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DS-06-264110050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. C6OG arc4 1 PERMIT APPLICATION OCT 2 (4 2006 Master Permit No. FBC 2004 BUILDING Permit Type (circle): Value of Work For this Permit $ Type of Work: Describe Work: ❑Addition Miami Shores Village Building Department Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple 1e odder) ] ���)� Phone # �� °'� 6 \ A � '4) Owner'l Address Z=O City V 1U:�__ Tenant/Lessee Name Mt P Job Address (where the work is being done) J r b City Miami Shores Village County FOLIO / PARCEL # Is Building Historically Designated YES NO a � Contractor's Company Name C:::45 , Cit. > bF -�, Phone # .- q--- 2. ( 24 - Contra is Address Ars 0 ' City aAfoo Zip b Phone # - o c � State Certificate or Registration No. Certificate of Competency No. Q 2 c ® 1 l Architect/Engineer's Name (if applicable) 54L-fge,4-1 # State Qualifier Name r`,(2- Miami -Dade Zip ✓ 2 Zip Square / Linear Footage Of Work: 0126166 144 yrr ❑Alteration ew ❑ Repair/Replace ❑ Demolition ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *,g ** *, * *** * *, ** ** * * * * * * **** * * ** * *x * *�r****** ** Submittal Fee $ Permit Fee $ / ell!, CCF $ CO/CC Notary $ 5 ' Training/Education Fee $ 1 .2-0 Technology Fee $ 4 Scanning $ q - Radon $ DPBR $ Zoning $ Bond $ .90f . Code Enforcement $ Double Fee $ /► Structural Review. $ Total Fee Now Due $ 45 5- 00 See Reverse side -a Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS. and 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 1 r..` of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged bef re me this day of ikVe, 20(k, by IOWA who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print My Commission Expires: ***************irk********* Of APPLICATION APPROVED BY: (Revised 02/08/06) 1151r Signature The for oing instrument was acknowledged before me this day of 2Q by ©SCCir L ✓ " � ' r , who is personally known to me or who has producedS as identification and who did tak NOTARY PUBLIC: Sign: f Florida f Print. a(tara A Estop My Commission Expire ^-- mission DD510584 ,-r IF S. . i.t * * * * * * * * * * * * ** Plans Examiner Engineer Zoning V �'�S Inspection History Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 , Project <NONE> Owner: MIAMI SHORES VILLAGE Phone: Job Address: 9390 2 Avenue Miami Shores, FL Parcel: 1132060132940 Block: Lot: Scheduled Insp # 02/07/2007 INSP -2787 Inspection Type Final Roof Inspector Date Completed Jorge Rodriguez 2/8 /2007 Inspection Status DENIED NO PERMIT AVAILABLE JR 02/07/07 02/07/2007 INSP -30624 Foundation CANCELLED Jorge Rodriguez 2/8 /2007 02/12/2007 INSP -30626 Foundation DENIED w /FEE Claudio Grande 2/12/2007 No permit posted, available for inspection. 1/12/07 CG. 02/14/2007 INSP -39773 Foundation APPROVED Claudio Grande 2/14 /2007 CREATED AS REINSPECTION FOR INSP- 30626. No permit posted, available for inspection. 1/12/07 CG. 03/09/2007 INSP -30627 Final DENIED Claudio Grande 3/8/2007 Sod needs to be planted through areas surrounding the new parking. 3/8/07 CG. 04/02/2007 INSP -42596 Final APPROVED Claudio Grande 4/2/2007 CREATED AS REINSPECTION FOR INSP- 30627. Sod needs to be planted through areas surrounding the new parking. 3/8/07 CG. Thursday, July 29, 2010 Page 1 of 1