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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
DEK 15 2021
�F�`BC 20 2d
Vy BUILDING Master Permit No. J — 0�
PERMIT APPLICATION Sub PermitNo.fj�-Vy tZ-ti-32-�3
IdBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING [:]MECHANICAL []PUBLIC WORKS ❑ CHANGE OF [-]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 60 NE 105 ST
City: Miami Shores C.ounU: 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 Title holder):LINDA PROCTOR Phone#:786-473-2782
Addrecs-60 NE 105 ST
City: MIAMI SHORES State: FL Zip:33138
Tenant/Lessee Name: Phone#:
Email:
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:
Address: City: ^State: _Zip: _
Value of Work for this Permit: Pr,( Square/Linear Footage of Work:
TypeofWork: ❑ Addition LJ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
CCF $ CO/CC $
DBPR $ Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ `—f-0 , oz:>
(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.
"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 qlfptoved and a reinspeffl4i fee will be charged.
ng instrument was
day of _,_,&
me or who has produced
4t� 06Z,- Signature
NT CONTRACTOR
edged before me this
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Is rsonall own to
as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: 1.+91/Y1.m,.y /" /1
PrintNatary:
Seal: -AT 4, Dlane GomezPublic �ieoi Fionda
My COmmW6i0n HH 060002
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The foregoing instrument was acknowledged before me his
day
1 l o is personally known to
me or whogproduced _ as
identification and who did take an oath.
NOTARY PUBLIC: I�/C:
Sian- _ 4 J - 7/ r
Seal:
APPROVED BY f{ 1Z /7 vI Plans Examiner
Structural Review
Cynanolary
t Public
aarraa«««#rraararr
Clerk
(aeNsed02/24/2014)