REV-16-3154vis4,06)-
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BUILDING
PERMIT APPLICATION
[I BUILDING ❑ ELECTRIC
(PLUMBING ❑ MECHANICAL
JOB ADDRESS: 118 NW 103 Street
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
RECE
NOV 117722016
BY: C14 r \
FBC20lq
Master Permit No.
❑ ROOFING ® REVISION
16-105
Sub Permit No. 1:2+�V I („1-315c1
❑ EXTENSION ❑RENEWAL
❑PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores
County: Miami Dade
Zip: 33150
Folio/Parcel#: f i— 310 i- 0 2 2- 00 30
Occupancy Type: Load:
OWNER: Name (Fee Simple Titleholder):
Is the Building Historically Designated: Yes NO X
Construction Type: Flood Zone:
Each Morning LLC
Address: 11527 SW 64 Street APT D
BFE: FFE:
Phone#: 305-676-2225
City: Miami
Tenant/Lessee Name: Vacant
Email:
State: FL
Phone#:
Zip: 33173
CONTRACTOR: Company Name: Franklin GC & Glass Corp
Address: 9110 Fontainebleau Blvd # 104
Phone#: 786-260-7968
City: Miami State: FL Zip: 33172
Qualifier Name: Franklin Castellanos
State Certification or Registration #: CGC 151750
Phone#: 786-514-2842
Certificate of Competency #:
DESIGNER: Architect/Engineer: Eusebio M. Mora Phone#: 305-235-7500
Address: 8752 Southwest 143 Street City: Miami
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
State: FL Zip: 33176
Description of Work: VI ReAR—
FEZ ANCNoQZA6)
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 15-- 03 CCF $
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $ 813 .CO
(Revised02/24/2014)
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 1 (-� j
�J 1 • op
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.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of NO C/6M Q&2_ , 20 16 , by
1)A kJ ICOR fir✓ N IEW ftwho is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED BY
(Revised02/24/2014)
DAMIAN CARLOS GARCIA
MY COMMISSION #GG019573
EXPIRES: AUG 09, 2020
Bonded through 1st State Insurance
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
(f day of NOVal 1362 , 20 16 by
vfRAN kLl N GA5TE1,I.AI4/cP ivho is personally known to
me or who has produced )>(Z1Vg I,ICCNS6 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: >.1-4 IAIJ RCI A
Seal:
Plans Examiner
DAMIAN CARLOS GARCIA
MY COMMISSION #GG019573
EXPIRES: AUG 09, 2020
Bonded through 1st State Insurance
Zoning
Structural Review Clerk