-Our professionals and businesses range 11 STATE OF FLORIDA
from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND
and they keep Florida's economy strong. PROFESSIONAL REGULATION
Every day we work to improve the way we do.business in order to CCC 1327714 ISSUED: 08/24/2014
serve you better. For information about our services,please log onto
www.myfloridalicense.com. There you can find more information CERTIFIED ROOFING CONTRACTOR
about our divisions and the regulations that impact you,subscribe TOTH,O , ROBERTO CARLOS
I, to department newsletters and team more about the Departments BILANTAR, INC.
initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly.
We constant) strive to serve you better so that you can serve our
y Y Y Y
customers. Thank you for doing business In Florida, IS CERTIFIED under the provisions of Ch 489 FS
and congratulations on your new license! Expvauon dare AUG 31 2016 L1400240=172
DETACH HERE
RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
CCC1327714
The ROOFING CONTRACTOR
Named below IS CERTIFIED '
Under the provisions of Chapter 489 FS. t +`
Expiration date: AUG 31,2016
TOTH, ROBERTO CARLOS �•
BILANTAR, INC.
20200 NW 2 AVE#402
MIAMI GARDENS FL 33169 r Y
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ISSUED: 08/24/2014 DISPLAY AS REQUIRED BY LAW sEQ# L1408240003172
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