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WS-17-1697e- AlAutesb—i cST/ii/a/r. 2 LLTS YT pfil- cptCc - BUILDING PERMIT APPLICATION ILDING ❑ ELECTRIC ❑ ROOFING PLUMBING ❑ MECHANICAL 0PUBLIC WORKS JOB ADDRESS: 2-(9- N E /0 <3 5 I r -e 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 City: Miami Shores County: Master Permit -No. Sub Permit No. ❑ REVISION X CHANGE OF CONTRACT Folio/Parcel#: (I 2_2-3) • 01 LI 0 0 Is the Occupancy Type: Load: _ Construction Type: Mia RECEIVED JAN 3 3 NV FBC 20N s�'� uU 1-1-1(01 El RENEWAL LATION ❑ SHOP DRAWINGS Zip: SS ( jT torically Designated: Yes NO food Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): IckV r C,I Phone#: 305 - -35 7- 63 c) Address: '2'n- aJ / 0 5 STS- City: /'°► / Lf 0'14' 6)10-'e S. Stat Zip: I ? • Tenant/Lessee Name: //' Phone#: /17/4 , r Email: CONTRACTOR: Company Name: Address: 2C) SSV / City: r'11 EA Qualifier Name: 'D 631 e1 t,6 icier �W L Phone#: 3o5 -SO 6 30 State: '� l— Zip: 33 / 6 5 • State Certification or Registration #: CG C /5 1 9J_ '239 3 r� DESIGNER: Architect/Engineer: S 2 ! l i 5 2,2 161 1</' St.\ VllovSW ck.I Value of Work for this Permit: $ 6 ft 23 J 0.0 Square/Linear Footage of Work: Phone#: i( Certificate of Competency #: Phone#: c/.59- ?t0-7 - O 9 3 6 . City: bo -o. goor State: FL Zip: 3 5 Z/ Z`a • Address: Type of Work: ❑ Addition ❑ Alteration ❑ New 1(9 1/1c6loitict)�� Description of Work: `s; 2ww✓J Repair/ ePlace Z `J1�IC li ❑ Demolition f rend, Specify color of color thru tile: Submittal Fee $tel./.( A , n CCF $ 3 CO° DBPR $ 20 Scanning Fee $ Technology Fee $ • 5 0 Training/Education Fee $ Structural Reviews $ Permit Fee $ I 2_0 Radon Fee $ (Revised02/24/2014) CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 7Z Bonding Compa e (if applicable) Bonding Company's Address A014 City State A7/9;1 Zip Mortgage Lender's Name (if applicable) vY /fi Mortgage Lender's Address "4 City State A/1/9 / 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 $2500, the applicant►must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building •e mit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signatur v OWNER or AGENT The foregoing instrument was acknowledged before me this _IQ_ day of IQCP,(NAr , 20 (k , by CDOW1a c,°t , who is per nown to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ti'RY PVe,, NATHALIE CEPERO • Notary Public - Slate of Florida Commission # GG 049216 +� ��.•' My Comm. Expires Dec 19, 2018 ,, Y�• Bonded Through Na onal Notary Assn. ************************** APPROVED BY (Revised02/24/2014) Sign Thejff�i regoi : BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 01 f��'F((BCCC20( /"(' Master Permit No.VV J) �" I G I Sub Permit No: BUILDING 0 ELECTRIC 0 ROOFING 0 REVISION 0 EXTENSION 0 RENEWAL r ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF p.CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO ,. Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Sim"plee Titleholder):13Yt L7 L d 3 , ( le-- Phone#: % 'V$ 77 J -43 t 3 7 Address: aQ7 /V i /t . j/— City: !Z',/1/1 5ho1/e.5 State: L— Zip: 331 ✓ pd Tenant/Lessee Name: Phone#: Email: ( jGo��IJ��G/f�'J!1 i�. LDf CONTRACTOR: Company Name: Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace QAiN LtA- lv 0 OF \ rel 1 1 - Description of Work: ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ 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 commenced prior to the issuance of a permit and that all work construction in this jurisdiction. I understand that a separate p FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information applicable laws regulating construction and zoning. installations as indicated. I certify that no work or installation has will be performed to meet the standards of all laws regulating ermit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, is accurate and that all work will be done in compliance with all "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 app_;,,, d and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument�was acknowledged before me this The foregoing instrument was acknowledged before me this c IG day of i -ea I4a-1 , 20 , by day of , 20 by 1A4/ , who is personally known to me or w Ut'Oit,e,E- me or who has produced as identific• n and who did take an oath. identification and who did take an oath. NOTARYNOTARY PUBLIC: Sign: Print: Seal: ho is personally known to as produced `c1J4 Sign: "Vi•PQ ..-N ra per o% Notary Public State of Florida Se l: } r Sindia Alvarez 1.4'0F cl My Commission FF 156750 ,` lova.o Expires09/03/2018 9.'F.}�,jII-v.'°'..•4,: %�-..l.. R`..J�..A_ R. A.A. A. A.Ll..,4_ rs� ****#.###ii.i##i**********...a.*************#*************######i..##i******** **************************** APPROVED BY (Revised02/24/2014) Plans Examiner Structural Review Zoning Clerk Z-15-2.018 Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 Permit: WS -1-17-169 Address: 297 NE 105th St Miami Shores FL 33138 We, the owners of the above property, request that the permit referenced above be cancelled. We are choosing to no longer work with the company that was hired to provide two outside doors for our house and after more than 14 months have failed to provide those doors. The first permit for this job was obtained in February 2017. When they had failed to deliver the product by August, they obtained a new permit to replace the expiring permit and promised that the doors would be delivered. On December 1, 2017, we were told that the doors were ready to be installed, yet by January they had not been delivered nor installed and that permit expired on January 23, 2018. Two days later we were contacted by a company representative (the permit runner) and sent a request for a new permit to be signed and returned. We asked for evidence that the doors were ready and were not provided with such evidence. We declined to sign the request and returned it to the company with our explanation for doing so. Our many calls and e-mails to this company since October went unanswered and were not returned, therefore, we have not been able to actually speak with anyone at the company about our order. The fact that they have several thousand dollars that we paid them (1/2 the total cost of the doors) is of grave concern to us and we plan to pursue all options to recover our investment. We have also learned that two of the people we have dealt with in the past no longer work for the company. We have no intention of continuing a working relationship with the company which is why we have decided to request a cancellation of the above referenced permit. Thank you,