DS-03-23-696Miami Shores Village
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
FBC 20
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ PLUMBING ❑ MECHANICAL ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: / / 7 A /D t
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: ;2 0 le O l 1 1 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: %'/ 0 BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ��" � L Phone#: 7j1& -325 -3z *?7
Address: /l % A C,5:' lO2�
City: A'It StateZip: ?3
r
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Phone#:
Address:
Email:
Qualifier Name: Phone#:
State Certification or Registration M Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
Email:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ® -pair/Replace ❑Demolition
Description of Work: eco�LA<;4� 4t,40 3_1 _A4 A
Specify color of color thru tile:
Submittal Fee $ Permit Fee $D 010 CCF $ / ' CO/CC $
Scanning Fee $ DCA Fee $ 2 DBPR $ Notary $
Technology Fee $ ! D ' C Training/Education Fee $ .4 4:� O Double Fee $
Structural Reviews $ P&Z Review $ Bond $
TOTAL FEE NOW DUE $ /
VT
(Revised04/26/2024)
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 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 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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
---7'40 day of %br"u0.rTi 2045- by
Fe,-r'nQrd-v TL ✓b who is personally known to
me or who has produced rL -t)L as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign: L>,-,, �Al Sign:_
Print: V � VL-t:VL. 7A.43 Print:
as
Seal: W,,filgo, Vivienne Yao Seal:
tiPpY P& 1 i
Comm,0222410
P` Expires: Jan. 31,2026
hIc•StateofFlorida
**********:Yiq���vQir ��#�i�****************�+•��*�**/*1��*•***�***Jrrrrrrrr*rrrrrrrrrrrrrrrrrrrrr*rrrrrrrr
APPROVED BY <6 1 J Plans ExaminerZoning
Structural Review Clerk
(Revised04/26/2024)
FERNAN DO TORO
117 NE 102 ST, Miami Shores, FL. 33138 1 7865253277 1 fetoro1 @hotmail.com
02/26/2025
Miami Shores Village
Permit Clerk
Company
10050 NE 2 AVE
Miami Shores, FL 33138
• Dear Miami Shores Village:
I need to cancel permit DS-03-23-696 with the above address. The tile work or any type of
work was never done. It's under Type Driveways/Sidewalks/Slabs - Addition/Alteration.
Sincerely,
Fernando Toro
Miami Shores Village
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 l'
FBC 202 )
BUILDING
PERMIT APPLICATION
=i;UILDING ELECTRIC = ROOFING
Master Permit No.S-03 --2b —M
Sub Permit
❑ REVISION I EXTENSION ❑RENEWAL
_PLUMBING MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: % / 7 Al Z .57 ,7)/A-rn i 4141n.12S /�9- —.-)v /.IO
City' Miami Shores D County: Miami Dade Zip:
Folio/Parcel#: //- �1406— 0�3 �6 j 0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: -� Flood Zone: O BFE: FFE:
OWNER: Name (Fee Simple Titleholder):Ei�/'�/r%/`� �4'`� Phone#: 7P4'"��5��"Z 77
Address: // 7 /.(E /C 2
City:'&17/'"/ State:
Tenant/Lessee Name: ., Phone#:
Email: /C,E % ootd- 1 J�yV%'r.A •Coo/-^
CONTRACTOR: Company Name: _
Address:
Email:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer: _
A
Certificate of Competency #: _
Address: City: State: Zip:
Value of Work for this Permit: $ l z O 4) ` d Square/LinearrFF�000ttage of Work: Id 0 fr
a
Type of Work: ❑ Addition ❑ Alteration ❑ New LI kepair/Replace ❑ Demolition
Description of Work: /��� TC� n /./4A1f '/640 % LG c�90,X % Gs^72A A --
Specify color of color thru tile: 6
Submittal Fee S IGD'Ob Permit Fee $
Scanning Fee $
Technology Fee
DCA Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Structural Reviews $
(Revised N'25 2022.
P&Z Review $ Bond $
TOTAL FEE NOW DUE $
Bonding Company's Name If app'icabie)
Bonding Company's Address
City
State
Mortgage Lender's Na'me•(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 instaliation 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 of
applicable ,aws regulating construction ano 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 oppiicent 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 p,operty 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 pasted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signaturef I -- Signature
OWNER or AGENT CONTRACTOR
The foregoing instru rArt was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 % - , by day of , 20 , by
who is personally known to
me or who has produces—+U(DL^' as
identification and who did take an oath.
NOTARY PUBLIC: I I t_ <
Sign:
Print
Seal:
HEBERT MARTINEZ
MY COMMISSION # HH 323276
EXPIRES: Ocfu w 16, 2026
APPROVED BY
(Revsed04105/2022)
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
###################################################################
Plans Examiner
Structural Review
Zoning
Clerk
612=..t :3was HAWIS AO H312INS
CITY
COPY
Miami Shores Village Building Department
Zoning Dept. Date
Building Dept. Date
Subject to compliance with all Federal,
State and County rules and regulations.
Permit#