RF-09-23-2408 Cancelled (2)Miami Shores Village
Building Department
SEP 11 Z0Z4
BY:
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
Master Permit No.ZS-2‘~IOE:>
Sub Permit No.
BUILDING
PERMIT APPLICATION
ROOFING RENEWALEXTENSIONREVISIONBUILDINGELECTRIC
□plumbing SHOP
DRAWINGS
CANCELLATIONMECHANICALCHANGEOF
CONTRACTOR
Ot>f\l^2l7-^eeJ~'JOB ADDRESS:
Miami Shores Miami Dade ZipLCity:County:
Folio/Parcel#:I I ^ao(bOi.^7<go Is the Building Historically Designated:Yes
Flood Zone:
NO
Load:BFE:FFE:Occupancy Type:Construction Type:
Cec:,I 'lcu~D noOWNER:Name (Fee Simple Titleholder):
Address:
Phone
City:RIlCLmi ujfl
FL.Zip:33 /State:
Tenant/Lessee Name:
Email:0 C
Phone#:
♦com
3Ob-3S(-/p_o0//TO.Phone#: Kg-r^ou.PN ^/ooP,/CONTRACTOR:Company Name:he-^s,LonoOg i/]UOmAddress:
.'^n/vOSho .331
Phone#:
Email:
Qualifier Name:
State Certification or Registration #:
DESIGNER:Architect/Engineer:
Email:
Certificate of Competency #:
Phone#:
^-●5~0 O.OO Square/Linear Footage of Work:.●O OValueofWorkforthisPermit:$
]AdditionTypeofWork:
Description of Work:Q \J"-^
Repair/ReplaceAlteration DemolitionNew
4-^.Ua f\in d CeeTs j \Jo^Ueu m pToD-P.e.istb-^i Vi lexs s.k-od C)r<SKF5
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Permit Fee $
DCA Fee $
Training/Education Fee $
CCF $
DBPR $
CO/CC$.
Notary $
Double Fee $_
Bond $
TOTAL FEE NOW DUE $
P&Z Review $
(Revised04/26/2024)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip.
Application is hereby made to obtain a permit to do the work and installations as indicated.1 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.
u 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.
Signatu Signature.^5—O
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me thisTheforegoinginstrumentwasacknowledgedbeforemethis
1\day of
I \o^
..bybydayof^20^20
who is personally known to
La.
.,who is personally known to
me or who has produced me or who has produced asas
identification and who did take an oath.identification and who did take an oath.
NOTARY PUBLIC:NOTARY PUBLIC:
Sign:,Sign:,
\f ^\/[ruL-^Print:Print:
Vivienne Yao
Comm.-HH 222410Expires'.Jan.31,2026
Seal:Seal:
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ZoningPlansExaminerAPPROVEDBY
ClerkStructuralReview
(Revised04/26/2024)
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SEP 11 Z024
BY:
Rr38-Z^/-Zj9(o
Miami Shores Village
Building Department -tED)
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING
PERMIT APPLICATION
Master Permit No.
Sub Permit No.
BUILDING □ELECTRIC y ROOFING ]REVISION ]EXTENSION ]RENEWAL
PLUMBING □MECHANICAL CHANGE OF
CONTRACTOR
[CANCELLATION □SHOP
DRAWINGS
f OS AJ ^JOB ADDRESS:
5/OSCity:Miami Shores County:Miami Dade Zip:
Folio/Parcel#:Of
Load:
Is the Building Historically Designated:Yes
Flood Zone:
NO
Occupancy Type:Construction Type:BFE;FFE:
OWNER:Name (Fee Simple Titleholder):
Address:9C ^T
City:M f/
Phone#:
P Zip:State:
Tenant/Lessee Name:
Email:
Phone#:
CONTRACTOR:Company Name:oh (P-^(o 9
Address:A)h
Email:
Qualifier Name:
State Certification or Registration ^C
DESIGNER:Architect/Engineer:
Address:
Value of Work for this Permit:$^^0
]Additi
Phone#:AY<Shorr’^-f [/Yo 9
Oh<rOOu/rCDiihc aoi r oA
SOae'i>'i>JK Phone#:7fYr-:iO t X
Certificate of Competency ft:_
Phone#:
City:
Square/Linear Footage of Work:
epair/Repiace
State:Zip:
Type of Work:Alteration New DemolitionW((^^/V ^CS/^^i/Ccdeif^Pc(Sh5-ftC^h CcXJ ^/U
^^4aC(-/J CQ oLu‘f\fy‘!lr\poloj-foTi hAwks\y rin
Description of Work:(T d
Specify color of color thru til ?;
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $,
Permit Fee $
DCA Fee $
Training/Education Fee $
CCF$_
DBPR$
CO/CC$.
Notary $
Double Fee $
Bond$.
TOTAL FEE NOW DUE $
P&Z Review $
(Revised04/05/2022)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City ;ate Zip.
Application is hereby mad^obtain a permit to do the work and installations as indicated.I certify that no work or installation hascommencedpriortotheissuanceofapermitandthataliworkwillbeperformedtomeetthestandardsofalllawsregulatingconstructioninthisjurisdiction.I understand that a separate permit must be secured for ELECTRIC,PLUMBING,SIGNS POOLSFURNACES,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 allapplicablelawsregulatingconstructionandzoning.
u 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.ft
Notice to Applicant:As a condition to the issuance of a building permit with an estimated value exceeding $2500,the applicant mustpromiseingoodfaiththatacopyofthenoticeofcommencementandconstructionlienlawbrochurewillbedeliveredtothepersonwhosepropertyissubjecttoattachment.Also,a certified copy of the recorded notice of commencement must be posted at the job siteforthefirstinspectionwhichoccursseven(7)days after the building permit is issued.In the absence of such posted notice,theinspectionwillnotbeapprovedandareinspectionfeewillbecharged.
CONTRACTOR
Signatu Signature.
OWNER or AGENT^^
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this/^day of11'T ,20 7.2,day of .;by .,20 ^by
me or who has^ocftrced
70^j who is personally known to who is personally known to
me or who has produced
identification and who did take an oath.
as as
identification and who did take an oath.
NOTARY PUBLIC:NOTARY PUBLIC:
Sign:.Sign:.
Print:Prim
Seal:►A'.'?CATHERINEADUFFIN
;MY COMMISSION #HH 089522
EXPIRES:May 14.2025BondedThniNotaryPubBcUndetwrlfera
Seal
ftCATHERINEA.DUFFIN
EXPIRES;May 14,20ZTBondedThruNcteni^WtoU^
*♦***************,**************-,^*^,^,^;^j;,^^^i^|»i***
Mill
Plans Examiner
re
APPROV Zoning
Structural Review Clerk
(Revised04/05/2022)