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RC-13-2168 p Miami Shores Village Building Department `` a / by\, 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 tp��s I l3 FBC 201-D BUILDING Permit No. PERMIT APPLICATION Master Permit No. C'V3-a I e o Permit Type: BUILDING ROOFING JOB ADDRESS:. 1 g M LV I© S T City: Miami Shores County: Miami Dade Folio/Parcel#: I 2 Z 3 6 O D 3 0 ;Q Is the Building Historically Designated:Yes NO f/ Flood Zone: OWNER:Name(Fee Simple Titleholder): >4,ZD t tt' Phone#: Address: (010 D 4 2 1k"[C 4-V e S tqf 71✓ (� 5 0 City: M/If"j State: jr-7 L Zi 113 P� Tenant/Lessee Name: A-PIA Phone#: Email: rlDS E 0 /��LF L-LAD-� . (^ 0 a`'t CONTRACTOR:Company Name: K115, CO 6 57 2V CI-�O"S3(:2 �J T Address: qgo 5 W City: M l (+Nt/� State: �� 7�p: _ -3 3 3 Qualifier Name: �Uh*-) i;�/4jf �� `' Phone#: 3 8 S 53$a y State Certification or Registration#: i S t Le i 3 c of Competency#. Contact Phone#: Email Address eC125t %�+M �Ql� woo DESIGNER:Architect/Engineer: - Phone#: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: OAddition DAlteration ONew Mkt air)Replace ODemolition Description of Work: Aa%C1K EN C4/�6)�N E7 7S Color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Educatlon Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 0 ) � r • Bonding Company's Name(if applicable) i 4 Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zi 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 issua ce of building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a c y of the notic of co ncement and construction lien law brochure will be delivered to the person whose property is s ject to achment. Als a ce i. ed copy of the recorded notice of commencement must be posted at the job site for the,first inspe t' n w c occurs sev 7) s after the building permit is issued. In the absence of such posted notice, the inspection will n t e ap ro ed and a re' ecti ee will be charged. Signature Signature rent Contractor regoin instrument w acknowledged before me this o�f The foregoing instrument was acknowledged before me thisA day of ,20 ,by �t�1 � day of 20 ,by =��a who is personally known tome or who has produced JD-0h who is personally known to me or who has produced J L �'°"�Q- As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: lf�Sign: a Sign: A Print Ar, 2Z. print L'M tnfv�L My Commission Expires: - Y el f•,_ MYL.AI HERNANDEZ My Commission Expie6�,, MYLIU HERNANDQ MY COMMISSION#EE 221249 * My COMMISSION#EE 221249 *, '*: EXPIRES:December 1,2016 EXPIRES:December 1,2016 Bonded Tluu Notary Public Undenwrfters o Bonded Thru Notary Public Underwriters kk+kdaHsIskFssAskskt+dsek+k+ksk�sN�skskl�akak�skRokNsiadskkskdask�@sIaalademkk�Mikaksk+kdaskkkNa�mkikrtsMaaksk $sIs APPROVED BY / Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06110/2009)(Revised 3/15/09) SCOPE OF WORK NEW KITCHEN CABINETS. RELOCATE AND REPLACE THE EXISTING KITCHEN OUTLETS, CONNECTING TO THE EXISTING CIRCUITS ON THE ELECTRICAL A-2 =?` PANEL. KITCHEN THE ELECTRICAL LOAD IS NOT INCREASE. NO POINT ALONG COUNTER TOR ORETHAN & ' U. 4 ui 2 FEET FROM G.F I PROTECTED REG TACLE. PUT O/W RECEPTACLE UNDER GIN A-15 EXISTINGALL FIXED APPLIANCES ON DEDICATED C S. i; r PANEL E I A-511 s lL i 6FCI PROVIDE SMOKE DETECTORS TO BE 120V, W/BATTERY O i I �DISH'WVASHkk G � gip., �, € � �z BACKUP & INTERCONNECTED. :d € E r .-13y i Undercounter THEY SHALL BE INSTALL AT 4 2074 LEAST 3' OF A/C OUTLETS A-5 " uJ z . _ a ... .... . ,k GI:CI y ? CAI F I { O E f S Vuj t f k t DISPOSAL GFFCC0 j �. C S RUN P1 „ . I` A-7 rs _,. I ING A5 I - /4"EXISTA f E E IPE i._ GFCIE A 9 _&AIOU 1,3 �GFCI ® MICROWAVE RANGE 74" UP Undercounter ADD SMOKE/CARBON MONOXIDE DETE ®RS, KITCHEN REMODELING IS ® W 2 PAY AND ALL CLOTH AND RUB®E t INSULATED CONDUCTORS TO BE REP CED. 119 NW 110 ST M co (n MIAMI SHORES. FL 33168 Qv