DS-15-2780 Miami Shores Village
Building Department OCT 2015
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 -
INSPECTION LINE PHONE NUMBER:(305)762-4949 "x`1-4
FBC 20�'� 5
BUILDING Master Permit NoIDS
PERMIT APPLICATION sub Permit No.
QBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9899 NE 2nd Avenue
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 11-3206-013-4360 Is the Building Historically Designated:Yes NO NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Wells Fargo Corporate Properties Group Phone#:772-778-6189
Address:550 S. Tryon St., 30th Floor
City: Charlotte State: NC Zip: 28202
Tenant/Lessee Name: Phone#:
Email: 4V W1 L4f?!ZS
fV A-S
CONTRACTOR:Company Name: Albu &Associates Phone#:
Address: 2711 West Fairbanks Ave.
City: Winter Park State: Iria Zip; 32789
Qualifier Name: Jason Albu Phone#: 407-788-1450
State Certification or Registration#: CGC1520336 Certificate of Competency#:
DESIGNER:Architect/Engineer: RS&H Phone#: 954-474-3005
Address:3125 W. Commercial Blvd., Suite 130 City: Ft. Lauderdale State: FL Zip: 33309
Value of Work for this Permit:$$15,000.00 Square/Linear Footage of Work: 200
Q Alteration El ❑ Repair/Replace El
Type of Work: ❑ Addition
Description of Work: Concrete sidewalk renovation at entrance
Specify color of color thru tile:
Submittal Fee$ �5o d Permit Fee$ /CO CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ ( W
(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 issue . In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
00//Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoi g instrument was acknowledged before me this
tX4Ll day of ®CT66e 20 0 by day of OL� 6� ,20 TS by
totL-LV.- K (*1,aCT-LfCC ,who is personally known to ^� �� �"� who is personally known to
me or who has produced as me or who has produced A/14-- as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
s
Sign: Sign:
Print:T//_1® [s14"/ Comm 1 Pi
Seal: pr P Seal: �ATURA L• MORR.RRISamt* o, Rebekah A Campbell Nac,State of FloridaState of Florida. My CoWres March 9MY COMMISSIOhl-f �(;?, ,20184o �,_ , A FF 86293
thicug" 3rt'rl f �
APPROVED BY t Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)