RF-03-20-563 CanceledMiami Shores Village RECEIVE
Building Department MAR 13. 2020
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 BYE
INSPECTION LINE PHONE NUMBER: (305) 762-4949 't Em
CANCELLED FBc Zo ►�`°
BUILDING reeka� b4 Master PermitNO.4-'k w"5ko3
PERMIT APPLICATION KF-( -j.-20- I5,7& sub Permit No.
❑BUILDING ❑ ELECTRIC ❑■ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 29 NE 96th Street
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Carrington Mortgage Phone#:949-517-5185
Address: 1600 South Douglass Road Suite 200A
City: Anaheim State: CA Zip: 92806
Tenant/Lessee Name: Phone#:
Email: tewang007@yahoo.com
CONTRACTOR: Company Name: Bofam Construction Company INC Phone#: 631-714-1445
Address: 8523 Sandbirch Way
City: Lake Worth State: FL Zip: 33463
Qualifier Name: Austin G Akinrin
State Certification or Registration #: CCC1329221 Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
754-245-0102
Address: City: State: Zip:
Value of Work for this Permit: $ 5000.00 Square/Linear Footage of Work: 1188 sf
Type of Work: ❑ Addition ❑ Alteration ❑ New N Repair/Replace ❑ Demolition
Description of work: Repair flat roof
Specify color of color thru tile:
Submittal Fee $ SO, 0� Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF
DBPR $
CO/CC $
Notary.
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
(Revised02/24/2014)
Bonding Company's Name (if applicah`^'
:unaing Company's Address
City
State
:.iortgage Lender's Name (if applicable)
Mortgage Lenders Acores,
L'.r
tv State Zip
Application is herebv made to obtain a permit to do the work and installations as indicated. I certity 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 ail the foregoing information Is accurate and that ail 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 budding permit with an estimated value exceeding S2500. 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 copv of the recorded notice of commencement must be Posted at the fob 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.06iiispection fee will be thorned.
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SlgnatA-/�S0Nic6i, LI.0 Signature �1
0 W NER or AGENT
'I he foregoing Instrument was acknowledged before me this
dam 2G by
who is personally known to
me or who has produced Spa as
identltkation and who did take an ath.` 4 .
NOTARY PUBLIC: \ �d
CONTRACTOR
The foregoing instrument was acknowledged before me this
dayof 1�¢1j.I�,r-✓�o-r'✓ .20fc by
Gi�klc"A htdi-, ' *6�h personally vm to
me or who has Produced
Identification and who did take an oath.
NOTARY PUBLIC:
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APPROVED BY Plans EY�mr
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