RC-15-1784 (8) Miami Shores Village
Building Department FEB 22 20%
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 - �
INSPECTION LINE PHONE NUMBER:(305)762-4949 B °~
F(�BC 20
BUILDING Master Permit No. 6 c Is v
PERMIT APPLICATION Sub Permit N<j_" i 6 - 333
BUILDING ❑ ELECTRIC ❑ ROOFING [REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
//,, 102, CONTRACTOR DRAWINGS
JOB ADDRESS: 1 "1 I_i `� 1 C ry 2
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
1 9e_Td
OWNER:Name(Fee Simple Titleholder): �e Phone#:
Address: r 6liU�2. 1 C 11 1) .
City: State:State• Zip:
Tenant/Lessee Name: Phone#:
Email: 1 n
CONTRACTOR:Company Name: I V 9iq��� ( LLC Phone#: 5�j
Address: `
City: )_c do r ra�'6P P I Av e, e: L Zip: ?i [
Qualifier Name: HOraC6,21 �+ i!" B Phone#:
State Certification or Registration#:; G C I�".� 2 S Off.i Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: p . City: State: ' Zip:
Value of Work for this Permit: Square/Linear Footage of Work:
Type of Work: ED Addition F-1 Alteration F-1New ❑ Repair/Replace ❑ Demolition
Description of Work: A^IL P In A f-')
- 1 °ate b� 1 !,.=
Specify color of color thru tile: �
Submittal Fee$ Permit Fee$ Ck CCF$ CO/CC$
Scanning Fee$ r Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ S `� Bond$
TOTAL FEE NOW DUE$ f
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lenders Name(if applicable)
Mortgage Lenders 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 exceedin $2 ,the applicant must
promise In good faith that a copy of the notice of commencement and construction lien law brochure wi l be d livered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement rfiust b sted at the job site
for the first Inspection which occurs seven (7) days after the building permit is Issued. In th en of ch posted notice, the
Inspection will not be approvad and a reinspection fee will be charged.
Signature Sign
�_. A,
WNER or AGENT ONTRACTOR
The f oing strument was acknowledged before me this The oregoing instrumen nowledged before me this
y of ��-� 20 t ,by day of 20 �6 ,by
who personally known 2 w 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 oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: I r- 1 MY COULUISM J1 EFIMM2 Print: WMN Febuory W.2017
Seal: EXPOWS February 07,2017
(407)MG-W53 Seal:
APPROVED BY 1 Plans Examiner Zoning
Structural Review Clerk
(Rev1seW2/24/2014)
3 IYlldl l ll al IUI CJ V IIIdge
���� e a rtme nt
p
g�� 15PO
n v u ,Miami Shores,Florida 33138 FEE 0 5 Ogg
J - 04 Fax:(305)756-8972
V IN H NE NUMBER:(305)762-4949 L
�
FBC 20 t`�4
BUILDING Master Permit No. 1'�-)- 4,"i 4
PERMIT APPLICATION Sub Permit No. V V l 6~ 333
(BUILDING ❑ ELECTRIC ❑ ROOFING <REYISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: //( ` �1 �'�"' t bZ S'
City: Miami Shores County: Miami Dade Zia: 138
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: °�FFE:
OWNER:Name Fee Simple Titleholder): �'� 7 Phone#: J '� Jd qZR
Address: �?IS)I llt3 LJ I T<-� ,,,.
City: to )AnA&4 State: i`�L Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: �!�w 6 �. ���� ��C� one#: '14
Address: l �.
City: " 1/TM ,�:
A- ( State: Zip: �✓� �-�
Qualifier Name: Phone#:
State Certification or Registration M���'� oo?agq Certificate of Competency#:
DESIGNER:Architect/EngPhone#:
Address: G City: Rai`State: Zip: �3 r
Value of Work for this Permit:$ �n '042Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:Aj I VUj D-W)4'
Specify color of color thru We:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE S
f
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appirmW and a reinspection fee will be charged.
v
Signature Signature
0 NER or AGENT CO RACTO
The foregoing
gin ment as acknowledged before me this The foregoing instrument was acknowledged before me this
LZ- day o �bw" .20 i J ,by day off/ 20 . ,by
, .who is ersonally kno to b�''e?& �/�q(!!!gho is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC-
S Ig—n:
UBLIC:Sign•
Print: I�a C.GA ,L..- " Print:
Seal: �xrry Public State of Florida Se =aa Notary Public State of Florida
+P_ Joanna M Feliciano
fAchael Robert Jaar �$ My Commission FF 082753
My Commission EE 831947 pFpo Expires 01/12/2018
N pW Expires 09/03!2018
************ * * ****************************************************************
APPROVED BY ���' Plans Examiner Zoning
Structural Review Clerk