DS-07-25-1654 CanceledMiami Shores Village ECEIVE
Building Department DEC 0 3 2025
10050 N E 2nd Avenue, Miami Shores, Florida 33136 BY i r
Tel: (305) 795-2204 Fax: (3051 756-8972
CANCELINEDN LINE PHONE NUMBER: (305) 762-4949 F B C 20j 23-
BUILDING
Master Permit No. 0 S
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF
CONTRACTOR
10 Al f �(1A 1 h Si N
❑ REVISION ❑ EXTENSION RENEWAL
ANCELLATION ❑ SHOP
DRAWINGS
JOB ADDRESS: 7
City Miami Shores
Folio/Parceltk J I - ca13;L -o 3
Occupancy Type. Load __
OWNER: Name (Fee Simple Titleholder)
In, tii IfA (t
T'
Count,,
a - 0 3 (on
3 313�f
Miami Dade 21P- -
Is the Building Historically Designated: Yes _ NO
PA W(Al Flood Zone. BFE_ FFE %��p
c� 114no Phonek:� 9 O� - 3 7, ✓ `o "
Construction Type:
J e Sf e t /cA
Address
City
State:
Zip 3 2)
4f9 (07 3 331a(p
Tenant/Lessee Name.
Email./�,t{ �t f� '"j%^�
CONTRACTOR: Company Name LL q �r/L.U�(�In i(t1i/j(hSnett. N I I t / / d-
Address� 14;0 1 i0 �f II t(Ae ff (� h 3G
Email Mk(
Qualifier Name,
State Certification or Registration If
DESIGNER: Architect/Engineer. _
Email t=
Value of Work for this Permit: $
Type of Work: ❑ Addition ❑ Alteration
Description of Work: _ 'k-L-I
Specify color of color thru
Submittal Fee $
Scanning Fee S
Technology Fee $ _ __—-
Structural Reviews $
rtificate of Competency N'
_ Square/Linear Footage of Work:
❑ New R/l R
I epau/Replace
.I( rlfIV1W(AM
Permit Fee $ CCF S_
DCA Fee 5 DBPR $
Training/Education Fee $
P&Z Review $
❑ Demolition
CO/Cc $
_ Notary $
Double fee
Bond S
TOTAL FEE NOW DUE $
txevis "/26/2024)
Bonding Company's Name (d applicable)
Bonding Company's Address
City _ _ Slate
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 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 lob 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 ee will be charged.
Signatu
OWNER or AGENT
The foregoing instrument was acknowledged before me this
r�-._. day of h / ( . 20tlyk
by
I (S( C ((Akn9 ju nQ o is personown
me or who has produced as
identification and who did take an oath.
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
as
NOTARY PUBLIC: Seal: NOTARY PUBLIC:
Sign: ` Sign:
Print: Print:
Seal' E
SAVANNAH STONES
Notary Public. SWe Of Florida
i COTAM n No. HIM 3&W
MY Canndeeion ExPlres 4lti)rX127
........... .••..........u....0.............•................................
APPROVED by _ Plans Examiner _ _. _ _ _. _ . _. ___ tuning
Structural Review ___ Clerk
(Qe,o,i, r/261202a)
Jesse Cangiano
1516 NE 104th St
Miami Shores, FL 33138
Date: 12 3 2- S
Miami Shores Village Building Department
10050 NE 2nd Avenue
Miami Shores, FL 33138
RE: Request for Cancellation of Permit DS-07-25-1654 - 1516 NE 104th St, Miami Shores, FL
33138 �Ud - Ca� - o`t5 - 65 i
To Whom It May Concern,
I am writing to formally request the cancellation of Permit DS-07-25-1654, issued for the proposed
removal and replacement of the driveway located at 1516 NE 104th St, Miami Shores, FL 33138.
Please note that no work was ever commenced under this permit. As the homeowner, I respectfully
request that the permit be cancelled accordingly.
If any additional information or documentation is needed to complete this request, please feel free to
contact me.
Thank you for your assistance.
Sincerely,
496ang' no
eowner
Miami Shores Village ECEIVE
Building Department JUL 21 2025
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 BY.___!-__x
INSPECTION LINE PHONE NUMBER: (305) 762-4949
CANCELLED �FBC 20 ` 7/
BUILDING Master Permit No.,I s —p,i—
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ® ROOFING [3REVISION I3 EXTENSION RENEWAL
PLUMBING ® MECHANICAL ❑ CHANGE OF CANCELLATION I3 SHOP
�� CONTRACTOR DRAWINGS
JOB ADDRESS: 15 M //VJ N E 101 S ,t1 C'
City: Miami Shores County: Miami Dade Zip: 3 3) 3 b
Folio/Parcel#: 11 "113 Z - 0 31 - 0.3 (v D Is the Building Historically Designated: Yes NO
Occupancy Type:ku"Wcl: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):SC,SS G 4 C hr.1 dr.lA (a4 w) 0 Phone#: q S 9 Co13 3 3 Gi
Address: IS I (D NE 1014 St
City: Hi A h11 S I10 rc f State: FL Zip: 3 3 )3 8
Tenant/LesseeName: Phone#: qS9 fD7.3 33(0(0
i Email: fg" 011 e&w_ - (-Cy,—
CONTRACTOR: Company Name: LX pfdltc� b¢-VeiooMLtnl Se, rViCCS Phone#:g59'�q
Address:IZ21 KF "IAve F r }mil. Aiderdalg EL 33 309
Qualifier Name: MuI itig L o r)S Phone#: 'I 91 -11 I l717 d,
State Certification or Registration #:tr(9 C Is I � 3—) O Certificate of Competency #:
DESIGNER: Architect/Engineer:
Value of Work for this Permit: S .1'L Q 00
_Zip:
Square/Linear Footage of Work: I d Z S' F
Type of Work: M Addition [I3 Alteration M New [0 Repair/Replace ® Demolition
Description of Work: geT FQ(e 4Urar1 j (riVP.w" wi-m niw paw rS
Specify color of color thru the:IV
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee
DCA Fee $
Training/Education Fee $
CCF
CO/CC $
DBPR $ Notary
Double Fee $
Structural Reviews $
(Revised04/05/2022)
P&Z Review $
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
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_p4einspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
Is day of 14V]C, ,20LS- ,by
ULIC LG tun U who is ersonally kno n to
me or who has produced
identification and who did take an oath.
