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RF-12-779Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 LNSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING f I L. OWNER: Name (Fee Simple Titleholder): umel IC` L Address: CC Litt 1.3mdse r L N /1%«.n: Bea ac1n FL 33/ LI / City: /* qyt: eepkcI State: 1-10 ri1/4 Tenant/Lessee A1 e Name: 0 r. e j sch Email: PeAn. XQ YJ co. Co'7 Permit No. Master Permit No. — 2060 JOB ADDRESS: 1 1 605 Pcr-k City: Phone#: ,.31 Zip: 3 /�/ y Phone#: (3c) € O/ Miami Shores County: Folio/Parcel #: I (— 3 — 014 — 1350 Is the Building Historically Designated: Yes Miami Dade zip: 33(3g NO CONTRACTOR: Company Name: 4th Genp haft PCEeran. Address: 11320 .5J 20S DeNr,e 1 City: in a CR1 r ++- l State: '� I`i7 0L. �DD�et` i ■6 ISert Flood Zone: Lhone#: o)R7g °l Qualifier Name: Zip: 331 g9 Phone#: oco Kg-56v State Certification or Registration #: CCC 1322C7Y Certificate of Competency #: Contact Phone #: (305) $7$ -5G3( Email Address: R00 ,_ZC(J Mum. corn DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 3.5 coo Type of Work: %Addition Alteration Description of Work: I r0.. YV P ore t.) 15 e tre r - ekAa ins I i r, &new -1-; le roe t._ Square/Linear Footage of Work: Si r G t 1J "gi / /New ©tre Aepair/Replace %ft. ODemolition fuxe ,-F, rep lar,� tl-� 4,‘/-e Anse44 f VeA) Gis Thr Ito') * *** * *** ******** ***** **** ** ***** * *****Fees********** ****** +x **** * * * * * ** * * * * * * ***** **s Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ Honing 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 al: laws regulating ;;construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, '''WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S A1'Nll)AVIT: 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 -tio%)L Signature Owner or Agent Contractor .The foregoing instrument was acknowledged before me this 21 The foregoing instrument was acknowledged before me this a -'( day of 1144" 20 i2; by V l ( i 1 ( 1 4 4 1 6 F - (A1 day of a , 201 , by ieD b ert II)i e /M•' who is personall own to a or who has produced P As identification and who oath. ((1 V t d P .• ,�1an as identification and who did take an oath. NOTARY PUBLIC: `��o�� YO /4%'�,,� who is personally known to me or who has produced L- to Sign: print: My Commission Expires: co • 14 NV NOTARY PUBLIC: Sign: Print: My Commission ry 1 Zb . Ct A: -S • � •• 'ttY O ***** * * * ****a***** ** * ***w******* ***nix****** ** * *** ******** * *x,********* *.x******+trt# RAP* ax ************ /�... is j�0} O Mill APPROVED BY Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3115109) Zoning Clerk fl-ahNetrela Llc o i3 w; 6 by Frey C t. fates} Avneinow . HN f'`` (u hf , &Atoll ie�e rr' !`i _ u caer Ccdc4o brelS °�Sc. c.i t rO T �� • Permit No: 12 -779 Job Name: September 13, 2012 Miami Shores Viiiage Building Department Building Critique Sheet 2nd 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 1) Permit application must be signed by the contractor acknowledging that the tile installed must be color through. 2) Provide section Sections D and E for the new construction 4/12 slope it is not in new submittal. 3) The bottom of the flat roof PA is cut off. Provide a good copy. 4) Identify the deck slope. c (YJ 5) Provide a permit and plans for the lightweight insulation. The lightweight is for nor insulated concrete. Permit must include all required test data and specal inspection forms. 6) Provide all drainage calculations. The items submitted are incorrect and do not match the remainder of the submittal. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and reriace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 762 -4859 q11•3112- CkyvataflirS ficylteri op ki Uhe3 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 PERMIT APPLICATION SEP 12 2012 C 20 Permit No.F 12 ~ ` 7 Master Permit No 2- Permit Type: BUILDING ROOFING JOB ADDRESS: q 6 v 5- Pjik_ IV( City: Miami Shores t f County: Miami Dade Zip: 3 31 (1 n I Folio/Parcel #: / I 1 tbG — 0/ ` — f 3 S U Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): .Ue.V 1 A.i.e,(( a4- I) C Phone #: Address: 66 ({ 4 U i ev k or (4.../-e_ City: ..` 4-4,k; State: Z 3 / d F /Dre c Zip: -S? i (I ( Tenant/Lessee Name: Phone #: Email: /� - f D �(' j i.f Ilc CONTRACTOR: Company Name: Li-Fh lD 1 n RE 3TNLYtc, 2 41v-%-.1 Phone #: Address: 1k3 26 $ U 20 g Or t!-e p� .�// City: �ri ' ` -� ® State: f`-i®r\�p.... Qualifier Name: k® ice'' 4 is (.5-2-(1 State Certification or Registration #: CC C (32 R 6 71-i /� j Contact Phone #: SGr € Ct 5.O -tr €_ Email Address: Rib C1 c 2_C P \Oleo , Garr 1 DESIGNER: Architect/Engineer: Zip: Phone #: 3C)5 27$ 5-C3/ Certificate of Competency #: Value of Work for this Permit: $ 6s /00C-) 00 Type of Work:` ©Addition r.._, . .Alteration Description of Work: Color thru tile: � 5a,.stiern .03[eAc71 S e IeC K ******** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * ** ** * * ** * * * * * * * * * * ** * * * * ** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature l/ I Owner or Agent The foregoing instrument was acknowledged before me this +' S2_ day of <' 1, 20 [ Z by t &'7(4 i t SCh4 who is personally known to me or who has produced Ft— 1 D A$; identification and who did take an oath. NOTARY PUBLIC: Contractor The foregoinginstrruument was acknowledged before me this day of 1 i�( , 20 11-, by Inc ' t who is personally known to me or who has produced FIJI) )---(4i2.%-,...as identification and who did take an oath. NOTARY PUBLIC: oil 1/14,49 Sign: ��. �% 'S $j /ki, ,,,, ; Sign: z� @; • xpire�• : ~d _ -., Print: Print: _ 03106/1016 ° My Commission Expires: _ • NOTARY - My Co PUBLIC Commission # :-.(P/.• ;EE 1 73 05 9 .." Nt- �4:INi,' l'ilLo \o APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 5/2/2012XRevised 3/12/2012) )(Revised 06 /10 /2009XRevised 3 /15 /09XRevised 7/10/2007) Miami Shores Viiiage Building Department RECEIPT PERMIT #: ! - DATE: I, Contractor Owner o Architect PoL-A- 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Picked up 2 sets of plans and Address: T erylo )1* ) Ocurfes ott. raaar From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: I,1iKen c Constantino Builders, Inc. \'`■10l State Certified Builder 221 W. Hibiscus Blvd. # 128 Melbourne, Florida 32901 Office 321 - 725 -2837 Fax # 321 - 725 -1352 Florida State License # CBCA19897 October 19, 2012 Miami Shores Building Department Attn: Norm Bruhnn, Building Official Re: Keisch Cancer Center 9165 Park Drive Miami Shores, FL 33138 AGr 2 2 02 I am notifying you that we will not be using 4th Generation Roofing and Sheet Metal on the Dr. Keisch Cancer Project. Please replace permit # RF12 -779 (Permit for 4th Generation Roofing) with permit # RF12 -1946 for Z Roofing & Waterproofing. Thank You, Ken Constantino, President