REV-16-325 Miami Shores VillageiF
°
FEB n0 420(16
SD 35 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 2®
BUILDING (waster Permit No. ,,._____�S-' i3 64
PERMIT APPLICATION Sub Permit No.Eon -9 "6 2 7Z
[--j BUILDING ®ELECTRIC ❑ ROOFING [] REVISION EXTENSIO �R•NE AL
❑PLUMBING ❑MECHANICAL ❑PUBLIC WORKS M CHANGE OF ❑CANCELLATION ❑SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1236 NE 93 ST
City Miami Shores County. Miami Dade Zip: 33138
Folio/Parcel#:11-3205-027-0180 K the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Brian W Wong /Marilyn C Wong Phone#: !&-3T'U71-7
Address:1236 NE 93 STREET
City: MIAMI SHORES State: FL zip; 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: INDUSTRIAL ELECTRICAL SYSTEMS, CORP Phone#: 305-388-4648
Addness: 14050 SW 84 STREET SUITE 206
may. MIAMI State: FL zip; 33183
Qualifier Name: NESTOR I CORVEA Phone#: 305-3N-'648
State Certification or Registration#: EC13002182 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address City: State Zip:
Value of Work for this Permit:$1040.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: Plans revision: add 26 high hats and removed 7 exterior light fixtures.
Specify color of colo hru tile: �y
Submittal Fee$ Permit Fee$ Chiyy CCF$ Co/Cc$
Scanning Fee$ C'�� Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revbedoxl24/2014)
t
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. 1 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 �4
� 77"�_-Z• &Iez4f �-�
OWNER or AGENY CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Z day of ,20 t/& .by 3rd day of FEBRUARY 20 16 ,by
V i ,who is pers ai wn to NESTOR 1 CORVEA ,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 anth
FRANCISCO P. MORALES
•�rsr,?ue•,
NOTARY PUBLIC: NOTARY PUBLIC: :��.• `o: Notary Public-State of Florida
�'; •*; Commission#FF 39767
My Comm.Exp.November 17,2017
Sign: Sign•
onded Thru Nattonai Assocation-Florida
Print: Print: Francisco P. Morales
:��� I►P =8brte of[tide Seal:
Seal: C 0 FF 197448
's MY Conan.bOm Feb 9,2019
',its •• Badeddtrouprltla�ndinogryl r
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(RevlsedO2/24/2014)