Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
RC-07-20-1408 Cancellation App 1266 NE 94 StMiami Shores Village RECEIVED
Building Department DEC 14 ZON
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel; (305) 795-2204 Fax: (305) 756-8972 BZ''
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
FBC 20k-�
Master Permit No. V-c-- C)- /l 1— Lz�CR
Sub Permit
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores !!11 County: Miami Dade Zip:
Folio/Parcel#: l ?,D,�V ri� 17U Is the Building Historically Designated: Yes NO V—
Occupancy Type: Load: Construction Type: Flood Zone: 8FE: - FFE:
Tenanl
Email:
CONTRACTOR: Company Name: Phone#:
Address:
City:
Qualifier Name:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Add
Value of Work for this Permit: $
Type of Work: ❑ Addition ❑ Alteration
Description of Work:
0
Specify color of color thru tile:
Submittal Fee
Scanning Fee $ _
Technology Fee $_
Structural Reviews
Permit Fee $
Radon Fee $
City: State: Zip:
_ Square/Linear Footage of Work:
New ❑ Repair/Replace ❑ Demolition
Training/Education Fee $
CCF $ CO/CC $
DBPR $ Notary'
Double Fee $ .
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
Miami Shores Village RECEIVED
Building Department DEL
14
22�020
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 I ir�i
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
FBC 209
Master Permit No. L�cg
Sub Permit
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores ;;11 County: Miami Dade Zip:
Folio/Parcel#: 1 1 �1.D,� 01061Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: - FFE:
Tenant
Email:
CONTRACTOR: Company Name: Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration /I ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: C c&h'—'A of P& ttG{
Specify color of color thru tile:
Submittal Fee
Scanning Fee $ _
Technology Fee $_
Structural Reviews
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR$ Notary:
Double Fee $.
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $