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 $