CC-14-1465 (2) i hores e Villag - �' ---_-
JUL U 9 J14
i {g Department
0050 N. .AGenue,Miami Shores,Florida 33139. BY
Tel: 305)795-2204 Fax:(305)756-8972
N LINE PHONE NUMBER:(305)762-4949
A FBC 20 LO
BU I LDI N Master Permit No. CC., ly— (S
PERMIT A PLICAL' Sub Permit No.
(BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
T❑"PLUMBING F� MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 11300 NE 2 Ave UMN — &WIS t"
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Bary University Phone#:
Address:11300 NE 2 Ave
City: Miami Shores State: Florida Zip: 33161
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: SWR Construction Services, Inc. Phone#: 954-480-2800
Address: 1311 W Newport Center Dr. Suite C
City. Deerfield Beach State: Florida Zip: 33442
Qualifier Name: Jerry DuBois Phone#: 954-480-2800
State Certification or Registration#: CGC034031 Certificate of Competency#: 180-2092
DESIGNER:Architect/Engineer: Gallo Herbert Architects Phone#: 954-974-0300
Address:1311 W Newport Center Dr. Suite A City. Deerfield Beach state: FL Zip: 33442
Value of Work for this Permit:$ L Square/Linear Footage of Work:
Type of Work: El Addition El Alteration El New ElRepair/Replace A Demolition
Description of Work: Demolition — eq- 'S 60V e—
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$
TOTAL FEE NOW DUE$ (0
(Revised02/24/2014)
i Y
Bonding Company's Name(if applicable) N/A
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) N/A
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 uch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT Vruht
TRACTOR
The foregoing instrument
��was acknowledged before
Ume this The foregoing in acknowledged before me this
day of SN 020 1-I by day 20 by
who is personally knower 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: d I*14J4— 4
JA Y11 L
Print: Print:
JEFFRY J.YAO J L HOWARD
Seal: MYCONM MS1oN#EB36829 Seal: MY COMMISSION#EES76792
- EXNW:Nov®ber 12,2014 EXPIRES Jure 05.2017
48008-NOTARY Fl.Namy DkooM Aeras,Q&
(407) 153 FWWaN*ftgS®rvlmQW
************** *** ** ** 40/v
Plans
APPROVED BY "` 3 Plans Examiner �V ` Zoning
�y Structural Review Clerk
(Revised02/24/2014)
09/0312014 11:12 f AX) P.0011001
' STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395
1940 NORTH MONROE STREET
TALLAHASSEE FL 32399-0783
DUBOIS, JERRY WALLACE
JWR CONSTRUCTION SERVICES INC
1311 W NEWPORT CENTER DRIVE WEST
SUITE C
DEERFIELD BEACH FL 33442
Congratulationsl With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range STATE or FLORIDA
from architects to yadrt brokers,from boxers to barbeque restaurants, DEPART�IIE,- ►'O .,EUSINESS AND
and they keep Florida's economy strong. PROFS 0i •AW- ..ULATION
Every day we worts to improve the way we do business In order to C00034031 = -Iii um-f SQ8/01/2014
serve you better. For Intoorrrnation about our services,please log onto -
www myfloridallcenee.com. There you can find more Information CERTIFIED OILF3�tAA-GQN.I'RI4Cy6k
about our divisions and the regulations that Impact you,subscribe DUBOlB,JER �„L�4B
to department newsletters and loam more about the Department's a , ff��
Initiatives. JWR CONSTR13 1�14f 11XV10107114C
Our mission at the Department Is:License Efficiently,Regulate Fairly.
F�Jil
We constanitf strive to serve you better so that you can serve your ••• • • ��•'�°�
customers. Thank you for doing business In Florida, I$•C•6RTIFr';ADunasrths•pravlslpns.ofCh:489•FS.
and congratulations on your new licensel uori ifata;nuts a1;we L1406610WZM
DETACH HERE
RICK SCOTT,GOVERNOR
.... __w�_.......,._...... .. ........ .
•--••„••,_ON,SECRETARY• . _.
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION-INDUSTRY LICENSING BOARD
.CgCo34031
The GENERAL CONTRACTOR -
Named below IS•CERTIFIED
Under the.::provtsloris of*Chapter 4891=5.
FXpiratioh date: AUO 31,2016
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IMED: osro1n014 DISPLAYAS REQUIRED BY LAW SEQ0 L1408010002028