REV-11-23-2875CA
�J2 GI MIa�111�IgAMTd g e RECEIVED
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
---Tel: (305)295 _220_4 Fax: (3051756-8972
INSPECTION LINE PHONE NL)MBEM (305) 7624949
FBC 20
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BUILDING —_ Master Permit No.
PERMIT APPLICATION Sub Permit No. F—E:V— 1k- ZA -Z& 7S
✓BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[—]PLUMBING MECHANICAL ❑PUBLIC WORKS EJCHANGEOF []CANCELLATION [—]SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 60 NE 105 ST
City: Miami Shores County Miami Dade Zip•33138
Folio/Parcel#:11-2136-012-0040 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: __ FFE:
OWNER: Name (Fee Simple Titleholder):LINDA PROCTOR Phone#:786A73-2782
Cddra«•60 NE 105 ST
City: MIAMI SHORES
Tenant/Lessee Name:_
Email:
33138
CONTRACTOR: Company Name: LOCK TIGHT IMPACT WINDOWS & DOORS Phone#:954-686-6711
Address:15951 SW 41 ST Suite # 100
City: DAVIE State: FL Zip:33331
Qualifier Name: BILLY SHAWN SHAPIRO Phone#:
State Certification or Registration #: CGC1528924 Certificate of Competency#:
DESIGNER: Architect/Engineer: Phone
Address: City: State:_Zip:
Value of Work for this Permit: $9,,200(0 Square/Unear Footage of Work:
TypeofWork: ❑ Addition LJ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
n--- a -N...- -1
Specify color of color thru tile:
Submittal Fee $_
Scanning Fee $.
Technology Fee $
Structural Reviews $
nit Fee $ CCF $.
in Fee $ DBPR
Training/Education Fee $
CO/Cc $
Notary
Double Fee $
Bond $ _
TOTAL FEE NOW DUE $_
(aev1sed02/24/2014)
Bonding Company's Name (if applicable) _
Bonding Company's Address
City S
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. 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 Ich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be Vp oved and a reinspeetfJp fee will be charged.
The fo//ryeygoing instrument
1 `l day of S
me or who has
edged before me this
_, 20 U-1 by
Is rsonall own to
as
identification and who didtake an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: ip'r`Y' Notary Public Stale of Flonda
Diana Gomez
g • My COn1r11L96IM HH 060332
AlX Expires 11/072024
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Signature ' " �"�-✓ _
CONTRACTOR
The foregoing instrurtLent was acknowledged before me his
day of
1 ` `I o is personally known to
me or whQ4 produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal:
APPROVED BY _ i l I I 'Z I Plans Examiner
Structural Review
MA
Commission # GG 357404 1 It
Commission Expires 07.22-2023
Bonded Through - Cynanolary
Florida - Notary Public
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Zoning
Clerk
(RevisedO2/24/2014)