WS-08-21-2254 Canceled�Miar Village
NT)9,'"`y"'
Building Department cur,' n8zaz,
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BYe_
Tel: (305) 795-2204 Fax: (305) 756-8972 T
INSPECTION LINE PHONE NUMBER: j305) 762-4949
BUILDING
PERMIT APPLICATION
JABUILDING ❑ ELECTRIC ❑ ROOFING
MPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 60 NE 105 ST
FBC 20
Master Permit No, W`) VOc(
Sub Permit No.
❑ REVISION ❑ EXTENSION [—]RENEWAL
❑ CHANGE OF KCANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zio: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#:786473-2782
Address:60 NE 105 ST
City: MIAMI SHORES
Tenant/Lessee Name:_
Email:
State: FL
CONTRACTOR: Company Name: LOCK TIGHT IMPACT WINDOWS & DOORS
Address: 15951 SW 41 ST Suite # 100
City: DAVIE
Qualifer Name: BILLY SHAWN SHAPIRO
State Certification or Registration #: CGC1528924
DESIGNER: Architect/Engineer:
33138
954-686-6711
FL Zip: 33331
Phone#:
of Competency #:
hone#:
Address: /y City: State: Zip:
Value of Work for this Permit: .1'J Square/Linear Footage of Work:0
Type of Work: ❑ Addition ❑ Alteration ❑ New y� n❑ Repair/Replace ❑ Demolition
Description of Work:
fteplaLu
Specify color of color thru tile:
Submittal Fee
Scanning Fee $
Technology Fee
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $ co/cc $
DBPR $ Notary $
Double Fee $
Bond 5
TOTAL FEE NOW DUE
(Revi5ed92/24/2014)
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
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
applicable laws regulating construction and zoning.
accurate and that all work will be done in compliance with all
"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 whichye�urs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be a.. demand a reinspectyaq fee will be charged.
Signatu
OWNERor
The foregoing instrument was acl(rfOwledged before me this
_ day of —�� _--, 20 , by
ywho Is pe onally kno to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: VT
Seal:
SignaturOJV
CONTRACT
The foregoing instrument was acknowledged before me this
�dayo4*
f_ ,20 ,by
_ s pe onally known t
me or who has produced_
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
CIO
Print:
Seal:
ssatt;slImsmsssxssmssa
APPROVED BY _ __� vPlans Examiner
Zoning
Structural Review
(Revised02/24/2014)
Clerk
6/6/2022
Lock Tight Impact Windows and Doors
15951 SW 41 Street, Suite #100
Davie, FL 33331
Office 954-686-6711
To Whom this may concern,
I Billy Shapiro need to request for a PERMIT CANCELATION.
Permit # WS-08-21-2254
Property address: 60 NE 105 ST MAMI SHORES, FL 33138
CUSTOMER HAS CANCELED CONTRACT WITH OUR COMPANY, NO WORK HAS
BEEN DONE IN THE HOME.
Thank you!
SIGNATURE OF QUALIFIER:
PRINT NAME: BILLY SHAPIRO
STATE OF FLORIDA
OON AflIAMI DADE
SWORN TO ME BEFORE THIS � DAY OCF 22 V
I,m
BY: r U
SIGNATURE OF NOTARY PUBLIC:
PRINT NAME:
PERSONALLY KNOWN)90R PRODUCED IDENTIFICAT O
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: WS-08-21-2254
Permit Type: Windows/Shutters
Work Classification: Window/Door Replacement
Permit status: Approved
Issue Date: 09/0912021 1 Expiration:03/09/2022
Location Address Parcel Number
60 NE 105TH ST, Miami Shores, FL 33138 1121360120040
Contacts
LINDA PROCTOR Owner LOCK TIGHT IMPACT WINDOWS AND Contractor
60 NE 105 ST, MIAMI SHORES, FL 331382031 DOORS INC.
Other: 3057576268 BILLY SHAWN SHAPIRO
15951 SW 41 ST, DAVIE, FL 33331
permits@locktightimpact.com
Description: REPLACE 6 WINDOWS & 2 DOORS Valuation: $ 9,200.00 Ins ectton Requests.
305-762-4949
Total Sq Feet: 0.00
r�®vim
Fees
Amount
Application Fee - Other
$50.00
CCF
$6.00
DBPR Fee
$2.70
DCA Fee
$2.00
Education Surcharge
$2.00
Scanning Fee
$12.00
Technology Fee
$4.50
Windows/Shutters Fee
$130.00
Total:
$209.20
Payments
Date Paid Amt Paid
Total Fees
$209.20
Credit Card
09/09/2021 $159.20
Credit Card
08/31/2021 $50.00
Amount Due:
$0.00
Building Department Copy
In consideration of the issuance to me of this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all t e foregoing inform tion is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futh e, I authorize the bo na contractor to do the work stated.
Authorized Signature: Owner / pplicant / Contractor / Agent Date
September 09, 2021 Page 2 of 2
Miami Shores Village ENTERE.n
Building Department AUG 31 2021
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: G L
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
IdBUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING MECHANICAL PUBLIC WORKS
JOB ADDRESS: 60 NE 105 ST
FBC 20 D-0 -- h
Master Permit No. W S
Sub Permit
❑ REVISION ❑EXTENSION []RENEWAL
❑ CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
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#:786-473-2782
Address:60 NE 105 ST
City: MIAMI SHORES State: FL ZIP: 33138
Tenant/Lessee Name:
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
State Certification or Registration #: CGC1528924
of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: _^State:_Zip:
Value of Work for this Permit: $9,,20000 Square/Linear Footage of Work:
Type of Work: ❑ Addition I•`_7 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Replace I Q Windows &
Specify color of color thru
Doors
Submittal Fee $ Permit Fee $ CCF 5 CO/CC $
Scanning Fee $ Radon Fee $ DBPR 5 Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
Bond $ q
TOTAL FEE NOW DUE$
(Rev1sed02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
E.
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 rch occurs seven (7) days after the building permit is issued in the absence of such posted notice, the
inspection will not be a, p oved and a reinspeefilbe fee will be charged.
OWNER
The foregoing instrument was $
(_yl`` __ day of V
me or who has produced
howledged before me this
20T, by
who is (rsonall n to
as
Signature
CONTRACTOR
The foregoing instru mXnt was acknowledged before me his
day
o is personally known to
me or whotdisproduced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
APPROVED BY Plans Examiner ____Zoning
Structural Review Clerk
(ReNsed02/24/2014)