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REV-10-1496 (2)
Miami Shores Village MAY 3 1 .Z01b Building Department )01Y, 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. Rc-9 -��-2��7 PER IT APPLICATION Sub Permit No.040 lb- BUILDING ❑ ELECTRIC E] ROOFING ❑ REVISION EXTENSION ❑RENEWAL F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 40 Ct-/L,) d} l) ( -'� f- City: Miami Shores County: Miami Dade Zip: Foiio/Parcel#: /1- 21-34 -003- 036 o Is the Building Historically Designated:Yes NOy Occupancy Type: )r g Load: Construction Type: Flood Zone: BFE: FFE: � OWNER:Name(Fee Simple Titleholder): .4©/4 0 6 411-0O Ort' J'N C Phone#: 2 �' '?�/- 2` 6/3 Address: ���' y ti' SL-T )�i✓`� City: M 1 .4 i- State: Zip: 33173 / Tenant/Lessee Name: 11/ 4 Phone#: Email: CONTRACTOR:Company Name: f-r Jy� "� + 9414 N6 3y f tk� X- Phone#: � tO Address5$dO 5W 197 -41L 0240 3 City: M t'Q"k + State: Zip: 3 ,51 F3 Qualifier Name: L e P" L/C-AJA Phone#: 7fk- 3'f4 -1 g�� State Certification or Registration#: 6-45-e 115V 2 6 0 f Certificate of Competency#: DESIGNER:Architect/Engineer: �1-71-0IV- A T-0Ledo Phone#: �J) ' °S-- -1 5r�-S' Address: -1444 5LJ / rl L^ '� SCJ ry /�� City: r ; State: Zip: s� Value of Work for this Permit:$ z C2 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: } V 1t- i 1�6ew S Specify color of color thru tile: Submittal Fee$ Permit Fee$ as 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 ex a ing$2500, the applicant must promise in good faith that o copy of the notice of commencement and construction lien law bra c ur will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commen nt must be posted at the job site for the first inspection w ' seven (7) days after the building permit is issued. In t / sence of such posted notice, the inspection will not b pprov d and a inspection fee will be charged. / ignatur Signature 7OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of m A�1 20 I by _day of MQ`' ,20 1W by who i ersonally know to � Q��� f�C��;�, 1 Q who is personally known to me or who has produced as me or who has produced d r I NK,l('S I I C, RSC, as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: C Print: r[1 S a n h d(4. Seal: 4501 -lF41'.; Alyssa HernandezSeal: . ?�/��, `.���:• .a�;, Alyssa Hernandez COMMISSION #FF91679F COMMISSION #FF916795 oQ: EXPIRES: September 9.2W- EXPIRES: September 9.2019 ''�,,�FpF C`•` www.AARONNOTAR C'v�` '% ��` �AARONNOTARY.COM �h+N�k�k+x*�N****�bMtdIN4 *�k�k�k�k�%�k�k�k +h*NkF+k * * t*�k�k*k*�r�k*�h*N�kNcN�kNaW�krtw�k* Ti�i *N��k �kw �N�kM��k�k�k�k�kN�*�R�k�k*�k4�B*k*�NN�* �NN�* APPROVED BY ` Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) r La.,.-sLAJZ,"o.Architects, Inc. August 10, 2016 Miami Shores village Building Department 10050 N.E. 2"d.Ave. Miami Shores, FL 33138 RE: 4040 Group Inc. 40 NW 111 street Miami Shores,FL Dear building official: The owner for the above referenced project hired our firm to certify two lopening that were framed in without inspection. I personally visited the job site and viewed the method of construction and to the best of my knowledge find it acceptable. Please note that the contractor removed the existing drywall so I can visually inspect the work. Essentially 2 x 4 wood studs at 16" o.c. were place to infill the wall. The studs were fastened to 2 x 4 top and bottom plate with tek screws through existing wood sub-floor. The 1/2" gyp. Wallbd. Was fastened to studs with 1- 5/8" long drywall screws. Thank you for your attention to this matter. If you have any questions regarding this matter please feel free to contact me at 786-543-0851 incerely, Luis LaRosa AR#0017852 12980 SW 52 Street (work)305403-7926 Miramar,FL 33027 e-mail: llarosa@larosaarchitects.com Y i L LAZa4otArchitects, Inc. WON& t 12980 SW 52 Street (work) 305-403-7926 Miramar, FL 33027 e-mail: llarosa@larosaarchitects.com 1 f r/l+ Cutz LARazk Architects, Inc. i �':•213q ll 1, pa �✓1i f 2 3 4 J O / Y .tea 4.- 17 18 10 10 RS a 15 Rb 17 18 1D 10 Y y -iu 12980 SW 52 Street (work) 305-403-7926 Miramar, FL 33027 e-mail: llarosa@larosaarchitects.com