RC-06-19-1493Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ` �-
Tel: (305) 795-2204 Fax: (305) 756-8972 J
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
F-JPLUMBING ❑ MECHANICAL CHANGE OF
JCB ADDRESS:
CONTRACTOR
'1kkiz, )w
FBC 20
Master Permit Nolo DG
Sub Permit No.
CANCELLATION
❑ EXTENSION
❑ SHOP
DRAWINGS
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone: BFE: _
/� ,9� ..T2�t.S'z
OWNER: Name (Fee Simple Titleholder):/tSAt�CAC74-{ /�£'�CJ r 'Lcr Phone#:
RENEWAL
FFE:
1�z-Slav
Address::��0 027 SO
City: VA( t rat t ' State: Zip:
Tenant/Lessee Name: ,o Phone#:
Email: bc�- — WCe-.447tiV 0 77, ,7
CONTRACTOR: Company Name: Phone#:
Address:
Email:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Email:
value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Wark: Acdiiition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews
CCF$ CO/CC$
DCA Fee $ DBPR $
Training/Education Fee $
P&Z Review $
Notary
Double Fee $
Bond $,
TOTAL FEE NOW DUE $ _
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 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 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.
�d
Signature � Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument wa cknowledged before me this
day of �NL/ 1� . 20 2 . by o-
ct wh is personally known to
me or who has produced 01'' �� as
identification and wba-dW take an oath.
NOTARY PU
Print:°'''
Seal. Jared McSween
NOTARY PUBLIC
County of Macon
State of North Carolina
FMv Comm. EsDires November 17
APPROVED BY
The foregoing instrument was acknowledged before me this
day of .20 , by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Plans Examiner
as
Zoning
Structural Review Clerk
July 8, 2025
RE: RC-06-19-1493 Cancellation
To Whom it May Concern:
Please cancel and remove permit RC-06-19-1493 from the building permit
system. This was a proposed addition to 9650 NE 5th Avenue RD, Miami
Shores, FL 33138 that was never initiated due to a divorce of the then
married couple who have subsequently divorced.
The home has been sold and is now in escrow scheduled for close on July
15, 2025. As timing for this cancellation and removal from the permit
system is of the essence please process as soon as possible.
Contact me at 305-318-3180 with any questions.
Thank you,
Lisa McCarthy
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Teh (305) 795-2204 Far. (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
BUILDING ❑ EtECTRIC Q ROOFING
❑PLUMBING ❑MECHANICAL ❑PUBLICWORKS
JOB ADDRESS: 9650 NE 5TH AVENUE ROAD
E z
JI1N 2 7 1019
i 1
,((F��BC 2-0,�11 Master Permit No. q" 1993
Sub Permit
❑ REVISION 0 EXTE'NS40N ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City Miami Shores County: Miami Dade Zip:
Folio/Parcel#:113'206-017'-0160 IstheBuildingHistorically Designated. Yes— NO
Occupancy Type: RES Load: Construction Type: Flood Zone: X" BFE: FFE:
OWNER: Name (Fee Simple Titleholder): THOMAS P MCCARTHY, LISA H MCCARTHY Phone#: 786 295 5298
9650 NE 5TH AVENUE ROAD
City: MIAMI SHORES
Tenant/Lessee Name: _
Email: fisa-mccaTthy@
CONTRACTOR: Company Name:
Address:
City:
State: FL Zip: 33138
Zip:
Qualifier Name: Phorre#,.
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: T.TODD MARTIN Phone#: 305 673 2121
Address:7261 NE 4TH AVE SSTrEr101 city: MIAMI State: FL zip: 33138
Value of Work for this Permit: $ CGIO-OW Square/Linear Footage of Work:
Typeofwork. N Addition ❑ Alteration ❑ New ❑ Repair/Repiace ❑ Demolition
Description of Work: 790 SF DEMOLITION. NEW ANTERIOR LAYOUT, REMOVAL AND REPLACEMENT COI=
INTERIOR FLOORING. ADDITIONAL 432 SF TO EXISTING HOUSE.
NEW POOL (UNDER SEPARATE PERMIT) NEW DOORS AND WINDOWS (UNDER SEPARATE PERMIT)
Specify color of color thru
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF $_
DBPR $
co/cc $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
(Revsed02/24/2014)
,, 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,
",MACES, ,BO4L,Ei(, 44EATfRS, TANKS, .AIR'C1DND1T1{fl?*RS, IETC-._..
:OWNER`S AFF4DAVJT: J certify -that ,aJl the- foregoing infor.matiGn Js accurate and. that all ,mxk -will Abe rune an comphaftce wJth 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 FINANONG, CONSULT WITR YOUR LENDER OR. AN ATTORNEY BE.FORE, 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 chprged.
Signatu
OWNER ear AGENT
The foregoing instrumen
t was acknowledged before me this
!a5- day of 4 1 120 by
1 :lit PICO� rA�A\i , who is: personally known to
me or who has prod uce,d-_t�('t�lC'�'`5 UC-CYISe_, as.
identification and who did take an oath.
NOTARY PUBLIC:
1 1
� 1 ►� � Imo//r
o '
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of , 20 , by
, who is. personally. known to
me or who -has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
as
Seal: Seal:
iciE
ate of Florida
ba Arteta
�i < GG 292288023 * * * ***************************************************************
APPROVED BY
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk