REV-16-1871/40
BUILDING
PERMIT APPLICATION
❑BUILDING
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
❑ ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 9701 BISCAYNE BLVD
FBC 2010
Master Permit No. RC -15-1024
Sub Permit No. 'REV (@ 7 I
El REVISION ❑ EXTENSION
❑ CHANGE OF
CONTRACTOR
❑ RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores
County:
Miami Dade Zip: 33138
Folio/Parcel#: 11-3206-014-3320 Is the Building Historically Designated: Yes NO X
Occupancy Type: R-3 Load:
Construction Type: V
Flood Zone: X BFE: FFE:
OWNER: Name (Fee Simple Titleholder): JOSE G. CASTRO & MARIA G. ALE
Address: 9701 BISCAYNE BLVD
Phone#: 305-582-2836
City: MIAMI SHORES
Tenant/Lessee Name: NIA
State: FL Zip: 33138
Email: info@r-method.net
Phone#:
CONTRACTOR: Company Name: R -METHOD CONSTRUCTION, INC.
Address: 2541 SW 119TH TERRACE
Phone#: 305-914-5355
City: MIRAMAR
State: FL
Zip: 33025
Qualifier Name: LORENA TELLO Phone#: 305-798-7620
State Certification or Registration #: CGC 1519419 Certificate of Competency it:
DESIGNER: Architect/Engineer: JOSE RUBEN JIMENEZ, ARCHITECT Phone#: 305-582-2836
Address: 300 OAKWOOD LANE SUITE 100 City: HOLLYWOOD State: FL Zip: 33020
Value of Work for this Permit: $
Square/Linear Footage of Work: ICC N7n}1100
Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Structural revisions as required by inspections. 5'" e,cui 1-u 0,erN,
1 moo.
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Specify coli65ofcpoi2,thraJRttilep°..kw.„
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Submittal Fee � �• .�r,+��..PermitFee'$)"
Scanning Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
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6tOS .et mfra0 tld •`; " P ; :c
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CCF $ .me 10.0411moit:,1 CO/CC`.$ oo5 .•'�
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ C/6 `W
Radon Fee $ DBPR $
(Revised02/24/2014)
j t ;
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 commence ent must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In th
inspection will not be approved and a reinspection fee will be charged.
Signature d� Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
6 day of
1)
The foregoing instru
, 20 (40 by 5 day of
_ q. CGlSdry , who is per nown to Co at -cal
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
ence of uch posted notice, the
CON • CTOR',
ent was a knowledg
Sign:
Pring110
— — — — — — —
,•Ori' 4 NATHALIE CEPERO
Seal:1 Notary Public - State of Florida
•a My Comm. Expires Dec 19, 2018
�••? Commission # FF 152862
APPROVED BY
(Revised02/24/2014)
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************
, who is pe
before me this
,2040 ,by
known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
Sign: L— ,r.J
Print: —
Seal: ,•rnY'u;•., NATHALIE CEPERO
( ?fl
t Notary Public - State of Florida
..k--.1,-,,,A1
'My Comm. Expires Dec 19, 2018
`� e•- Commission # FF 152862
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******I �..4+r.i ... Aixieliklbograll
Plans Examiner
Structural Review Clerk
Zoning