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REV-18-2264Miami 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 BUILDING ❑ ELECTRIC ❑ ROOFING PLUMBING ❑ MECHANICAL PUBLIC WORKS RECEIVED AUG 2 3 1018 Q-4 T I O�- FBC 20 (4 Master Permit No.i 1RC4-18-929 Sub Permit NoR _ \/ ( E ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOBADDRESS: 701 Grand Concourse City: Miami Shores County: Miami Dade Zip: 33191 Folio/Parcel#:11-3206-017-2230 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Olga Nadja Zubrik Phone#: 954-608-9543 Address: 701 Grand Concourse City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: ORONI Inc Phone#: 305-685-0412 Address: 14040 NW 6 Court City: North Miami State: FL Zip: 33168 qualifier Name: Orlando Iglesias Phone#: State Certification or Registration #: CBC1251654 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zi Value of Work for this Permit: $ `� Square/Linear Footage of Work: c7 Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: New floor the in bedrooms and resurface kitchen cabinets. Specify color of color thru the: Submittal Fee $ Permit Fee $ Q CCF $ 1-' CO/CC $ Scanning Fee $ Gt-) Radon Fee $ O DBPR $ t 1 Notary $ Technology Fee $ ? r) Training/Education Fee $ °� rx> Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ G I ]j ]25 (Rev1sed02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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: 1 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. %Signature 104 Signature OWNER or AGENT CONTRACTOR Theforegoinginstrument was acknowledged before me this The foregoing instrument was acknowledged before me this 14 day of AW iAS+ 20 IR by I J day of 20 (0 by 061 k6f'A Z-br i l - who is personally known to ari�rjo IeshS who is personally known to me or who has produced bL or fiQt as me or who has produced DL c h - (1_ as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print. z Print: 1,01 VOL Seal: e�:�i;,e�, uyapa T. Vasquez Seal:! �.� = Suyapa T. Vasquez Commission FF942611 Commission # FF942611 .'� Expires: December 9 2019 "= Expires: December 9, 2019 -` d� a"'' �o�'' Bonded thru Aaron Notary APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Ccctp� f e1�1s arw ERMIT_#_�___s' RECEIVED Miarr, S'icr�s Village AUG 2 3 2018 'FRO\ED BY DATE MING DEFT L� _DG EPT g i IO cGk l �-JCF r, 1 41 F,: -r nt z' �} 8 V AWte�lNbroaa , _s w 1 '-�Cl CT4AI-Jotbgc�, - 3313K ft --rl L i$ t ✓" r C_f_"".Q iluft .. y...• 0 o,r+� ,+ . • ., so {1 t FL�R PLAN • • • • • • • • � • •�,� �y„Eb,F w waft to os..r aa.r ORC•M ZChATN./tTTJfi