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EL15-1484 mi Shores Village °17-n' 1 ding Department JUL a zo15 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 may_-_. -- Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 F'BC 20( 1 BUILDING Master Permit No.—Ac— PERMIT o._;/ZC-PERMIT APP KATION Sub Permit No.-+L �5 — i Lf ❑BUILDING ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL F-1 PLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County Miami Dade Zip Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): '70(' -� �-/.��r 'V/ Phone#: 60/,7 - 4 f3'--I&56 Address: ,y��'� 9� City: /l "�� 4��-1 State: �L Zip: Zi 1.3 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: /��(l?c J -��l X e'1 y c-- Phone#: ,66 8j$ Address: ?��D > �� r City:; State: Zip: j /.32 Qualifier Name: Phone#: 7106CV-1$ State Certification or Registration#: �h /002 9-9 YO Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �00 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ /Re lace Re air p p ❑ Demolition Description of Work: 6 j e 6 G c.z Specify color of color thru tile: Submittal Fee$ Permit Fee$ '©O CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ PE; ra in (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. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Q day of�� 0 rt 20 l r� b 0g day of �� 20 15 by ��,�✓�1 A( � onally known MA2Z RLQ G ��N who is personally known to me or who has produced as me or who has produced Q1\kL LI Q q,—,as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: 6 Print: s:o. ..» ` #FF084828 0r AI Notary Pulplic State of Florida Seal: � •� MY COMMISSION � _.; Seal: Sindia Alvarez ��:; '�° EXPIRES January 21.2018 < My commission FF 156750 "�`~"" Fbridallotary�rvi�pOT III OF p� Expires 0010312018 lao7)396-0153 ************************************************************************************************************ i �5 APPROVED BY ��Y Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) i Miami Shores Village .5`I Q--9 Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 h ,d Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No: <<.G ( 5-13-3 Page g 1 of 1 Structural Critique Sheet .1 S Cf)-;, ZIA, QYC�ti. L719��ati, ,� (�� L� �2.tiv cY l.^toL/a cin Y Qom- VL/3 Wv.a.�� tn.o 1 c��+�blN t�►-g� - I�,m,"oC � Ydl�. STOPPED REVIEW Plan review is not complete,when all items above are corrected,we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re-submittal drawings. Mehdi Asraf