FW-14-2217 ! �
Village G
OCT 0 8:2014
�'�� °ent
1 BY
10MU-'"Ayerye,Oland Shores,Florida 33138
Tei43W- --A%-231 fa7 j30S)756-8972
N' if01164 RM(305)M-4949
FBC 20/0
f l
BUILDING master Permit No. -22-0
PERMIT APPLICATICI �. Sub Permit No.
BUILDING ❑ELECTRIC ; ROOFING REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL d, PURlICWORKS -EJOWraf OF QCANCELLATION ❑ SHOP
ONTRACTOR DRAWINGS
JOB ADDRESS: 89 NW 106 Streeli
City: Miami Shores 1 e
Folio/Parcel#:1121360060170 tEfe-i3 dffleg Histaricagy Designated;Yes NO X
Occupancy Type: Resd. Load: C� rr'ret _Fk iZone: f1FE: FFE:
&
OWNER:Name(Fee Simple Titleholder) e�Ni� a»de
'+ brkA'Sabate Phone#:
Address:3966 Park Avenue
city Miami State: FL "p: 33133
Tenant/Lessee Name: Phon
Email -
CONTRACTOR:Company Name: BILAj IWC" Phone#: (305) "2659
IO
Address: 20200 W 2ND AVENUE S
city: MIAMI GARDENS Vie; FLzip
; 33169
Qualifier Name: ROBERTO TOTH: phot: (305)3357812
State Certification or Registration#: 5 l_ Cert1f[cate of Competency#:
:-
DESIGNER:Architect/Engineer: Y Phone#:
Address: City: State: Zip:
Value of Work for this Permit-,$ f0- ®D /iJfu3hr Fame of 1A!'ork: j,�D'09,
Type of Work: 1-1 Addition ❑ ration New ❑ Repair/Replace ❑ Demolition
Description of Work: NEW WOOD CE =5 r
Specify color of color thru tib'
Submittal Fee$ It Fee$ CCP$ CO/CC$
Scanning Fee$ Ra ¢ F4*$ -DBPR$ Notary$
Technology Fee$ Tra fft/fou Im Fee$ Double Fee$
Structural Reviews$ i Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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Bondl'ng Company's Name(if applicable);
Bonding Company's Address , -
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City S e Zip
Mortgage Lender's Name(if applicable)'
Mortgage Lender's Address
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City State Zip
Application is hereby made to obtain a armit to do the work and Installations as Indicated. I certify that no work or installation has
commenced prior to the issuance of permit and that aft-work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I and rstand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS,. POOLS,
FURNACES,BOILERS,HEATERS,TANKS, hit CONDITIONER i TC--.
OWNER'S AFFIDAVIT: I certify that all; a foregoing Information is aecurate and that all work will be done in compliance with all
applicable laws regulating construction d zoning.
"WARNING TO OWNER: Y -fM:=,-T0ef�RO-A NOTICE OF COMMIENCEMENT MAY
RESULT IN YOUR PAYING - -1 l '1 TO YOUR RRO . V YOU INTEND
TO OBTAIN FINANCING, CO . LT=Wr OURAMERORAN ATr0RNffBEF0 RECORDING
YOUR NOTICE OF COMMEN I MENT."
Notice to Applicant. As a condition to Issuance sof a building permit with an estimated value exceeding$25iW,the applicant must
promise in good faith that a copy of the mtkatifcer 'and construction Hen law brochure will be delivered to the person
whose property is subject to attachment, ,;a cert copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs se (7)days after the Hding permit is Issued In the absence of Such posted notice, the
inspection will not be approved and a re pection fee will be charged.
/9.('�- OK
Signature Signature
"4�ER or AGE IT CONTRACTOR
The foregoing instrument was ackno edged bef a this The foregoing instrument was acknowledged before a this
day of 20 by V2 day of 20 by
I yy) whdi is personally known to who is personally known to
me or who has oroduced as me.or who has produced as
identification and who did take an oat . Identification and who did take an oath.
NOTARY AN NOTARY PUBLIC.
;;YPve�. DAVID J FE DAVID J FERNANDEZ
C .1p{tY PVA'.
a MY COMMISSIOI`�#EE054428 . �h:
r '= MY COMMISSION#EE054428
Sign � ' • � EXPIRES Janu 11,2015
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��• 1 to No ry ice.com Sign. r � •`
Print: ° Print: nom
Seal: Seal:
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)