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EL-17-2634r BUILDING PERMIT APPLICATION ❑BUILDING yELECTRIC PLUMBING 0 MECHANICAL JOB ADDRESS: 1250 NE 101 st. 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 RECEIVED NqV 08.2 BY•1 Y� FBC 20i- Master Permit No,PC-N _p — 2G32 Sub Permit No. 1 L R 2)3`4 ❑ ROOFING ❑ REVISION ❑ EXTENSION El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR ❑ RENEWAL SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: CANCEL 11-3205-008-0020 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Maria & Neil McGuinness Address: 1250 NE 101 st. Phone#: (3) 3 LI "Z--III 2- City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: 1-04k I 6OL4/Ct Clt-C—kc L- 36.4—_ Phone#: q5 / " 3 Yo - 3-J 3 Address:sl / ?-a-3 % Nt'l% 3 ' 51 City: Cd (A-! S f rSt1 State: FL Zip: r3 -SO C r Qualifier Name: tbOM V)i c—r, IPO(ft O 'V Phone#: { ip5 V (SO ,-,n (3 State Certification or Registration #: t- C. / ;CDC) )-��! % Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $ 2000 Type of Work: ❑ Addition ❑ Alteration n New ❑ Repair/Replace ❑ Demolition Description of Work: LminirOde eletAriCA1 <>LAMAS 's sP; 4-'cor4Q Zip: Square/Linear Footage of Work: Specify color � of color thru tile: Submittal Fee $ Sv ' Permit Fee $ J V" /de9 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ ' C� DBPR $ 2. 2S Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ I (0 • ‘--/S (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 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 ignature/ 2 mnigerm The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this %l dayofOCt' ,20 t% ,by 4.jfr day of AI' ,20l' ,by l0. l i t' U 0 1eS5v sonally kno to as me or who has produced ho is personally known to Dpntn.c. 94 ((aft) as me or who has produced identification and who did take an oath. NOTARY PUBLIC: identification and who did take an oath. NOTARYPUBLIC: Sign: / Sign: Print: Print: .,� Seal: •.Nancy Seal: • /j1 )Nan1Cajuste 1155 EXPIRES: �/F4, 2018 'WV WWW.AA APPROVED BY �/V�� Plans Examiner "rig JENNIFER R. A'HERN PU •y. •� : = MY COMMISSION # GG 100114 • •���- o • EXPIRES: May 23, 2021 Zoning Structural Review Clerk (Revised02/24/2014)