DEMO-03-21-554 CanceledMiami Shores Villag(�-✓T�,TED
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
CA%�:ELLED FBc,,,Z102� �
BUILDING Master Permit No. `P�(-63'Sc33
PERMIT APPLICATION sub Permit NO.TX-MQ —03- 21-s51
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
QPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 29 N.E. 95th ST
City' Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 -3206-013-0690 Is the Building Historically Designated: Yes NO X
Occupancy Type: SFR Load: Construction Type: CBS Flood Zone: BFE: FFE:
OWNER: Name (Fee simple Titleholder): J A ROD ENTERPRISES INC Phone#: (305) 742-8285
955 N.W. 98th ST
City: Miami Shores State: FL
Tenant/Lessee Name: N/A
Email:
CONTRACTOR: Company Name: HOREB Construction Corp.
Address: 5901 N.E. 151 St Suite 211
City: Miami Lakes State: FL
Qualifier Name: MR. EDUARDO I CUADRA SR
State Certification or Registration #: CFC1428563 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City:
Value of Work for this Permit: $ 103 ' Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
Description of Work: DEMOLITION
Specify color of color thru the:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
❑ New ❑ Repair/Replace
Technology Fee $ Training/Education Fee $
CCF
DBPR $
33138
N/A
(305) 467-4751
33014
(786) 200-8582
Zip:
0 Demolition
cO/Cc $
Notary $
Double Fee $
Structural Reviews
(Revised02/24/2014)
Bond $ _
TOTAL FEE NOW DUE $
/09*4\
f'O%S
Bgnding 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 low 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 occ ev n (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approve n a r nspection fee will be charged.
Signature
OWNER or AGENT
The f;7oing instrum
entged before me this
bday of20 �y
Swho is personally known to
me or who has produced At1— as
identification and who did take an oath.
NOTARY PUBLIC:
r
Signature
CONTRACTOR
The foregoing instrumentwasacknowledged before me this
l U day of 20 21 , by
t�;y �� �E: C.yeNA , who is personally known to
me or who has produced 'FL �S� as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: M1 Sign:_
Print: Print:
;;p••,y ANAiS ARAd N if''% ANAIS ARAGON
Seal: ''Notary Public -State of Florh
?° y'ir>r Notary Public - state of Florida Seal: +� . Commission # HH 78394
'� •; # ff 207214 �.r My Commission Expires
Mr Comm. Expires Apr 25, 2019 •ill• January 07, 2025
APPROVED BY
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk
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