PL-14-2774 iami Shores Village17
Building Department jEC8 2814
10050 N.E.2nd Avenue,Miami Shores,Florida 33138Tei:(305)795-2204 Fax:(305)756-8972 '
INSPECTION LINE PHONE NUMBER:(305)762-4949
ERC 20
BUILDING Master Permit No._7FP1 Ll
PERMIT APPLICATION Sub Permit No4A_ ILi Z71 1y
F-IBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
OPLUMBING ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I L IF— -1 :a?, S�
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: I - 32-�� - d I -_3 3 Oz C"::' Is the Building Historically Designated:Yes NO—
Occupancy Type: Load: Construction Type: L , Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):�S ri ( ` "I 4S Phone#: 3c:�!s 3 �
Address: ! lc::� I -::-5'�� C-1 I "-�S -41� -44= 4-
city:.�s--g-1 L l---I-.cp✓ amu✓ State: Zip: 3� Is4
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: ESSIG t , INC Phon #: 305-949-0000
Address: 1800 NE 151 ST -- - -
City: NORTH MIAMI State: FL —zip:` 33162
_
Qualifier Name: DANIEL ESSIG Phone#:
State Certification or Registration#: CPC052505 Certificate of Competency#:
DESIGNER:Architect/Engineer:U---g��;;tl iy-v�- 723I�L�/1� � Y
1 ✓ -1 Phone#:�' "
Address: S S.�� �� t�- -� 4. City: � State:-FL— Zip:
Value of Work for this Permit:$ I i Square/Linear Footage of Work:
Type of Work ❑_ Addition _❑_ Alteration New ❑_Repair/Replace Demolition
6 -e- ---
Description of Work: t _
pLn I
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ L Z S- : CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 19 3 -`7 6
(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 fir inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection ill not be approved and a reinspection fee will be charged.
Signatu - - -_ -- Si ure
OWNER or AGENT CONTRA
The foregoing instrument was acknowledged before me this The foregoing instru e t w c nowledged before me this
2- .ay of d ,20 I ,by � day of 20 14-- ,by
(Y � h(o is erp sonally known to DANIEL ESSIG ,who is personally known to
me or who has produced W.= as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTA Y-P-UBLIC: ;ya966sa�L�ar,as` NO ARY PUBLIC. ®gg01 �illi7:17 .
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Sig Si ber2j FaA.o� � SI
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)