REV-16-1737Miami 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
BUILDING
PERMIT APPLICATION
0BUILDING ELECTRIC ❑ ROOFING
El PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS: 518 NE 94 Street
5414
FBC 201q
Master Permit No. RC -15-3040
Sub Permit No. RE\( 16— (: 33'
Q REVISION ❑ EXTENSION ❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
DRAWINGS
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#:11-3206-014-0960
Occupancy Type: Load:
Is the Building Historically Designated: Yes
Construction Type: Flood Zone:
BFE:
NO
FFE:
OWNER: Name (Fee Simple Titleholder): Juan J Guerra Phone#:
Address:518 NE 94 Street
City: Miami Shores
State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Atlantis Electrical Corp
Address: 12803 SW 20 Terrace
Phone#: 786-395-6790
City: Miami
Qualifier Name: Francisco Perez
State: FL Zip: 33175
Phone#: 786-395-6790
State Certification or Registration #: EC:1'3001914
Certificate of Competency #:
DESIGNER: Architect/'Engineer:,,• ! " , Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition n
Alteration
Description of Work: 14$ f cir L
❑ New
7.V1 Ct cr,1/
❑ Repair/Replace
n Demolition
•
4 ` Ve
• i
i,'n ^.q'. w . -'n
Specify colorof color fhriu; tile:_:
00141, h ii i.. 101
Submittal Fee $ Permit Fee $
Scanning Fee $ - Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
rt'
CCF $
(Revised02/24/2014)
•
DBPR $
'1
•••,,
,Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ c
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 • - . pproved and a reinspects• n fee will be charged.
Signat
The foregoing instrumen was acknowledged before me this
2.1 day of J tint , 20 1 to , by
.Soar► j Gutrrc , who is personally known to
me or who has produced pt- D -fi({
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
2 1 day of Jun{ , 20 no , by
r
FTAnCA S c o 'RU'•GZ , who is personally known to
as me or wh
Print: -�J %4ti .,. j . VCS Ue
I-. vasuez
Seal:`' �' Commission # FF942611
Expires: December 9, 2019
�Boded thru Aaron Notary
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APPRO
*********
Commission 1 FF942611
Expires: December 9, 2019
Bon , nu,Aaron Notary
/G
(Revised02/24/2014) Z
DL # On (e as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Plans Examiner
a pq U T ���'
, ttt.)."*,, Suyapa T. Vasquez
'., �'= Commission 1 FF942611
Expires: December 9, 2019
Bonded thru Aaron Nom
Zoning
Clerk