RC-15-821 (6) wIld][11 t al lUr eb V 111d6e --
to IS artment OCT 05 2015
U AV
Shores,Florida 33138
1 7 (305)756-8972 0
BER:(305)7624949 _
FBC 200)
BUILDING Master Permit No. 1RC I
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑EXTENSION ❑RENEWAL
PLUMBING MECHANICAL []PUBLIC WORKS CHANGE OF [CANCELLATION [ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /�S�f d �C 'DL
City: Miami Shores County: Miami Dade Zip: 331 3
Follo/Parcel#: l j- D2-?1 " 0/3- O&—(C) Is the Building Historically Designated:Yes NO_
Occupancy TypeC�(Y' N. Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):� '� t�s r--U L ) Phone#: S(�
Address: op-:400 �AIC s02 g'C�k ec 0 if x
City: GAJ Ca,P�j M J Q State: r-1, Zip:
r
Tenant/Lessee Name: Phone#:
Email: lvv,.c��+� t_,�y u��p. •Clo'rvNI
CONTRACTOR:Company Name:A&mm uA4 CL - t4e _ Phone#:
Address:-- �g�� N f�.l 2 gL+Q � 1A M,; let
City: M1'l l /% I-%^t State: � Zip:
Qualifier Name: i3 Yve' it G tJ 41, Phone#: (110L3
DR.
State Certification or Registration# G G 66 ,17,9-1(, Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work. ❑ Addition Ix Alteration ❑ New ❑ Repairygeplace ❑ Demolition
Description of Work: Q) cc)^ Of
W C�S�n �^ y�U�` W E^ �-��Ii✓'
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ (M' CK) CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ 1 i 4-160
TOTAL FEE NOW DUE 9
Bondfn'd dompany'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 comm en ust be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in 1.a absence such posted e, the
inspection will not be approved and a reinspection fee will be charged.
Signature 4 Signature
OWNER or AGENT CO
The fo ng instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Jt' day of f C� .20 Js by � day of n0 C'Jt��2 .20 1� by
r N 8Ck/r+. .who f nally known to A KIZENGVQ�iv(s personally known to
me or who has produced as me or who has produced-z"-640',We- N as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print —L Print: pul3tis State of Rocido
w FU2 , PJADINE AUSTERFIELD Seal: • . FZia Alvarez
Seal: >'U."w��o
��� Notary Public-State of Florida � � My Commission FF 156750
k`.� =My Commisston Expir Nov 7,201 �p� Expires 09/03/2018
_ Comr
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APPROVED BY �(•``q\D Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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eMiami Shores Village , Ww
10050 N.E.2nd Avenue NEMW
�.' Miami Shores,FL 33138-0000 7 '
�Zbn ` Phone: (305)795-2204 ,
Expiration: 112312015
Project Address Parcel Number Applicant
10540 NE 2 Place 1122310130540
SRP TRS SUB LLC
Miami Shores, FL 33138- Block: Lot:
Owner information Address Phone Cell
SRP TRS SUB LLC FL (954)671-1400
Contractor(s) Phone Cell Phone Valuation: $ 35,000.00
TONY'S ALUMINUM CORP _ (305)805-7854 (305)9046061 Total Sq Feet: 00
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review
Final PE Certification
Date Denied: Window Door Attachment
Type of Construction:KITCHEN CABINETS AND BATHRO Occupancy:Single Family Framing
Stories:1 Exterior: Insulation
Front Setback: Rear Setback: Drywall Screw
Left Setback: Right Setback: Window and Door Buck
Bedrooms:3 Bathrooms:2 1/2 Fill Cells Columns
Plans Submitted:Yes Certificate Status: Review Building
Certificate Date:
Additional Info: Review Building
Bond Retum: Classification:Residential Review Plumbing
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Planning
CCF $21.00 Review Electrical
DBPR Fee $15.75 Invoice# RC-4-15-55137 Review Electrical
DCA Fee $15.75 05/27/2015 Check*7126 $1,099.50 $60.00 Review Electrical
Education Surcharge $7.00 04/09/2015 Check#:7063 $50.00 $0.00 Review Structural
Permit Fee $1,050.00 Review Mechanical
Scanning Fee $12.00
Technology Fee $28.00
Total: $1,149.50
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore,I authorize the above-named contractor to do the work stated.
May 27,2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
May 27,2016 1