DEMO-18-1065 (2)Miami Shores VillageFw Mom'
Building Department °'' 10
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
FBC 20
BUILDING CANCELLED Master Permit No)—)D -1
PERMIT APPLICATION sub Permit No.
❑ BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION [:]RENEWAL
[:]PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 2oa A, W It l Tem.
City: Miami Shores County: Miami Dade Zip: 3316IV)
Folio/Parcel#: L12— l3 (, 66 1 Q GAO Is the Building Historically Designated: Yes NO
Occupancy Type: ( Rk Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �eKh�t�/V ��^�'jr^` Phone#:
Address: 941>5 Sri 53 ST
City: HuI yok1 State: t1 Zip: -331'-J5
Tenant/Lessee Name: Phone#:
Email
CONTRACTOR: Company Name:, riSpl:cilf-rs (Hc Phone#: 3oS :W(o 31D(=,
Address: �.y�-15 N G I ST
City: State: � t Zip: )3a
Qualifier Name: Mi c ae l ra ;,%A V-., Phone#: 36
State Certification or Registration #: 1zZM g« c1 Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
City:
Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Zip:
Type of Work: ❑ Addition ❑ (Alteration ❑N-e-w ❑ Repair/Replace 0 Demolition
Description of Work: <AeVY o t%1, ),h.t _�ir v �Otn-h��ry,S t W aDa -Any + nod f
Sped ffj%color of *color th?tt tile::
Submitta`I1Fee $_� " Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
i-
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zi
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. f
"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 6-1-building permit with an estimated value exceeding $2500, the applicant must
promise in good,!,aith 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
ti OWNER or AGENT
'r
The foregoing instrument was acknowledged before me this
day. of 20 by
who is personally known to
me or who has produced
as
Signature
CONTRACTOR
The foregoing instrument -was acknowledged before me this
clay. of /1 f� L 201 by
n C AHAM
(V�Ini IPE.I. �ah�� Roils personally known to
Z. L712.t1 me or who has producedEC, LA-C�E "3 y—`'s
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLI .
"# r a Y •, 3 4 ... n ,: Yi t y
.. .t f ,
t •� 1
Sign:
Sign:
Print:
Print:
►A P:Uj
Seal:
Seal:
;n?y
JL*,.
SINDIAALVAREZ
,:
MY COMMISSION # GG 238273
;P
o;
EXPIRES: September 3, 2022
**************************** *** **t** ****************************
n°. Bonded
Ttuu Public tMde�wfts
*******
APPROVED �Y J �'J�
Plans Examiner
Zoning
!;
Structural Review Clerk
(Revised02/24/2014)
GRAHAM BUILDING INSPECTIONS, Inc
Master Professional Inspector, Florida Association of Building Inspectors
(RPI #0194 Member since 1994)
Florida licensed Home Inspector # 3241
Dade County General residential contractor # 000017565
Florida Registered Residential Contractor # RR 282811799
845 HE 71 ST., MIAMI, Fl. 33138
E Mail: gbisinceI990@amail.com. Cell: 305 776 3106
TO: Miami Shores Village Hall Building Department
FROM: Michael Graham
RE: expired permit at 200 NW 111 Terr
DATE: December 9, 2019
Dear Sirs:
This is to ask that an expired permit at the above address be removed from my record. Over a year ago,
I was going to be the contractor responsible for renovations at that house. We took out a temporary
fence permit and a demolition permit.
I began demolition operations and the developer removed my company from the job and picked
another contractor, who continues to renovate that house today.
The secretary of the developer has been most cooperative with me, contacting the present contractor
and asking him to remove my name and place his own company's name on the permit. As of Friday she
told me he has promised to do that.
Can the Village help in expediting this matter?
Sincerely
Michael Graham