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EL-09-1393BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder Owner's Address" 1 s V 1St o City OOkIrthCk Tenant/Lessee Name E -MAIL: Job Address (where the work is being done Contractor's Company Name Contractor's Address State 1---t Architect/Engineer's Name (if applicable) Value of Work For this Permit $ ® Type of Work: ['Addition Describe Work: i Submittal Fee $ - - S0' OZ� Notary $ Scanning $ 3 Bond $ Structural Review. $ Training /Education Fee $ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Fee $ Radon $ Code Enforcement $ Miami Shores Village Building Department Is Building historically Designated YES NO ['New /' ®f'®® 0' o City Miami Shores Village County Miami -Dade FOLIO / PARCEL # � ®. on -00 g 0 Permit No. O9 13 13 Master Permit No. / p i %. e //e B�;'► e�yr; ni -. Phone # Phone # hone # State �� ZinT 1 Phone # Square / Linear Footage Of Work: a:***wwwwxxxxxxwwww**wwwwwwww ** wwwwxr .wwFeeswww*wxxxxxxxxxxxxxx w*w DPBR $ Double Fee $ Total Fee Now Due $ See Reverseside -+ AL16 20200 Zip City Qualifier Name fl(D 1Q5 r..4S5 Phone # L iaP 3q State Certificate or Registration No. Certificate of Competency No. E -MAIL: El Repair /Replace ❑ Demolition WW xx x ***zxx xxx xxx **w CCF $ 0 CO /CC Technology Fee $ 9'S0 Zoning $ 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. [ 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: 1 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 O N ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a il< .'rmit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commenc onstruction lien law brochure will be del vered to the person whose property is subject to attachment. Also, a certified copy of-t sr ed notice of commencement must . - posted at the job site for the first inspection which occurs seven (7) days after the but /erm is issued. In the absence . " such posted notice, the inspection will not be a d. ppproved and a reinspection fee will be charged ✓ rt % /I�� Sign: Print: 494Y P Notary public State of Florida Frank Marrero 0538 of L� • ExplrM1 B 0e/30/2011 My Commission Expires: APPLICATION APPROVED BY- (Revised 02/08/06) Signature Owner or Agent The n in foregoing was acknowledged before me this g g 1S . The foregoing instrument was acknowledged before me this day of '6 , 20 C , by AciP i-e Mineo-orit , day of (t 6 4 , 20 Aby 445 Dos CC F who is personally known to me or who has produced who is personally known to me or ho has produced As identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: re'/3 Print: My Commission x Y.x xxx Y. C* *******xxxx *Y: '. xxxic8cxx xx 4: icr., Yz, Yx dc, cxx xxxxxxxxxrxr . ,Yxxxa:xi:•xxx*xx,Y xxxxr. ® , -2E Contractor Zoning 1.1,k11, Plans Examiner Engineer Thank you, Douglas Bassett Qualifier BROADVIEW $ECUR 14CELLED To whom it may concern, This letter is in reference to the canceling of permit # eI -08 -09 -1393 for 901 NE 91 TERR. The permit was pulled but it can't be installed because she is remodeling. Please cancel this permit since it could not be installed. e of Florida W o e ey Radti e Carols : MAY Commission DOd099eS '? Expires 031294012 2 9 fi „9 The next q%-ert'hr .o' Brink's Horne Sea,-k FEB 1 9 2010 JJ B 8491 NW 17 ST DORAL, FL 33126 Roofing Contractors, Inc. January 13, 2010 Village of Miami Shores BUILDING DEPARTMENT 10050 N.E. 2nd Avenue Miami Shores, FL 33138 RE: PERMIT CANCELLATIONS PERMIT #: RF -12-09 -2072 OWNER'S NAME: Francisco Paula JOB ADDRESS: 62 N. E. 110 ST. zip # CCC042815 As the owner of S & J Roofing Contractors, Upon signing this affidavit and having my signature notarized, I am signing and attesting that the work was not performed as originally requested on the permit. Please be advised that this is a request to cancel the above referenced information. Should you need any further information, Please contact me at (305) 887 -7779. Printed Name of Contractor STATE OF FLORIDA COUNTY OF MIAMI -DADE k‘.!©=L[1„.1 / 3 Swom to arm! subscribed before me this day of Oadv4 2009', /0 By ��� / (SEAL) Personally known or Produced identification g..awea.aeue rf ewneeneeeeee ANA T. RODFi1GUEZ Comm# DD0749259 Expires 2/10/2012 ® •�� /ngm�i'� rim Ma Notary Asst. Inc la a.. e. ee. eee eee.eee.eee.ee.aeeneee.e CONTRACTOR'S NAME CONTRACTORS ADDRESS: QUALIFIER'S NAME: REASON OF CANCELLATION: Work has not taken place. Commercial • Industrial • Residential 173 West 22 St., Hialeah, Fl. 33010 Phone: (305) 887 -7779 • Fax: (305) 887 -7183 www.sjroofing.com la JAN 2 i 2010 BY:.. Mem 0•50101111111.30 S & J ROOFING CONTRACTORS 173 W 22 ST HIALEAH, FLORIDA 33010 JOSE A PEREZ