NOTARY
y/ PUBLIC:
cfvn• �/ tM.(i��l
Print:
SAVANNAH STONta
Seal: * NotaryPublir,State OrFbrida
ComMsslon No. HH 38M
�'• My Commission Bow:41101P0V
The foregoing instrument was acknowledged before me this
day of L n 20 Z.s by
P'lck*w JtA nIi who i ersonallykno to
as me or who has produced
#######################################################
identification and who did take an oath.
NOTARY PUBLIC:
Print: JOV1,411FLIkyl OTtill
Seal: �.,,,� SAVANNAH STONES
* * Notary Pubik, State OF Florida�.� Commission No. HH 385005
My Commission Evinis: 41101P027
APPROVED BY `1C- CS Plans Examiner
as
BY P&Z DEPT
DATE: D - '4 BY; Zoning
Structural Review
(Revised04/05/2022)
Clerk
t[: lei. ''. . � r�7'. ,si . '��:�tl t:.f �?'-.
if�°`..'{i��� �J•Ykl
r
wY.Lv:y»..�..'...-.:;+k+i.,rA•.��4�1i�'1�—'�C-•!*r�#_:= �ti�¢a;.
. y J
i�i.'c'K!�? jti .•% ?i+ %Utz!
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.01EIV�
Miami Shores Village
Public Works Department 2 12
0
(305)795-2210 JUL
Public works forms are available from the building department, 10050 NE 2"d Ave., Mia W ores, FL 33
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property CANCELLED Permit#: Pw-07-2-s lwo 7
Name of Applicant (if utility see below): _Te,SS e (A n G1�fdnO
Owner off the following described property: vJ
Legal Description: Lot IS Block_Subdivisiongi Ver f2aj gart< 40P P 6 10-7a
Folio#; ll-22.262. -032 - 03&0
Address:►,6/ro NJ log Sf Miovni Short( 11 lloar FL 35139
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone: Email:
State Certification or Registration #:
State:
ZIP:
Certificate of Competency #
CONTRACTOR NAME: r;XPC(lI r[(n ULyr.�QD�l7](Ai 6erVtccJ
Qualifier/Authorized Agent: �lA }{(�Or).t
Address: )2?q ((ofn Ave
city: Far f Lau e rc101,C State: r 1, zIP: 3 3 3 0
Telephone: 9S4 7y1 I7id Email: c}
State Certification or Registration #: COIL lSlq370Certificate of Competency #:
Requests permission to install (describe wi
way: gte Ia(t Llrivtl.VA�I
Type of Work: ❑ Paving ❑ Utility
❑ Landscape ❑ Antenna
DESIGNER: Architect/Engineer
Address:
City:
Telephone:
Registration #:
attach separate page if necessary) in the adjoining right of
State:
Email:
❑ Sidewalk ❑ Electric ❑ Irrigation
141 Other4f rlA.otty-cii: unijuli ntw Vryeli in
7" dritcway Crcplaumcnt)
ZIP:
Value of Work for this Permit: $ 51000 Square/Lineal Footage of Work: 1S0 SE
***** Fees*****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $
L
Bonding Company's Name (if applicable):
Bonding Company's Address:
City:
State:
ZIP:
Application is hereby made to obtain a public works permit to do the work in the right of way 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, regulation construction in
this jurisdiction. I understand that separate permits must be secured for
APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be
done in compliance with applicable laws regulating construction and specifically construction in the
right-of-way.
"WARNING TO APPLICANT: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF-WAY. 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 public works permit with an estimated value
exceeding $2,500, 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 the
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 public works permit is issued. In the
absence of such posted notice, the inspection will not be approved and a reinspection will be charged.
Signature
Applicant or Authorized Agent
The foregoing instrument was acknowledged before
me this -L&-day of .TtA h C 20J by
TeSfe C no who
is n to me or who has produced
as
identification.
NOTARY
I /, � 2 &VIQ
J*1
SEAL• .,rR.k..
Elaw
AVAHI•:,• =TONES Public,: r o+t%d•
mission Nu..mtssbn Expires.:: n 21
Signature
Comp V/Utility Agent
The foregoing instrument was acknowledged before
me this 19 day of Ju n C 20 2.- by
INL1ifhLW Won-( who
is pargsisalliek to me or who has produced
as
identification
NOTARY PUBLIC:
Sign: �(
d�S^l &t/1/��"
1VIP..��
Print:clQ.U��%f
1
SEAL:
� *
SAVANNAH STONES
Notary Public, State Or FWIda
No. HH 385005
1W
Commission
My CommissionEVIM:411012W
PWRPWNFWW—
APPROVED ., a� Public Works Director, or Designee
2017-04-15