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BP-04-985Owner's Address City /i'(% At / 514.t nd'. State rz_ Zip 33 /ak- Tenant/Lessee Name Phone # Job Address (where the work is being done) See mt.— a dv _ ' j s a , C.. 10 1 J-1- City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO � �• iam• rV1 ores zT•11 age ��Y�tL�© Building Department jut 2 o me% 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 V. • . Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit No. 13PO4-qa5 Master Permit No. Permit Type (circle): Building % Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Tideho er XiPte L Ate 4 Nfttu s50 ,JEtatS+ Phone # 305- 3'71 /OO1 Contractor's Company Name awre ( Phone # Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit At/t .... agfAl.'Wr (r,:-.. � r y p4,4,t Type of Work: ['Addition ❑Alteration ❑New Describe Work: Repair/Re lace ❑ Demolition v • L G W/ J^G4- Ce t �,�-.�l-l� s ./s-.e..C� •+^ % T' , fko alove5 - (. lqtrq * ******* ************ **Fees****************************** S.I ,.—.. Submittal Fee $ 60 • W Permit Fee $ ai60 — CCF $ 0 CO/CC Notary $ "e— Training/Education Fee $ � Technology Fee $ 5".r-• Radon $ Zoning Bond $ �. Scanning $ 3-- `Te Code Enforcement $ Structural Plan Review. $ '.••'" Total Fee Now Due $ f�J A (Continued on opposite side) 1 v Build'ng I spection Request Date 0 5.°°..# Type Insp'n Permit No. JC) 04° tAiTAr\d Name Address G-SZ Company Phone # Inspection Date�2/) I � Correction Re-Insp'n Fee hulloing tnspecuuon is eyuest • Date �► Type Inspin tom} 1 Permit No. P-04--- 61631 Name OrkelOn 5501\k• JO/&,L companyOUArkev Phone # Inspection Date Approve Correction c,(e C:3 Re-Insp'n Fee r.1)