DEMO-02-22-389Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
1301 NE 100TH ST, Miami Shores, FL 33138 1132050140020
Contacts
_....................................... ...w ._...._._.....----- _...._......._._.._........._..._._........._.._..............___- ._.........._..........._w..._.._...___._-..-_.......- .
NANCY CIGNO Owner MIAMI BEACH SEAWALLS, INC. Contractor
P.O. BOX 530188, MIAMI, FL 33153 BRIAN MORETTI
13899 BISCAYNE BLVD 151, NORTH MIAMI, FL 33160
Mobile: 3053087962 SEAWALLC@BELLSOUTH.NET
Description: REMOVE LIFT Valuation: $ 500.00 Inspection Requests
30S 76��4949 `
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Scanning Fee
$9.00
Technology Fee
$1.25
Walls, Signs, Other Demolition Fee
$50.00
Total:
$115.05
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$115.05
Credit Card
02/14/2022 $115.05
Amount Due:
$0.00
In consideration of the issuance to me of this permit, I 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 the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
/ Applicant / Contractor / Agent
Date
February 1 ,, 2022 Page 2 of 2
Miami Shores VillageE�
Building Department 14
100SO N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (30S) 79S-2204 Fax: (30S) 756-8972--
INSPECTION LINE PHONE NUMBER: (305) 762-4949
F B C 20742)
BUILDING Master Permit No.bfLYr"z _02-ZZ —3
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC
❑ ROOFING
❑ REVISION
❑ EXTENSION [:]RENEWAL<D
I died
❑PLUMBING ❑ MECHANICAL
❑PUBLIC WORKS
❑ CHANGE OF
❑ CANCELLATION ❑ SHOP
CONTRACTOR
DRAWINGS
JOB ADDRESS:
City: Miami Shores
County:
Miami Dade
Zip: ,� R
— 2 cs
Folio/Parcel#:
Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction Type:
Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
41.
JL -1
Phone#: 2)0 �
13 0 N` l00 ��
Address: /
City: / ► / /~ � &t�
State:
Zip: -733 l JU
Tenant/Lessee Name:
Phone#:
Email: iYl O✓vi C y G ! ( h Q & 0-0�, Gdkli
CONTRACTOR: Company Name: x
Address: / 7f%D� ! 0' ✓ ��� �2
City: }�
Qualifier Name:
. ✓vk emu: /3.e�
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Ela�_
State: > % Zip:
Phone#:
Certificate of Competency #:
one#:
'7 )
Address: City: State: Zip:
Value of Work for this Permit: $ 6- 0-0 Square/Linear Footage of Work:
Type of Work: El Addition ❑ Alteration ❑ New /❑ Repair/Replace Demolition
Description of Work: \� L . �'J� LJ� �f , -Y — " q -
Specify color of color thru the
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $_
Structural Reviews $
Training/Education Fee $
CCF $
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ I S • a S
(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
WE
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 wiljits�be approved and a reinspection fee will be charged.
Sign
ER
TIC foregoing i rume w s acknowledged before me this
/! V day f 20 Z 2 by
A240ty CSC 10
me or who has produced
is personaaffy-lZnown to
identification and who did take an oath.
as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
dayofy� 20 ZY by
Tri Alk. %//��6 � who is personally to
me or who has produced as
identification and who did take an oath.
NOTARY P NOTAR BLIC:
Sign: S'gn:
Print. Print:
Seal:t�?!+., PAMELAS.DARIANO Seal: PAMELAS.DARIANO
*: MY COMMISSION # HH 054960 MY COMMISSION # HH 054960
EXPIRES: February 20, 2025 = a� EXPIRES: February 20, 2025
Bonded Thru Notary Pubk Underott s Bonded Thru Notary Public Undeneiters
APPROVED BY V Z- Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)