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REV-17-1429BUILDING PERMIT APPLICATION UBUILDING ❑ ELECTRIC ❑■ PLUMBING ❑ MECHANICAL 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 RECEIVED MAY 3 (1 7017 FBC 2014 Master Permit No. RC -15-1024 Sub Permit No. RE V 17:17 k q 2q ❑ ROOFING Q REVISION 111 PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: 9701 BISCAYNE BLVD ❑ EXTENSION ❑ RENEWAL CANCELLATION ❑ SHOR DRAWINGS City: Miami Shores County: Miami Dade Zip: 33138 Folio/Parcel#: 11-3206-014-3320 Is the Building Historically Designated: Yes Occupancy Type: R-3 Load: Construction Type: V Flood Zone: OWNER: Name (Fee Simple Titleholder): JOSE G. CASTRO & MARIA G. ALE Address: 9701 BISCAYNE BLVD NO X X BFE: FFE: Phone#: 305-582-2836 City: MIAMI SHORES State: FL Tenant/Lessee Name: N/A Email: info@r-method.net Phone#: Z;p: 33138 CONTRACTOR: Company Name: A.A. J ((j I UM V ((S & (loc. Address: 1154:) "v4 '1, City: iv An `IA (♦ • State: ft"- • Qualifier Name: AlA114 ilhifi5PC o State Certification or Registration #: ' Of C' 1 il VI Is .. PFione#: Zip: 3716c Phone#:S�' .8119 3", Certificate of Competency #: DESIGNER: Architect/Engineer: JOSE RUBEN JIMENEZ, ARCHITECT Address: 300,0AKWOOD LANE SUITE 100 Value of Work for this Permit: $ 2500.00 Phone#: 305-582-2836 City:" HOLLYWOODState: FL Zip: 33020 Square/Linear Footage of Work: 55 Sf Type of Work: ❑ Addition Iidi Alteration ❑ New i I Repair/Replace n Demolition Description of Work: Revisions for renovating one of the existing bathrooms in the 2nd Floor. Specify color of color,thru tile: Submittal Fee $ P Scanning Fee $ 3 • Gz, 2 •fib Technology Fee $ Structural Reviews $ (Revised02/24/2014) ''"";, rt Permit Fee $ 15.° ' U O' CCF $ �.%� 4,10 '� roe'«C� tC Ott'_ 1 $ Radon Fee $ 2 • 5 DBPR S. . 25 Notary $ Training/Education Fee $ v G a 7 Double Fee $ 951 Bond $ TOTAL FEE NOW DUE $ ' b .C-- 3V '1 t t BondingCompany's,Name (if applicable) . Bonding Company's Address ri r City State Zip Mortgage Lender's Name (if applicable) Mortgage LAder'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. Signature NER or AGENT Signature. NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrumerit was acknowledged before me this day of MA- 20 ^] by day.of , 20 /7 , by C,FAr_ • l , who is personally known to 414 -in /4 P.s. , who is personally known to • me or who has produced ,(V (2. LICe3.-.Se" as me or who has produced personally /N oWn as identification and who did take an oath. NOTARY PUBLIC: r identification and who did take an oath. NOTARY PUBLIC: Print: V ILD A.- +n ti Y ' Sea:: 1 .•!+ F.., rr ft-,,- ty; APPROVED BY (Revised02/24/2014) Sign: Print: 1/)fq lib►/ O( Seal: Plans Examiner Structural Review ****************** Zoning Clerk