REV-16-2649 '
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Miami Shores Village
c T -D
Building Department SEP 27 2076
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 _Tj
FBC20 � �-I � �
BUILDING Master Permit No.WS-8-16-2337
PERMIT APPLICATION Sub Permit NoT�TV I �-2( q 9
BUILDING ❑ ELECTRIC ❑ ROOFING ❑E REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9312 NE 9th Place
City: Miami Shores County: Miami Dade Zia: 33138
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Nancy Smith Phone#:786-205-0011
Address:
City: 9312 NE 9th Place State: Florida Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: PP3 Construction, Corp. Phone#: 305-389-0065
Address: 750 NE 96th Street
City: Miami Shores State: Florida Zip: 33138
Qualifier Name: Gabriel Rodriguez Phone#: 305-389-0065
State Certification or Registration#: CGC1516509 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 ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: Eliminate (1) opening a /7
Specify color of color thru tile: �
Submittal Fee$ 0 Permit Fee$ `(� ) CCF$ CO/CC$
Scanning Fee$ P .C Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$_7
Structural Reviews$ Bond$ [ r�
TOTAL FEE NOW DUE$ T
(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 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
OW E or AGENT C TRA R
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
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`- n day of re"L`Y(J~ 20 1� by Z�� day of
�� ��l'� c� '20 10 , by
ON �'�� who is oersonally known to ��M�, i'ntbt(o - , 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 oath.
NOTARY PUBLIC: NOT4PUBLC:Sign• Sign•04 AAA-
ry u Print
. Jeffry J Yao EP-01
: Notary Public Stale of Florida
My Commission FF 168481
er
Expires 11/12/2018 M��B FF 166481
Expires 11n2no18
** * * ** * .*.* **** * ***. *** ***�►* * * ** ** **** ****** * * *.* ******»**** *** **
APPROVED BY v/ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Building Department
Product Approval Schedule /Comparison Chart Address: t � Permit No. 057— `38 Z
Oqng Deserl tion of Window Product Acceptance Product Approval Opening Design Rough Opening Shutter Required Mullion Required Impact
or oor or u ion um r Design Pressure Pressure Size Yes-o- Yes/ o 'es No
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