DEMO-19-644Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date: 04/10/2019
Parcel Number
48 NE 111TH ST, Miami Shores, FL 33161 1121360040050
Contacts
Permit No.: DEMO-03-19-W
Permit Type: DemoH don
Work classification: Residential
Permit status. Approved
Expiration: 09/23/2019
REGINATEIXEIRA Owner HOMEOWNER Contractor
48 NE 111 ST, MIAMI SHORES, FL 331617047 HOME OWNER
Description: DEMOLITION OF STEPPING STONES TO CANCEL Valuation: $ 400.00 Inspection Requests:
PERMIT#DS-01-19-220 r
5-762-4949
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
Building Demoloition Fee
$50.00
CCF
$0.60
DBPR Fee
$3.75
DCA Fee
$2.50
Education Surcharge
$0.20
Scanning Fee
$3.00
Technology Fee
$6.25
Total:
$116.30
Payments
Date Paid Amt Paid
Total Fees
$116.30
Credit Card
04/10/2019 $116.30
Amount Due:
$0.00
Building Department Copy
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 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
egula ' nstruction an zoning. Futhermore, I auth ' the above named contractor to do the work stated.
c)-
Auth ized Signature: Owner / Applicant / Contractor / Agent Date
r
April 10, 2019 Page 2 of 2
Miami Shores Village
Building Department
100SO N.E.2nd Avenue, Miami Shores, Florida 33138
RECEI-' 7FID
MA 262019.
BY'. -
Tel: (30S) 79S-2204 Fax: (305) 756-8972 `
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
4' BUILDING ❑ ELECTRIC ❑ ROOFING
FBC 20 1 =1
Master Permit No.DEMV _b3- ( (-(oq /
Sub Permit No.
❑ REVISION ❑ EXTENSION [-]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
I ,, ii I 1 CONTRACTOR DRAWINGS
JOB ADDRESS: 42 l l S
City: Miami Shores County: Miami Dade Zip:33 t G i
folio/Parcel#:
the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
{OWNER Name (Fee Simple Titleholder): �(�. Q, (�� Phone#:
rAd'dre� (--fR K-P-; l f LS 1
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR -�Company Name: 0)Ajy - Phone#:
Address:
City: State: Zip:
Qualifier Name:
State Certification or Registration M
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit $I Ad(D O� Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
Specify color of color thru the:
Submittal Fee $
Permit Fee $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Zip:
❑ Demolition
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
_ Double Fee $
Bond $
TOTAL FEE NOW DUE $14 6' -30
(Revised02/24/2014)
• t ♦"
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
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 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 re Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day —(off PA�P_Gt4 20 i� by
(�I x �t lt—�"A , who is personally known to
me or who has produced T�'
nd who did take an oath.
NOTARY :
Sign:
Print�F�
Seal:
*********************
APPROVED BY
(Revised02/24/2014)
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
as
SINDIA ALVAREZ Seal:
MY COMMISSION # GG 238273
EXPIRES: September 3, 2022
ed Thru Notary Public Undernr t.
de-
rExaminer Zoning
Structural Review
Clerk
Phis Property described as:
got 5, Bloc.c 1,
;ULLEGE I1EIGICIS,
according to the Plat
;hereof as re d d
Plat
Book C!, Page 6
of the Publ__r. Records of
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