PL-15-2138r • t
Miami Shores Village -CF,
Building Department
AUG 21 2015
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY -
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
BUILDING ELECTRIC ROOFING
FBC 20'
Master Permit No. u A 9 r 153 1
1
Sub Permit No.2L 2 08
REVISION EXTENSION RENEWAL
15Q,PLUMBING MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
10B ADDRESS: 10 rox-A `-U n QOW'160 I
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 1-t> Phone#:
Address: J
A _
City: V1 !/I"" 1 State:
Tenant/Lessee Name:
Email:
e#:
p:
y CONTRACTOR: Company Name: deAf 1)4f * J'i 2 Phone#: 30S Fj V0
Address: , d S1/ -try
City: I l ll""l 1 a Zip:
Qualifier Name: lA 1/' 4,
p
Phone#: A
State Certification or Registration #: CFC- 14 q 0 $ Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Valu foeWmit:ork for Per $' _. Square/Linear Footage of Work:
Typeof Work: CO Addition 0 Alt ration New
z
pair/Replace Demolition
Description ofWork: l /L T 4 to y).
Specify color of color thru the:_
Submittal Fee $ J v W Permit Fee $ 22S'
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Revised02/24/2014)
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
G
TOTAL FEE NOW DUE $
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: 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 bsence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
l
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
dayof fav 20 /` by
AIX17 &S/2%le/7 who is personally known to
The foregoing instrument was acknowledged before me this
day of 20 At by
za,mI who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: (,,/ue /yg Print:
Seal:.,, SONIA GUERRA Seal: ..,
t: MY COMMISSION # EE17rMS _ SOMA GUERRA
EXPIRES March 08, 2018 - t'e MY COMMISSION # EE177346
3960133 F oAdeNoWyg q,
APPROVED BY f_ Plans Examiner Zoning
Structural Review Clerk
Revised02/24/2014)
Miami Shores Village RECEIV
Building Department
AUG 12015
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 LO
1
BUILDING Master Permit No. Ln . ` eJ31
PERMIT APPLICATION Sub Permit No.
OBUILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL
F-IPLUMBING MECHANICAL PUBLIC WORKS [:]CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER: Name (Fee Simple Titleholder): AA.)
Phone#:
Address:`
A
Z N i 1.A16i4 iQ
City: _ r i Orn l State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
y
b - Phone#: b 2
Address: Z-11252- >(177
67y
City:
Qualifier Name:
State Certification or Reeiltra
one#:
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Add
Type of Work: 9 Addition
Des rcipionofWork:
Alteration
p: 33/7
Cityr "'--+ State: Zi •
Square/Linear Footage of.
Wy
o
j
New Repair/Replace Demolition
kw (U/1
Specify color, of color thru the
Submittal Fee $C. 1 Permit Fee $'-'3.2-89 ' CCF $ CO/CC $ 00
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $Sil:y) `
TOTAL FEE NOW DUE $ 3, I t ' e V
Revised02/24/2014)
T ( •
r
BondingBonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
I
Mortgage Lendelr's Address
City State
Zip
Zip
A—
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."
r-,
Notice to Applicant: As a condition to the issuance of a building p`riit witb an estimaWed'Vplue excet'lirig $25017 the pplicant must
promise in good faith that a copy of the notice of commencement and, construction lien law brochure will be delivered ;to the person1.
whose property is subject to attachment. Also, a certified copy of the recorded notice of co encement mustbe'posted'at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. t e absence of such posted notice, the
inspection will not be approved and a reinspection fee,will be charged.
Signature Signature '
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of 20 /5 by
6/1 CLOS who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
The forgoing instrument was acknowledged before me this
b
day of
t
A-1 20/5- by
De/ i iZ who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
f•
Sign: I
ZoAf
Sign:_
Print: hi 4 e/;,-4 Print:
Seal: SONIA GUERRA Seal:
MY COMM133ION # EE177346
EXPIRES March 06, 2016
APPROVED BY D 1 I Plans Examiner
Structural Review
Revised02/24/2014)
valfy-4
SONIA GUERRA
MY COMMISSION # EE177346
EXPIRES March 08, 2016
Zoning
Clerk
Miami Shores Village
Building Department JUL 1
10050 N.E.2nd Avenue, Miami Shores, Florida 33138`r: _
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
F-] BUILDING ELECTRIC ROOFING
t r':-
2016
FBC 20 4 +h
Master Permit No. 4?e 3 -/$ = 5-3
Sub Permit No. P L + b-1%
REVISION EXTENSION LkJRENEWAL
PLUMBING MECHANICAL F-] PUBLIC WORKS CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: c7A0 r tel/ L0 _ Ce ro'-
City: Miami Shores County: Miami Dade Zip: 2-34V
Folio/Parcel#: //- 3a010 _ -g/ Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Phone#:_lp> 3/`7 USS S
Address: / V;
z/ La /2,-/ n /?ngUl.-f S
City: State: "rL Zip:
Tenant/Lessee Name:
Email
CONTRACTOR: Company Name: L
Address:
City: A-i/q 177 1
Qualifier Name:
i
Phone#:
Phone#:
Zip: .3314-5
Phnnaff/his% -//,Y1)
State Certification or Registration #: Certificate of Competency #: CFC' /eI2 r' 42
DESIGNER: Architect/Engineer: ne#:
Address: City: State: ZZiip:
Value of Work for this Permit: $ O p Square/Linear Footage of Work:
Type of Work: 0 Addition 3 Alteration New Repair/Replace Demolition
Description of Work: / // ,+
G.CIG 7Y%'J , G s iO/ r2rr10L EGLi1.
Specify color of color thru tile:
Submittal Fee $ 5Q W
Permit Fee $ 21J CCF $ V CO/CC $
Scanning Fee $ 0) Radon Fee $DBPR$ Notary $-
Technology Fee $ Training/Education Fee $ 1-90 Double Fee $
Structural Reviews $ Bond $ y
TOTAL FEE NOW DUE $
Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zi
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 Signature
OWNER or A4/NT CONTRACTOR
The foregoing instrument -was acknowledged before me this The foregoing instrument was acknowledged before me this
c2 day of /`y/ 20 by ick
j
day of 2016 _ ' by
who i own to `//L<t/ (/G/7 who i sons y c n to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: ;;•:: SONIA GUERRA Seal:
MY COMMISSION # FF971557
EXPIRES March 15, 2020
APPROVED BY 74 1Li Plans Examiner
Structural Review
Revised02/24/2014)
SONIA GUERRA
MY COMMISSION # FF971557
EXPIRES March 15, 2020
Zoning
Clerk