‘OWNER’ INTTTTALS:_ [APPLICANT'S INITIALS: i BUILDING DEPARTMENT MASTER, SUB OR REVISION PERMIT APPLICATION [DIRECTIONS: Use this form to apply for a BUILDING OR TRADE (SUB) PERMIT or REVISION oniy, Pecu= refer to Pic Works or Parring & Zoning for work specie to those departnents. Fl out form completely for faster processing, | ATRRED (7) asters are required. PLEASE SUBMIT ALL. PAGES OF APPLICATION. } "APPLICATION Tyre: (F MASTERIPRIMARY PERMIT CITRADESUB PERMIT or SHOP DWG | 1D REVISION EIRENEWAL Gee Adin Boxee page) | AcTentewainnach fenmtvensimenytrseceabaretinopne) = = 200/0. Gee Proper Agraria) T5020 hw joy aye unr B/OY ze. PLAT BOOKPAGE. SUBDIVISION: POP! if property does not have a physical address, please complere a PZ Request for Address with the ‘Planing & Zoning Department via wnvaieytdoralcomypermiting, Must hae Flo ¥# to move forward. NOTICE: Application ts hereby made to obain a permit 10 do the work and installtions as indicated. | ‘erly tat no werk or lnsallaton has commenced prior to tha Issuance of a permit and that all work will be «performed to meet the standards of all laws regulting conscructon inthis jurisdiction. | understand that a separate perm ust be secured for ELECTRICAL WORK, MECHANICAL, PLUMBING, SIGNS, WELLS, POOLS, ROOFING, 'SHUTTERS, WINDOWS, FURNACES, BOILERS, HEATERS, TANKS, and AIR CONDITIONERS, ete. "OWNER AFFIDAVIT: | 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 HAVING TO. PAY. TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, A NOTICE OF [COMMENCEMENT MUST SE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN. [ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE Or COMMENCEMENT. WIRED: ‘QUALIFIERS SIGNATURE rasootacrines ARES EDC) Setter conpy Sane = COUNTY OF id Sworn 9 (or aimed an aubirbed before we by meant of Dohrn prevnce or ‘Ty of idenacation Produced. FPA mAsTEnm On OH PINT APPLETON ew. 2026601JOD ADDRESS, DIRECTIONS: Use the checklist and items below to gather information PRIOR to submitting for 2 permit. You wall Center this information in the electronic permitting system at yyrtyotoralornipermitting: BUILDING PERMIT TYPE: Gloct mastersub pamitiype See bow Branone DinecHanicaLrRe Dascraca, runaneicss work. Leave BLANK for siblrade permits, Select above) WORK CLASS: (Pick one ype based on sope oFwork for REVISION DISCIPLINES) ‘Droornc Drooonan (sures Claw constRucTION Cloaious te R0oF ean Clonveway rPavERS/S.AB stor onawins FATERATION-INTEROR Corence wa ClascrncaL wasn DareaTon-pxexot Droousea ‘Droooman Greparnerace Ciseoiaccisonr sup DEVELOMENT REVISION TYPE: (ex AL oats tece) ae suo Cauwencicas Csmuctura lascracaL ‘Dhroomns Czownc Decree. Brooorany ‘Cireuc worxs REVISION DESCRIPTION: ‘CURRENT USESOCCUPANCY OF PROPERTY ORSPACE: See Cupar = eneienbulingor, JOB DESCRIPTION! SCOPE OF WORK: change of use TasancranoueTorne Clres 4 SINATEDYALUEOF WORE Gow erode Eho {ORCHANGEINVALUS 20,000 AREA OF WORK (s);__LENGTH (i rare og new onan oral wr Torro) (argh wood dior Ces we) FLOODPLAIN INFORMATION PA saxienne.__ Blank Lotc#aoare FAA f.000 20% Blank SURVETORNAYE: Fad exc .000 ELEVATION. SURVEY DATE. Ff iovrsr oon aevanon BENCHEARK LOCATION FEY covresr nacre .EVATION, BENC-MARK ELEVATION — Bed coves race ny OB CKPTIONT SURVEY DATUM, Unknown COnEITONAL LETTE DATE ‘OTHER ADHINISTRATIVE PROCESSES: me oa Clrnocess ExTENsION Cicance oF conrmactor enivare rovinen CPerMir EXTENSION 10d wang period urls sed by BO roa Kanne tsb Des ea beth Qaies ‘pene Reg ore. Deer rane TIcHANcE OF ARCHITECT) rravie ENGINEER Nov Pus tbessbiaed Tip Oyen & tp Cty of ora Bulding Department e401 n¥V 53 Terrace, 2* Foor Doral FL33L66~ Tet (305) 593-6700 ~Fax: (305) 59 wun enjatoratcomfouiing or war ekyoldaalcony/ permit, aaaMASTER PERMIT [APPLICANT'S TIALS JOB CONTACTS: Fileu tis section complete, Tis ieformatonwilbe used to cannes contact the > Permiting System. il oucaddonal forms as needed for as many contacts as you wish to add to ths permt. __— ALL CONTACTS MUST REGISTER awn cist confpurmting for a Cen Sc Senco er accu GOWNERTENAN Hx prolecoxpnton caer tg aerad rer form esi IE eres PROPERTY APPRASER or on LEASE AGREEMENT) PS 4 appres JOQSS Nw SOM sh ppl 20 cm Important Note: BAL esuredter ymemnotesen) ese Owretd G gout fen enact . afer, owoer PHONE. 30, 10dc) ce should have resi ete mnt ann to | dle i re mess Me Reset ara SES =e BUAL Reaureclornn ciara) Dossy. worl gmail.com = PHONE. $82" 31090IGe expedtors ete should NOT use the SAME email logn aeress for mtiple owners drases or projects CONTRACTOR! QUALIFIER SUB CONTRACTOR or OWNENBUILDER CCOPPANT NATE, LUCENSEEQUALRERNIE, ADDRES. {STATE EMAL Reqareiar prenratianony PON Se a elas DBPRORCTQBLUCENSE NUMBERS) PROFESSIONAL LICENSEICONTRACTOR REGISTRATION NUMBER W! CITY OF DORAL: © Fre OMA tured wah the Gry efDerd m= eontsaor OR owner! Plese alow the nsicos 3 aot anton con/letearmnsntdbuldnelconractomrsriraan or pee ctgotoralcom a: erholderafldov RESTRICTIONS APPLY, desnromenttouldingorms baling RENEWAIS “CHANGE OF CONTRACTOR PROFESSIONAL TE) Last Approved Inspection: CO) Fonmreceved eee Oy brontsce Se a Be Newtonacer patna Fi ao Roeland (ng proton) é [oe ee FY ewApytaton Requred Code Carge rayarernowmen EH inane Regurement EY auoinc neceRTICATION/STR GLAZING fA tema) eenet see Fn red Cae Cel 1 Regueaiont LE) pS Tn addition to the requirements of this permit, there may be addtional restrictions found in the fuble records, and there may be addtional permits required from other governmental entities eich as water management districts or federal agencies OR local homeowner's associations or [andlord authorization, See Forms: DORAL Affidavit for HOA or Landlord Auth Linniced Work at httpsllewn.cltyotdoral.com/all-departments/buildinglforms-building!. Cy of Dora Building Department erace, 2 Floor, Daal FL 33166 ~ Tel (305) 383.6700 ~ Fax: (305) 598-6618, rehyoldorlcomfouldng or www ciyldoralcom/perrattng, 0 or wasn 58 om CVS FRA APPLCATINS Veron 20220501, ace .0¥