PL-17-2455BUILDING
PERMIT APPLICATION
❑BUILDiNG ❑ ELECTRIC
Miami Shores Village
Building Department
10050 N,Elnd Avenue, Miarni Shares, Florida 33138
Tel; (305) 795=2204 Fax; (305) 756-8972
INSPECTION UNE PHONE NUMBER; (305) 762-4940
ROOFING
PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS
QB ADDRESS; 405 NE 99 Street
City: Miami Shores
REVISION
RECEIVED
SEP 2 5 2018
Master Permit No, PI I — ZL(SS
Sub Permit No,_
EXTENSION
❑ CHANGE OF ® CANCELLATION
CONTRACTOR
i
County: Miami Dade t Zio:
Folio/Par€ei#; Is the Building Histo►icaily Designated; Ye§
Occupancy Type; Load; construction Type;
RENEWAL
❑ SHOP
DRAWINGS
NO X
Flood Zone; EWE: FFE:
OWNER; Name (Fee Simple Titleholder): Al Davis Phone#;
Address!405 NE 99 Street
city; Miami Shores
Tenant/Lessee Name: NA
Email
State; FL
CONTRACTOR; Company Name: Mr. C's Plumbing & Septic
Address; 19932 NW 2.Aventie
city; Miami
qualifier Name; tremble Ettrick
state certification or Registration #; $R9915 6 Certificate of Competency #:
DESIGNER: Architect/€ngineer; NA Phone#:
Address; City; state; Zip:
Value of Work for this Permit; $ Square/Linear Footage of Work;
Zip: 33138
Phone#;
State: FL
Phone#; 395-651-78 9
Zip: 33169
Phoneff:
Type of Work; ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
�
Description of Work; i O COhLIU ? 1 — ZLLS 5
Job cancelled
❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
S€anning Fee $ Radon Fee $ NPR $ Notary $
Technology Fee $ Training/Education-Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revi§00?/a4/2914)
Bending Company's Name (if applicable) NA
Bonding Company's Address
City State _.
Mortgage Lender's Name (if applicable) NA
Zip
Mortgage Lender's Address
City state Zip
Application is hereby made to obtain a permit to do the work and installations 45 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 Taws regulating
construction in this jurisdiction: I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANK, AIR CONBITIONERS, 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; A5 a condition to the issuance of o building permit with en estimated value exceeding $25QQ, the applicant must
promise in good with that a copy of the notice of commencement and construction lien law brochure will he delivered to the person
whose property i5 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 ob ence of Such posted notice, the
inspection will not ' a' proved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of f / e e v- , 20 / � by
`Ott., j?/I ►it;
me er who has produced
, who is personally known to
Pe ✓e+S Licence_
identification and who did take an oath,
NOTARY PUBLIC:
Sign:
Print: pit MPet4;4
Seal:
a5
;: `'i.o;y. DONALD MARTIN
'- MY COMMISSION # GG102743
=�±Y�, EXPIRES May 09, 2021
• *********##* ***
APPROVER BY
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
Y' day of ft'Yes` , 20 44 , by
irkie ek , who is personall known to
me of who has produced a5
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Pen ti l e( AC
###***#****#***##***•
Plans Examiner
;;: DONALD MARTIN
MY COMMISSION # GG102743
41 EXPIRES May 09, 2021
•
Zoning
(404002/24/20141
Structural Review
Clerk
Mr. C's Plumbing & Septic Inc.
19932 NW 2" Avenue
RO, Box 693239, Miami, Florida 33269-0239
Dade:(305) 651-7859/5652 Fax (305) 651-5610
Brow:(954) 927-2140
Miami Shores Building Department
Miami Shores, FL
Re: PLe10.17-2455 405 NE 99 Street
The owner of the ahovemontioned property cancelled this Job in 2017, We would like to
close out this permit,
If you have any questions, please do not hesitate to call,
Best regards,
Kemhle Ettrick
Operations Manager
Limns SR061536
10\490-1
BUILDING
PERMIT -APPLICATION
❑ BUILDING ❑ ELECTRIC
• PLUMBING ❑ MECHANICAL
JOB ADDRESS: 405 NE 99 Street
City:.. Miami Shores
Folio/Parcel#:11-3206-017-0390
Occupancy Type: Load:
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
❑ ROOFING
El PUBLIC WORKS
RECE1Vn
13 1I
i--1
BC t'U
Master Permit No.21 \ 9 2L6S
Sub Permit No.
❑ REVISION ❑ EXTENSION El RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
County: Miami Dad = , ip:
Is the Building stori y Desi ted: Yes NO X
Construction Type: Flo •: one: 0, BFE: FFE:
OWNER: Name (Fee Simple Titleholder): William Davis
Address:405 NE 99 Street
City: Miami Shores
Tenant/Lessee` Name:
Email:
•
State-_F
Phone#:
Zip: 33138
Phone#:
CONTRACTOR: Company Name: Mr. C's Plumbing & Sep/
Address: 19932 NW 2 Avenue
Phone#: 305-651-7859
City: Miami State: FL
Zip: 33169
Qualifier Name: Kemble Ettrick Phone#: 305-651-7859
State Certification or Registration #: SR061536 Certificate of Competency #:
DESIGNER: Architect/Engineer: NA
Address: City: • State: Zip:
Phone#:
Value' of Work for this Permit: $ 2400 Square/Linear Footage of Work: 200
Type of Work: ❑ Addition ❑ Alteration
Description of Work: Drainfield repair
❑ New 0 Repair/Replace
❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ r 6- " CCF $ CO/CC.$
r1
Scanning Fee $ Radon Fee $ �" . oi, DBPR $ vZ • ac, Notary $ -
Technology Fee $ Training/Education Fee $ - Double Fee $
Structural Reviews $ Bond $3 _
TOTAL FEE NOW DUE $ 1. i'3• 0 c
(Revised02/24/2014) i , 1 8 - os
{
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.
Signature
OWNER or AGENT
The foregoing instrumen was acknowledged before me this
Lb12 v- , 20 I > , by
OM l)aUl4
day of
, who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Iona/6l [) v-t r.
;ik "4*... DONALD MARTIN
MY COMMISSION # GG102743
"-',?;,,, EXPIRES May 09, 2021
*******************************
Signature
CONTRACTOR
The for going instrument w s cknowledged before me this
Gs�e 20 r7 by
day of
Pw4hl L y
b'(i(
, 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
Plans Examiner
y(1.4 ld Mav'i'v-
DONALD MARTIN
ts
MY COMMISSION # GG102743
EXPIRES May 09, 2021
—I-1-1 "' 1111
k********
Zoning
(Revised02/24/2014)
Structural Review
Clerk