REV-16-2859 RECEIVED
Miami Shores Village crop
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC20 ��
BUILDING Master Permit No. VQ'�> -S-/� - Z-5-77
PERMIT APPLICATION Sub Permit No7104 (10- 2 8!�q
❑BUILDING ❑ ELECTRIC ❑ ROOFING PREVISION ❑ EXTENSION []RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
pp CONTRACTOR DRAWINGS
JOB ADDRESS: Z90 O 4
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: -�)to G 'S 2--il) Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): � �� (Dy, 61ksSe44- Phone#: S ��qJ c'
Address: Z-�-+G tQ C 1 C)kA Srt
City: W\00 n-6 SN2�s State: Zip: -2--)
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: �� 1 V �== � 7s Phone#: �C; 171 c7
Address: C) Kk (C , p
City: N\ yyY 0 &arctc State: (' Zip: .3c!y
� ��� vlZ
Qualifier Name: C � Y-1CA ����� Phone#:
State Certification or Registration#: c- l rl-s ) l'�3 1 Certificate of Competency#:
DESIGNER:Architect/Engineer: -Tk� L,,-\ A--<, Oc S Phone#:
Address: d L ° • II City: c /, is r State ® Zip: 3 'l
Value of Work for this Permit:$ Go Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:�' -c � LDQ nA I`-'fi-)D — A
A.
Specify color of color 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$ Q/
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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing i trument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of n4 ,20 ,by 20 day of Qt`1u r ,20 ' by
_ &d 5�C-F( who is personally known to Cr(bt)eZCa v u-L-z 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: NOTARY PUBLIC:
Sign: Sign:
Print: N NICT Print:
mycommmsoN 9�87309
Seal: R F10910 " Seal: WCOMMIRSION#FF
EXPIRES Sept/{209P pUgeh19.22
42 Q� Ulliym
m
APPROVED BY Plans Examiner Zoning
a
c'
Structural Review Clerk
(Revised02/24/2014)
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DESIGN ASSUCIATES P.A.
ARCHITECTS i ♦ PLANNERS ♦ INTERIORDESIGN
APC CERTIFICATE NO AA26X 133 1
Date: October 18, 2016 '
RECEIVED
0000..
.. 0000
To: Miami Shores Building Department '
OCT 2 0 2016 0.000. 0000 .•.•••
Building Services Division Director •••••• • • •
0000..
10050 NE 2nd Ave •••• •• •
Miami Shores, FL 33138 •••• •• ••;••.
Inspection Section
0000.. 0000 0000.
0000 0000 0000..
0000..
Re: Permit No. WS-8-16-2377 •
Bassett Residence ..0000� � �.� ��•
270 NE 104 St. .. 0000
0 0Miami Shores, FI.33138 00 0
Special I' ct ield Report
To whom it may concern,
We have been retained by the undersigned to ratify field inspection for permit No. WS-
8-16-2377 (with attachments). Our office performed a visual site observation and a
"work-with" progress inspection for the installation of the window in question.
On page three of this report, please find a Floor Plan with the window designations
prepared by: Prestige Windows and Doors. The location of the window in question is #3
& #4. A corner assembly where each window is attached on one side to a 4" round steel
column (Refer to detail on page 3). The detail shws the _xictina
attachment of the new windows. Kriiami Shores AMIase
Methodology APPROVED BY
• Site observation 7_0M NG F)EPT 1
• Photos — page a e 5 '1
�9 r,r � --
Recommendations Ctthe-steel
To add sufficient bearing and for the window frame to fit tight agai column.
Install a shim on each side (Interior and Exterior) install frame and install fasteners that
are shown on the detail on page 3 of this report.
7600 West 20th Avenue, Hialeah, Florida 33016 Phone:305-557-3400
marc@scavuzzoassoc.com
AR00004956
Bassett Residence
Page 2 of 2
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This document is being prepared in accordance with the Florida Build A4*tode 'a'rlde """
must be submitted to the City of Miami Shores Building Department in **0r nctiort yvitFj ;••••;
the Application
� for a Certificate of (either Occupancy or Completion)'#orefhe abdve* 0000.
referenced Structure. 0 0.0 0• 0 0.0 •• ••'
es 00 0000 see*:*
If you have any additional questions or concerns please feel free to contictirits once aft e e e;;
305-557-3400 or email us for expeditious response. :••••• .
• • e sees•
T.M. DESIGN ASSOCIATES,
ARCH ITECT; P..-�
M. 9. 9 zzo R.A. 0 004956, (for the firm)
2 7600 West 20u'Avenue, Hialeah,Florida 33016 Phone:305-557-3400
ma rescavuzzo @tmdesisn a rch itects.com
AR00004956
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