MC-07-1455Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
1236 NE 92 Street
Miami Shores Village, FL
1132050270490
Block: Lot
BARBARA LEVY
Owner Information
BARBARA LEVY
1236 NE 92 ST
MIAMI SHORES FL 33138 -2937
Valuation:
Total Sq Feet:
$ 2,000.00
0
Contractor(s)
COOLING METHODS
Phone
305 - 622 -9434
Cell Phone
Tons: DUCTWORK
Additional Info:
Classification: Residential
Approved: In Review
Comments:
Date Denied:
Date Approved: : In Review
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$0.40
$5.00
$100.00
$3.00
$2.50
$112.10
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.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Address
Eatus AP VED
Expiration: 01/1
Phone
Total
$ 0.00 $ 0.00
Payment Type:
Amt Paid Amt Due
5‘7,54
')UL PAS
$ 0.00
Available Inspections :
Inspection Type:
Smoke Det Test
Final
Hood
Rough
Rough Duct
Smoke Test
Ventilation
July 16, 2007
Date
CeII
Monday, July 16, 2007 1
Date
Thursday, July 19, 2007
07/19/2007 Check
Payment Type
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Number: MC -7 -07 -1455
Invoice Number: MC -7 -07 -29183
Applicant: BARBARA LEVY
Company Name:
Owner Address:
1236 NE 92 ST
MIAMI SHORES, FL 33138-
Job Address:
1236 92 Street NE
Miami Shores Village, FL
Check Number
5754
Amount
$112.10
Change
$0.00
Total Payment: $112.10
Page 1 of 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING 011 16k7y
PERMIT APPLICATION -E d
FBC 2004
Permit Type: Mechanical
Owner's Name (Fee Simple Titleholder) f /'ibig 49LFVy Phone # 30 7 Z 71i.2
Owner's Address /2alo /v G 92/14 gr
C ity A %rf fj State 94.
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done) 22 77..4' 9 t T
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name c ,/ , r' 6- / i/C . ). S - Phone #
Contractor's Address /70 (i 0 Wed
City ,r/9- State Zip .33oSS�
Qualifier Name W 7Z /2,7 Phone #. C' 622 5y'3/
Certificate of Competency No. C�e:).2 /3Y'
State Certificate or Registration No e zti
E -MAIL:
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ /eon
Type of Work: EAddition
Describe Work:
❑A lte rat ion
DNew
* ***xxx'xx********xaY9e******xxx xxxa:4*w***F xxxxxx ****ekxxxxxxx kx*** ***ikxxxxxx k *xx
Submittal Fee $ Permit Fee $
Notary $ 5'00
Scanning $ D
Training /Education Fee $
Radon $
l
DPBR $
Permit No.
Master Permit No.
Zip . /35
Phone #
r
Square / Linear Footage c f Work:
Repair /Replace
CCF $ 1 - 20 co /cc
Technology Fee $ 9 "W
Zoning $
❑ Demolition
Bond $ Code Enforcement $ Double Fee $ C. K .f 54
Structural Review. $ Total Fee Now Due $ 1 / 2 40 1 9 %Al
See Reverse side -+
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 't 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: 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 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 nj/ be approved and a reinspection fee will be charged.
Signature
/ Owner or Agent
The foregoing instrument was acknowledged before me thisO ( 'The for o'ng instrument was acknoow d before j j ee tthi s
2 0D by L l4# P% 4 F V , day o , , \N CI, day o , 7 Y / d f 20 M by
who is s 'ally know o me or who has produced who is personally known to me or who has produced
al
As identifi
NOTARY PUBLIC:
(Revised•02 /08/06)
# 4,4
APPLICATION APPROVED BY:
Fi ci n 8 n d vflet ath.
* MY COMMISSION # DD 518676
EXPIRES: March 25, 2010
Bonded Thru Budget Notary Service
N O r �f''' . 7. IC:
qy
. ie •
int %41111111111111M •,
% %% %xxx xvw
- Signature
Sign: , -- ---
Print: 4, 7 oi- A
My Commission Expires: ,.... �0 /e) e Vi ' .sion Expires:
,��I n ** * * % % % %xxxxxx % % %xxxxxx
xxxxxxxxxxx % % %ic dc%%%% xx% xxxxx%%%%%%%% xxxxxxxxx %xxx %xxx::x %x %z%Se %, � �CCi ,
i
RI)
ntification and who did take an oath.
.r
Plans Examiner
Engineer
Zoning