RC-18-2044BUILDING
PERMIT APPLICATION
Miami Shores Village REC1C1`\7ZD
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
DEC 10 cG19
BY•
FBC 20
CANCELLEDlaster Permit No.�
Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLAT10 ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1$5 N.t- 10 () S:r
City: Miami Shores County: Miami Dade Zip: 33139
Folio/Parcel#: LJ3 Zd 6 C L 3 20-70 Is the Building Historically Designated: Yes NO
Occupancy Type: i ►n Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): VGN�el Rlt &AC<d 90+0 Phone#:
Address: 195 HL IV 5 T
City: R1f*?► % SkTy1Fc State: t:k Zip: Is1if?
Tenant/Lessee Name: Phone#:
Email:
1s
CONTRACTOR: Company Name: �ri' �V' 1C'�nS � JP�� S �"C Phone#
Address: � ,&
City: RtAm),
F1
3a� 74G36
Qualifier Name: h;el.Ae1 9V'01n k, Phone#:3D594-63co(
State Certification or Registration #: RZZiz_ $ l t-499 Certificate of Competency #: cvy(%4j 6
DESIGNER: Architect/Engineer:
hone#:
Address: City: State
Value of Work for this Permit: $
Square/Linear Footage of Work:
Zip:
Type of Work: Z Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: I lrn-58 E 1 I� *- ,L a }- �hS - �n - NE. be�YLSDl1
Specify color of color` &u #ale ^ `
Submittal Fee $ ? . ..:..:.....:. :.:... . ,_...: herUit.Fee`$" ... ; CCF $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $ DBPR $:
Training/Education Fee $
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
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. i _ . r`'
"WARNING A 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 estim"dted 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 !ie 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 Signature
r OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 by da^y7.of ����Z 20 1 9 by
who is personally known to %I(I �f�L Root- e-T �`- 674is personally known to
me or who has produced as me or who has produced -FL WJ QE3�?— Nas
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PU I
�. .,''
Sign: Sign:
Print: Print: �I Nt>
Seal: Seal: - "-
i►... .• SINDIA ALVAREZ
? MY COMMISSION S GG 238273
• o EXPIRES: September 3.2022
****************************** ****** ************************ •.�• iG&°�*dtl'Ri�'bPtlWialdnd ************
APPROVED BY (; 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 8 3241
Dade County General residential contractor # 000017565
Florida Registered Residential Contractor # RR 282811799
845 NE 71 ST., MIAMI, Fl. 33138
E Mail: abisincel990@amail.com. Cell: 305 776 3106
TO:
Village of Miami Shores Building Department
FROM:
Michael Graham
RE:
185 NE 100 St expired permit
DATE:
December 9, 2019
Dar Sirs:
Over a year ago, Graham Building Inspections was going to be hired to perform renovations at the above
address. We applied for a permit.
No work was done. We were told this company would not do the work in any case. Please remove this
expired permit from my record.
Sincerely
Ifs �
Michael Graham