RC-15-1257 (2) Miami Shores Village � Tv �
g Department NO03 2011
REV isi 0 . d venue,Miami Shores,Florida 33138 BY:
fi 0 795-2204 Fax:(305)756-8972
P I NE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING (REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF [:] CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
10 f
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: C,�onstruction Type: Flood Zone: BFE: FFE: c
OWNER:Name(Fee Simple Titleholder):'Bg++ /�P'�c� '�/ `�✓�� Phone#: — 7`
Address: �� �/S x,1/6 . � �82e
City: State: Zi
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Nam � �'� °�CJ��- °C1C'��`" "``� Phone#:796 " 41A0#0 1�Z
Address: � �
City: State: Zip: �3
Qualifier Name: U Phone#:
State Certification or Registration#: rr/�00� ?;�VCertificate of Competency#: (�
DESIGNER:Architect/Engineer: �� �eiTyT Phone#: �
Address: C '®®�'� �,r � `-��City: "v/ State: (�e--Zip:
Value of Work for this Permit:$ 3Za 7- �/ Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
j
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ d Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews Bond$
WZVI&W '1 TOTAL FEE NOW DUE$
(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 ae ce of such posted notice, the
inspection will not7approvd and a reinspection fee will be charged.
�,Signature Signatur
R or AGENT "-C-TQ�/
The foregoing-41r ment was acknowledged before me this The foregoing instrument was acknowledged before me this
day o " .1-20--9 ,by 18 day of OVIE1�� 20 )` , by
4ALAtL who is fersonally kno to - 6 wh'o is personally known to
me or who has produced as me or who has produced FL�yU`-��CX�SF as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PU IC:
S Sign:
Print
Seal:
d Notary Public State of Florida Seal:
�r'
Michael Robert Jaar
My Commission EE 831947 0°4®�� Notary Public State of Florida
p,pl Expires 09/0312016 ° Sindia Alvarez
�Qa My Commission FF 158750
9!03(2018
APPROVED BY f Plans Examiner Zoning
R
Structural Review Clerk
(Revised02/24/2014) ff
3810 NW 12 Terrace,Miami FL 33126 FI/9
CHANGE b OWNER
ORDER' ARCHITECT 0
CONTRACTOR 0
AIA DOCUMENT G701 FIELD O
OTHER 0
PROJECT:1460 NE 101 ST CHANGE ORDER NUMBER: 101
DATE: 12/10/2015
ARCHITECTS PROJECT NO.:
TO CONTRACTOR: AMENGUAL ELECTRIC INC. CONTRACT DATE: 9/14/2015
CONTRACT FOR: PRIME CONTRACT
The Contract is changed as follows: U E L 1 2015
APPROVED:
Construction M ifiag9w
Not valid until signed by the Owner,Architect and Contractor.
The original(Contract Sum)was $ 218,938.00
Net change by previously authorized Change orders $ -
The (Contract Sum) prior to this Change order was $ 218,938.00
The (Contract Sum)will be (increased) (decreased)
(unchanged) by this Change Order in the amount of $ 3,284.47
The new(Contract Sum)including this Change order will be $ 222,222.47
The Contract Time will be (increased) decreased) (unchanged) by
The date of Substantial Completion as of the date of this Order the re is
NOTE: This summary does not reflect changes in jAe Con a ,Co Ti Guaranteed Maximum Price which
have been authorized by Constructio r
HI ECT ONTRACTOR "�-�7 NER
q
Address 3810 NVN 12 TER r ss
Miami F03126 Joe
BY B j� &A— BY
DATE DATE 12/�0/2015�+ DATE ;d
/&_s
AIA DOCUMENT G701-CHANGE ORDER-1987 EDITION-AIA REGISTERED-COPYRIGHT 1987-THE
AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,D.C.20006 G701-1987
:oypaY rv�A Notary Public State of Florida
Sindia Alvarez
y Qq My commission FF 156750
9jFo�po� Expires 09/03/2018
Materials Labor Total O+P Total
. tion
ie Down Straps as Wr Structural En ' eer of Record T&M $ 1,801.35 $ 1,024.00 $ 2,825.35 16.25% $ 3,284.47
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Desmengual Electric,Inc. U C d 1
3851 NW 12th Terrace U
Miami,FL 33126-2816
Change Order
Change Order:
Project:
Date:
To r:
Bay Construction&Development,LLC.
The Contract is changed as follows:
Total:$2,519.03
The original Contract Amount was $218,938.00
Net change by previously authorized Change Oers $0.00
The Contract Amount prior to this Change Order $0.00
The Contract will be increased by this Change Order in the amount of $2,519.03
The new Contract Amount including this Change Order will be $221,457.03
The date of Substantial Completion as of the date of this Change Order therefore is
VALIDNOT G T AND OWNER.
Desmengual,Inc.
ARCHITECT CONTRACTOR OWNER
1
(Signature) (Signature) (Signature)
By By By
Date Date Date
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