PW-14-2097 (2) Miami Shores Village f -�
�eSv Building Department SEP 26 2014
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
FBC 20&�
BUILDING Master Permit No �p ��'c'
PERMIT APPLICATION Sub Permit No. 2:
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-]PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: L 1 7� 5,17
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type:
/ r Flood Zone: BFE: FFE:
OWNER: Name(Fee SI
tleholder): �Y J v Y (,ci d I / 101 . Phone#: -7�� 1 r-17 3
Address:: DQ �f/ Jim,
q 5 g
City: /�'l i q vw; S L-y e-5 State: Zip:
Tenant/Lessee Name: Phone#:
Email: /'�
CONTRACTOR:Company Name: C/�1 e f r� r0 C < Jf���� �� Phone#: 7 `l
Address: A/�"� 1( w Y
A
City: mo w.i State: Zip:
Qualifier Name: 7�- �/,�eS L-z.e4 ,.P -L Phone#: -1$6 -29 G1 - 7 Za �(
State Certification or Registration#: U jr.�-0 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ro �J Square/Linear Footage of Work:
Type of Work: ❑ Addition Er Alteration ❑ New c�- ❑ Repair/Replace ❑ Demolition
Description of Work: �� Q C�.�rC. ✓1n �e c + i ����pcn'—
Specify color of c /or thru tile:
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$
(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 abse ce of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACT R
The foregoing instrument was acknowledged before me this The fogoing instrument wa�nowledged before me this
day of 20 )Y� by �2 day of � 20 1}f by
who is personally known to �aS �fci �Z who is personally known to
me or who has produced as me or who has produced as
identification a d who did take an oath. identification and who did take an oath.
NOTARY PU C. NOTARY PU
Sign: Sign:
Ay,
RTINEZ
Print: ;: YHOSVANY MARTINEZ Print: - '- MY
MY COMMISSION#EE080681 '�T°,OFFL° EXPIRES April 04,2015
Seal: ", °� EXPIRES April 04,2015 Seal: (dol)sse o,53 FlordallotaryServica.com
(407)398-0153 FloridallotaryService.com
APPROVED BY l� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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Mr. ARTURO CADILLA �.•`
PROJECr AMMM SC" s 'N••1 D P .
841 NE 95 STREET MIAMI SHORE FL
EMIUANO OROZCO, P.E.
Mr.ARTURO CADILLA PHONE Flame R a�ar� Na 66341
ADDREM vm- 817 SW 122 A I�111�FL.33184
841 NE 95 STREET MIAMI SHORE FL 9-23-14 (786) 715 7125
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841 NE 95 STREET MIAMI SHORE FL
BY: EMIUANO OROZCO• P.E. '•• R l�
Florida Na 68341
Mr.ARTURO CADILLA � •N
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841 NE 95 STREET MIAMI SHORE FL 9-23-14 ��) 718 2'i5