REV-16-2682 Miami Shores Village R
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Y� Building Department Wo
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel• A5!? 72 �
INSPECTION .NE Rk10 N _ R, 0 7f2-4949 _11•
REFBC 208BUILDING `` K Permit No. 9's
PrUILDING
IT APPLICATION Sub Permit No.
❑ ELECTRIC ❑ ROOFINGREVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: CnZo I.) LO t S+
City: Miami Shores County: Miami Dade Zip: 3 1
Folio/Parcel#: 3 Z O (p Q 1-17 1 30 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): S i��`1�. �Ck e/ Phone#:
Address: Co 2D f 0�--' fib( S F
City: s State: Zip: 3 -'l3 ob
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: 0 V1 e S Pau , vk Phone#: L 3
Address: �0� OJT l�3 s
City: /l Atol_ L11- State: Zip: 3
Qualifier Name: ! G S 5'�- Phone#: -7
State Certification or Registration Certificate of Competency#: 23 S 0 O
DESIGNER:Architect/Engineer: Phone#:
Address: City: —State: Zip:
Value of Work for this Permit:$ D Square/Linear Footage of Work:)
Type of Work: ❑ Addition ❑ Alteration ew ❑ Repair/Replace ❑ Demolition
Description of Work:
U'v 0 V% Q V S L
Specify color of col thru tile:
Submittal Fee$_ Permit Fee$ I — CCF$ VJn CO/CC$
Scanning Fee$ CI .0,,0nn Radon Fee$ �. o® DBPR$ oQ Notary$ ,erg
Technology Fee$ • g V Training/Education Fee$ a 7 (7 Double Fee$ ie
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ If�l .
(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
ER or��AGENT �CONTRA
OR
The foregoininstrument was ackh Iwo edged before me this The foregoing instr nt was c n(Q�owl��edgedbefore me this
2 day of 20 1 by 2G day of 20 by
who is personally known to who is personally known to
me or who has produced Smoot s`t F l2 as me or who has produced CA,2l_()S qco',TA as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLI NOTARY PUBLI
m's
Sign: Sign: c�
Print: \� S '✓U� U Print: ��
Seal: o i sr io Seal: 4 0
n9 v 'Fr 195834 _+ s" _ hl 9 634
,c 20'19 c °�i9
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APPROVED BY Plans Examiner ` / oning
Structural Review Clerk
(Revised02/24/2014)
CTQB
Is Common Trades Qty wed
f' `BUSINESS Z RT1FiCA OF CgMpETENCY
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QUALIFYING TRADE(S)
0007 PAVING ENGINEERING
0009 EXCAU&GRADING ENG
0010 LAND CLEAR&GRUBY
JWWWKSWUSME
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Local Busi ness Tax Ilei pt
Miami-Dade County, State of Florida
-THIS IS NOT A BILL-DO NOT PAY
5092135 LBT
BUSINESS NAM E/LOCATION RECEIPT NO. EXPIRES
ONE STOP PAVING INC RENEWAL
1463 NE 173 ST 5318860 SEPTEMBER 30, 2017
NORTH MIAMI BEACH,FL Must be displayed at place of business
33162 Pursuant to County Code
Chapter OA-Art.9&10
OWNER SEC.TYPE OF BUSINESS
ONE STOP PAVING INC 196 SPECIALTY PA YM ENT RECEIVED
C/O ACOSTA,CARLOS M ENGINEERING BY TAX COLLECTOR
Worker(s) 1 E231500 CONTRACT 45.00 07/27/2016
0202-16-001747
!itis Local Business Tax Receipt orgy can"rmspaymerd of the Loch&einess Tax,The is note license,
e,
dthe hddeesgvali"coone,todobusinm&Holder n agcheRe eiptth anY9 sial
noIvaa nemelmulatmyJewsandrecpdMrentswFichapplytothebusiness
TheF MPTNQabovemistbecfsplayedonallCm rlwdalvehicles-Miami-Dade Code Sec ft-2711
Formoreichiarmatan visit miarri
Municipal Contractor's Tax Fbceipt
Miami-Dade County, State of Florida
THIS IS NOT A BILL-DO NOT PAY
OC No . Q31500
BUSINESS NAM E/LOCA TION
ONE SrOP PAmNG INC RECEIPT NO. EXPIRES
1463 NE 173 Sr SEPTEMBER 30, 2017
NOM MMIE3EAt}i,FL 33162 7487916
Pursuant to County Code
Sec 10-24
OWNER TYPE OF BUSINESS
ONE STOP PAIANG INC
C/OACOSTA CARDS ME RNG PAYM ENT RECEIVED
BY TAX COLLECTOR
225.00 07/27/2016
0202-16-001747
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