WS-15-2959BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
Miami Shores Village + 2� 2015
�o
Building Department �V
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �V
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑ ROOFING
F-IPLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS:
FBC20(4_..�.
Master Permit NO.WS'
Sub Permit No.
❑ REVISION ❑ EXTENSION 14RENEWAL
CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip: 3 1 3
Folio/Parcel#: I IL — 32- 0C6b — 38 — 0030 Is the Building Historically Designated: Yes NO K
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): f4t Q" 1 S L, o J)ES LO — vb Q D%S Phone#:
Address: —4 4fl A) E C� / sT
City: 64 101 " I State: � � Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: �p�,�F62 COKS"C12V C�1 C7/1/ Co p Phone#: 4V6 2S6 a} S-5—
Address: 3 S n SCA3 g25
City: k , t State: 7 (. Zip: 33 l
Qualifier Name: Qrd P� L-p �• C'iCV2\A q kA d t 2 Phone#: 7-L5-S
State Certification or Registration #: 0052---IS9 Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: t '' City:
Value of Work for this Permit: $ —T5m Square/Linear Footage of Work:
1 ZQ .
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New %I Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ M Permit Fee $ 0 CCF $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ �� • ��
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
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 brochur elivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commence ent must be osted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In th absence of sposted notice, the
inspection will not be approved and a reinspection fee will be charged. /f uc
Signature
OWNER or AGENT
.t
The foregoing instrument was acknowledged before me this
Z.O day of 20 { S— by
J who is personally known to who is persogdLy�n to
me or who has produced as me or who has produced as
a cC
BLI A'',Seal: Seal:
identification
NOTARY PU
Sign:Print:
I����g�Igsy.�tlfi�DENOo� EXPIRES: bi7tober 19, 2018
M1
Signatu
CONTRACTOR
The foregoing instfument was acknowledged before me this
I day of 20 1� by
identificati W-Y
p1;�Ac1PtY�rIA6�A�N0
MYCOMMISSION>fFF151424
NOTARY PEXPIR'vS:Octaber 19, 2ols
Sign: ; �IG��L%�Print:
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit No. WS-11-16-2959
Permit Type: WindoWslShutters
er it IkClassification: Window/Door Replacem
Permit Status: APPROVED
Parcel Number
Issue Date: 4/28/2016 j Expiration: 10/25/2016
Applicant
770 NE 91 Street Number: 1 1132060380010
DAMES &JANICE SPINNEY
Miami Shores, FL 33138- Block: Lot:
JAMES & JANICE SPINNEY 770 NE 91 Street
MIAMI SHORES FL 33138-3251
Contractor(s) Phone Cell Phone
PAHER CONSTRUCTION CORP (786)256-3755
Type of Work: REPLACE 14 WINDOWS AND 1 HURRICANE
No of Openings: 15
Additional Info:
Classification: Residential
Scanning: 3
Fees Due
Amount
CCF
$3.00
DBPR Fee
$3.75
DCA Fee
$3.75
Education Surcharge
$1.00
Miscellaneous Fee
$3.75
Permit Fee
$250.00
Scanning Fee
$9.00
Technology Fee
$4.00
Total:
$278.25
Phone
(904)262-7736
Cell
(904)655-9515
Valuation: $ 4,500.00
Total Sq Feet: 120
Pay Date Pay Type Amt Paid Amt Due
Invoice # WS-11-15-57864
04/28/2016 Credit Card $ 278.25 $ 0.00
Available Inspections:
Inspection Type:
Window Door Attachment
Final
Review Building
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I cgrtify-that aY the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zo�F�uthermore.,(authorize the above -named contractor to do the work stated.
April 28, 2016
Auto n ure: Dwner / Applicant / Contractor / Agent uate
Building partment Copy
April 28, 2016 1