PLC-14-1968 (3) All O1(5\0
Miami Shares Village ► ' CFIVED
Building Department
1005.0 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 t c)
BUILDING Master Permit No.14-1465
PERMIT APPLICATION Sub Permit No.?L—C. I\-( —►d►
nBUILDiro6 p ELECTRIC ❑ ROOFING r--j REVISION EXTENSION MRENEWAL
❑PLUMBING r-1 MECHANICAL PUBLIC WORKS ❑CHANGE OF r-1 CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
11300 NE 2 AveAV A '�?- ;01 . �&a 4 Il 1 S11)I =a
City: Miami Shores County:__ Miami Dade Zip:
FoliojParceW is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Flame(-Fee Simple Titleholder);Barry University Phone#:
Address.11300 NW 2.Ave
Miami Shares state: Florida ZIp: 33161
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Go Plumbing, Inc. Phone#: 954.554-1730
Address: 7927 NW 38th Court
city: Davie state: Florida Zip; 33024
Qualifier Name: Mark Gasch PhoneM 954-55417$0
State Certification or Registration#: Certificate of Competency M
DESIGNER:Architect/Engtneer: Gallo Herbert Architects Phone#: 954-794-0300
Address:1311 W Newport Center Dr, Suite C City: Deerfield Beach state: FL. zip: 33442
Value of Work for this Permit;;$ Square/Linear Footage of Work:
Type of Work: ❑ ration ❑ New ElRepalr/Replace El Demolition
s Builts for.job
Specify color of color thru We:
Submittal Fee$ Permit Fee$—9L=— n�f CCF$ Co/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ e _�
(Revised02(2412014)
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$250,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
SignatureLOW Si g
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
�cJ day of hAWe-"e5i 20 '_c( by 4 day of September .20 14 ____,by
'E--4t SCk 0 RCLOAA �L,who is a Mark Gasch
p �onaAy..kaoYvn to 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• Print:MINIMA — 11 ..,,
NAWGY(L
014• MY COMMISSION S FF 022429 3�:°r� ': MY COMMISSION#FF Q22429 ei
Seal: EXPIRES:July 28,2017 Seal: _ EXPIRES:July 28,2017 2
1, ended Tan,tJotary Pubflc undenvilers . Bonded Thru WM Public Underw6ers
############################################################################################################
APPROVED BY �Z'3'PY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)