WS-14-482Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS( YI�t7 IU� "i 1 `'r#i(P gl H4'
FBC 20
Permit No.
Master Permit No. (-A) S
ROOFING
City: Miami Shores County: Miami Dade Zip: !n f T
Folio/Parcel#: It 3 aD(Q- a36-
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): A LIlsc C#4-1-1• CX_S Phone#: (,Z� z ds- 7�O �Z
Address: 623 AE 92 4x6y- 8
City: / //�-l�
Tenant/Lessee Name:
Email:
S / State: Zip: 13313 00
q -IJ 4 Phone#: '
CONTRACTOR: Company Name:
Address: o1�� �S(�
City: n t kilVl l ; b
Qualifier Name:1r)�(K/`�Cf(( D ^-�
State Certification or ��R-egiistration #: G� Q « l
Contact Phone#: -55- -756- &S-93 Email
DESIGNER: Architect/Engineer: 0
to of Competency #:
V6 4Z 04E lS.�15-UL%
Phone#:
Value of Work for this Permit: $310 00 . 06 Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteraftiioonn ❑New eRepair/Replace ❑Demolition
Description of Work: II�C M �'
...Re LACr-- cs-S.R y..
Color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's-Name,(if applicable)
� TA* "Is; it, rl w ,
Bonding Company's Address
City 1i Q_' ^ 1 f1 State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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: Asa 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.
Signa,Oe
Owner or Agent
Signature dn��A
Contractor
The foregoing instrument was acknowledged before me this, The foregoing instrument was acknowledged before me this
day of /� , 20 , by ��,sE C�yt�y6{ Sd. day of 20 L, by �Q� n4i CO
� ^
who is personally known to me or who has produced / Q ori .rf. who is personally kno i o i or who has produced
J 1 V 1-S. 4 C . As identification and who did take an oath. W �'' as identification and who did take an oath.
�
NOTARY PUBLIC: ° NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Sign:
Print:
My Commission Expires
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APPROVED BY i���,se�/CeTet(�pl
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Structural Review
(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/1012009)(Revised 3/15/09)(Revised 7/10/2007) .� '.
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Zoning
Clerk
Miami Shores Village
Building Department
10050 N.E. 2nd Avenue
Miami Shores, FI 33138
Tel: 305-795-2204
Fax: 305-756-8972
11/20/2015
770 NE 91 Street
Miami Shores FL
RE: Process No.WS-3-14-482
Address: 770 NE 91 Street
Dear Owner,
Our records indicate that the above referenced permit has expired without obtaining the
proper permit approval. In order to serve you better, we need to keep our files up to date.
As per section 105.3.2 of the Florida Building Code, "An application for a permit for any
proposed work shall be deemed to have been abandoned 180 days after the date of filling, unless
such application has been pursued in good faith or a permit has been issued. "
Please be advised that open permits will hinder your ability to refinance or sell this property.
Please contact the Building Department, within 15 days of receipt of this letter in order to
take care of this matter.
Sincerely,
CD-1
Ismael Naranjo, CBO
Building Department Official
305-795-2204
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