SGN-16-2989BUILDING
PERMIT APPLICATION
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
❑BUILDING ❑ ELECTRIC '111!. — � ISION ❑ EXTENSION E] RENEWAL
FBC 2014 Cr
11
Master Permit No. SCS - 1H .-aPfiS-1 •
Sub Permit No.
❑PLUMBING ❑ MECHANICAL E] PUBLIC WORKS ❑ CHANGE OF EANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City:
g3`?�\PcrlC kue
Miami Shores
County:
Folio/Parcel#: t1 32 0606bc01
Miami Dade Zip: -3.34E3
Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type:ypCCC
Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Ve-S (__J Oki Phone#:
City: ` State: 'tom Zip: 3 3 I 'h6
Phone#: 30/..343
Address:
Tenant/Lessee Name: �1/ta(];-. bin ()pup
Ica loll oc r aa.q19,014. wvin -
CONTRACTOR: Company Name: ,—t W ti4evar Q( e k 1 �C
Email:
Address:
QL0 Gt3 S�
City: YJI L C> COvq
Qualifier Name: 1t& D (1 \e'vt:a Phone#:
State Certification or Registration #: C C.- 15-0(06-5- Certificate of Competency #:
DESIGNER: Architect/Engineer: + y Phone#:
Address: ` i.+ State: Zip:
Phone#: 1M-2 SI -03(40
State:
zip: 3 3 (..S7 .
Value of Work for this Permit: $
Type of Work: ❑ Adcition ❑ Alteration ❑ New J
Description of Work: Pied 1 U AA
1XC�Q-S 6k wee ire
.11
Square/Linear Footage of Work:
❑ Repair/Replace ❑ Demolition
1/412f4-'' y ,day.
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
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 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.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
'2
day of1-612.1.,&1-- , 20 lb , by
V-0\04/14 VOA
A Sal l C No is personally known to
me or who has produced -FL as
identification and • . did take an oath.
NOTARY PUBLI I ,
Sign: fill
Print: 1111111
�l X11
.� '�'N.
Seal: ,���•� .�'aM O SEBASTIAN MODERNELL NEVAREZ• � commission # GG 34000
:.
i I,f, I' :rMy Commission Expires
?..••'
September 27, 2020
•
14r4 -.colo S M 00 "&12I1 -1.i..
Print:
Signature
ONTRACTOR
The foregoing instrument was acknowledged before me this
204ela of u^kRe , 20 1C by
1 4a+7 -TO G&I-042W0 , who is personally known to
me or who has produced Is • Lc' S as
identification a • d who • d take an oath.
NOTARY
/;/L
Sign:
trarAim
Seal: ¼lYMARCELO
SEBASTIAN MODERNELL NEVAREZ
Commission # GG 34000
�.= My Commission Expires
%pn°a•'�� : • tember 27, 2020
***sss****s************* s*'
***********
Mititt .I,o 5 Kobei2NEL(_
APPROVED BY Plans Examiner
(Revised02/24/2014)
Structural Review
Zoning
Clerk
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION UNE PHONE NUMBER: (305) 762-4949
BUILDING
PE IT APPLICATION
iffBUILDING ❑ ELECTRIC ❑ ROOFING
El PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 9325 Park Drive gaii4OCK
City:
Miami Shores ountv:
RECPTN
NOV 0 2X016
13Y:
FBC20NSVtl
Master Permit No. S — 29
Sub Permit No.
❑ REVISION ❑ EXTENSION
❑ CHANGE OF ❑ CANCELLATION
CONTRACTOR
/YOut) •
Miami Dade Zip:
❑ RENEWAL
❑ SHOP
DRAWINGS
Folio/Parcel#:
11 2 060c 3000 f
Is the Building Historically Designated: Yes
Occupancy Type
OWNER: Name
Address:5834
Load: .4eonstruction Type:
(Fee Simple Titleholder):
Shores Condo, LLC
NW 113 Place
Flood Zone:
NO
x
BFE: FFE:
Phone#:
City: Doral State:FL ��.�?•
Zip: 33178
Hallock DesignGroup
Tenant/Lessee Name:
Email: kayla@hallockdesigngroup.com
Phone#: 305-756-3773
CONTRACTOR: Compa�nyy Name: '6 1IJ JU'& ��� 4 Phone#: jO- ZCr' O! 0
Address: ICAO VA. in "51-- ,ice`
Zip: SCI S
e z-1-'3io
•
Mi
City: r V(r/'Wh ' 1 ° i /) State:
Qualifier Name: V660 G157E2NJf O
State Certification or Registration #: C G G l 5O6 6 '"]
i 5
DESIGNER: Architect/Engineer:
Address: 0 10 4% 91
Phone#:
Certificate of Competency #:
Phone#:
�A
City: h1 rr '1A" State: Yt, Zip: 33 152
d
Ov
Value of Work for this Permit: $40 • Square/Linear Footage of Work
Type of Work: ❑ Addition ❑ Alteration ❑ New
❑ Repair/Replace 0 Demolition
Description of Work: Letters applied to building identifying company
.DSc -S ... -AO pobS )t-) i tL_p h -- b
Specify colorriof color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
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 t�a)all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A N
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO Y
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
YOUR NOTICE OF COMMENCEMENT."
OF COMMENCEMENT MAY
ROPERTY. IF YOU INTEND
NEY BEFORE RECORDING
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 c traction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the red ed notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building, 7mit is issued. in the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.,
Sightture
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before ril'e this
day of a Ve14R4�ii -, , 20 I`f' , by
�L4 KID -flows utli.c;S i, ,
f 2j— 1 ,w , who is personally known to
me or who has produced �`� tan reas
identification and who L•%1f•th.
NOTARY PUBLIC:
Sign:
Print:
Seal:
�►wA�T��ti'E�
Irina=�i;'r,�:wii�iiw�,w:r:�iii��;s:.��i:i:►
•' Com issio 34000
*i My Co ssion Expires
September 27, 2020
The foregoing instrument was
acknowledged before m�,this
G day of 0Vt'Mi �- , 20
-`44):,)1,0 C1nitio
by
is personally known to
me or who has produced
identification and who did
NOTARY PUBLIC:
P. ,,, ., yD�rSiign:
^titlnt:
Seal:
*******************•****s********A*****:*******s***s****s*s********************
APPROVED BY
Plans Examiner
Zoning