DEMO-16-1124Miami 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
PERMIT APPLICATION
{-1BUILDING fl ELECTRIC El ROOFING
RECEIVED
SEP. 2 5 201j.,
FBC 20'
Master Permit No. DEMO-4-16-1124
Sub Permit No.
L REVISION Li EXTENSION Li RENEWAL
PLUMBING [--1 MECHANICAL flPUBLC WORKS fl CHANGE OF 17 CANCELLATION
CONTRACTOR
JOB ADDRESS: 29 NE 91 Street
SHOP
DRAWINGS
City: Miami Shores
Folio/Parce18: 11-3206-013-0090
ounty:
Miami Dade Zip: 33138
Is the Building Historically Designated: Yes X NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Ido & Jacqueline Alexander
Address: 29 NE 91 Street
Phone#: 786-280-2937
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email: jackiwaksman@gmait com
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: 1:1 Addition Alteration El New Li Repair/Replace El Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CC F $ °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 o condition to'the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site,
for 'the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such' posted notice, the
inspection will not be approved andan fee will be charged.
Signature
OWNER or AGENT
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
2.4 day of 1'is"5/G—'1,-- , 20 ($ , by day of , 20 ;by
JRCQtLf+J ,.who is personally known to , who is personally known to
me or who has produced 14Y C(CJ9 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:
Print:
Seal:
APPROVED BY
,vM4A1
MARK KLEINMAN
Y COMMISSION 0 GG070740
EXPIRES Much 00, 2021
Sign:
Print:
Seal:
****************************************************************
Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)
L96 Miami Shores Village
0.60° Building Department
artment
BUILDING
PERMIT APPLICATION
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
REC \,r b
APR 2 -Ig 2010
BY: -ee1/4
Est
FBC 201`1
Master Permit No.L1v((4, ^
Sub Permit No.
DTcl-BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ PLUMBING E MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: GI I '1"-
City: Miami Shores
County:
Folio/Parcel#: (1 - 3 & ' ' - O( 00p 1 p
Occupancy Type:
Miami Dade
Zip: I
Is the Building Historically Designated: Yes X NO
Load: Construction T A•' Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder): 3-41-GK-Ili=mil t $- (j7i. CE4 -5RPhone#: l05 R 5I I33b •
Address: 2.! /- Eiort T
City: Pt t AAA. ( c 4 -co
Tenant/Lessee Name:
Email: 44te,c'e • pL'l.
rCONTRACTOR: Company Name:
Cityq -H I Ise:-Gj f-•F
Qualifier Name: LA -Pt S &a5:>002,- Z
tState Certification or #:
(ri(48O7-
Zip: 1`27 •
Phone#: 'T 4- 696•152'-2 •
'Zips
Phone#:, 5+ 6Hz.Z4Z
Certificate of Competency #:
DESIGNER: Architect/Engineer: Anne Jackaway, AIA Phone#: 305-297-0220
Address: 2630 SW 28th Street
Value of Work for this Permit: $
tit
�
Type of Work: ElAddition ❑■ Y Alteration ❑ New ❑ r
Repair/Replace l I Demolition
Description of Work: Partial demolition of existing garage (next permit will address new work, which is to make this a pool cabana with a raised floor level,
new windows and doors, and a raised roof, following the approval through the Planning Board). This demo permit will allow the repositioning of wall openings,
City: Coconut Grove state: FL Zip: 33133
Square/Linear Footage of Work:
prepare the existing electrical for new work, and remove the existing roof.
Specify color of color thru tile:
Submittal Fee $ ✓`) ' ° Permit Fee $ LI • CO CCF $ -i - 80 CO/CC $fo
Scanning Fee $ V:6 ' Radon Fee $ 3 • S ( DBPR $ a - S ` Notary $ 0
Technology Fee $ (O • c--4 0 Training/Education Fee $ 1 6a Double Fee $ P
Structural Reviews $ 12-0 - Cif Bond $ P
TOTAL FEE NOW DUE $ 3 T( • U 2-
(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 RE
RESULT IN YOUR PAYING TWICE FOR IMPROVE
TO OBTAIN FINANCING, CONSULT WITH YOUR E
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of • bu
promise in good faith that a copy of the notice of co by ence
whose property is subject to attachment. Also, certifie•'4
for the first inspection which occurs seven (7) • :'•. er
inspection will not be approved and a reinspection fee��rF
Signature
6. •
D v
ENTS T
R OR
OTICE OF COMMENCEMENT MAY
YOUR PROPERTY. IF YOU INTEND
N ATTORNEY BEFORE RECORDING
h a estimated value exceeding $2500, the applicant must
d construction lien law brochure will be delivered to the person
py : H+ • recorded notice of commencement must be posted at the job site
ye buildin• permit is issued. In the absence of such posted notice, the
ar
OWNER or AGENT
The foregoing instrument was acknowledged before me this
ZGJ day of 764P 124 C , 20 • , by
IDp ,p.4,,E)c,064JDer.--•, who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
***********************
APPROVED BY
(Revised02/24/2014)
`001 11111I1 ////4r,
fir �*_
• #EE860600
6,10 / , 11� O\\,plans Examiner
Signature
CON ACTOR
The foregoing instrument was acknowledged before me this
2Fik day of O'Pc-cL ,20 I •,by
W15 6G )2ab C CZ , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
Structural Review
* �G.o®,ems• '%_
z y •• #EE860600 .
Clerk