246 NE 92 St (7)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n
Permit No.
Name
Address
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
n9
ez.- 05- /o a-
BUILDING
PERMIT APPLICATION
FBC 2001
Tenant/Lessee Name
Total Fee Now Due $
(Continued on opposite side)
iami Shores Village
Building Department
7 0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Owner's Name (Fee Simple Titleholder)
Owner's Address % Li, � u�
_, qt.
City State L_
$ Value of Work For this Permit U
Master Permit No.
Permit Type (circle): Building Electrical i Plumbing Mechanical Roofing
Code Enforcement $ Structural Plan Review. $
Phone # 7x), 2,Y ` 0
Zip 7. 08 '�
Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Permit No. — Ica, -
Job Address (where the work is being done) `(' (P Val,( ¶2- C51"1
1 .
City Miami Shores Village County Mia i -Dade Zip 3 1 3 3
Is Building Historically Designated YES NO
t b7 _ 6/
Contractor's Company Name � r " >11 - Phone # Ciro) 23 - 3 �1 1
Contractor's Address ;)° fi l ldri
City State Zip (k
Qualifier G i/ (d U'c ✓1
Type of Work: ['Addition ❑Alteration lew ❑ Repair/Replace ❑ Demolition
Describe Work:
d
�-- — / ** * * * * * * * * * * * * * * * * * * * * * * * * * Fe * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Submittal Fee $50 ' 06 Permit Fee $ / .' e ' 0 CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
Bonding Company's Name (if a icable)
Bonding Company's Address
City State
N
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 o commencement must be posted at the job site
for the first inspection wh h occurs seven (7) days after the building permit i ssueIn the absence of such posted notice, the
inspection will not be appror)d and ' spection fee will be charged.
Signature
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * **
Chc 05/13/03
Owner or Agent
The foregoing instrument was acknowledged before me this/
day oy X114 , 206S' by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: ' � ' � til.c r -
Print: /4/b 9 6444 . .4'/
APPLICATION APPROVED BY
Contractor
The foregoing instrument was acknowledged before me this/7 4/
Si ' at 20G. b
day of , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
CC _
.,q7', `y ) . 7 �?
.''�` Alba Gaona My Commission Expires:
• My Commission 0022410ti ►0 Alba Gaona
to * * * * * ** Y **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 'com
*N * * * * * ** * * * **
Expires Ju 26, 2007 ' v mission 22410E
Fx no Expires July 26, 2007
******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
A1,4 Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 -795 -2204 Permit Number: EL2005 -102
Printed: 3/28/2005
Applicant: JAVIER REYNALDOS
Owner: REYNALDOS JAVIER
JOB ADDRESS: 246 NE 92 ST
Contractor ADT SECURITY SERVICES INC
Local Phone: 305 - 628 - 7434
Parcel # 1132060133400
Permit Status: APPROVED Permit Expiration: 9/17/2005 Construction Value: $1,000.00
Work: INSTALL ALARM SYSTEM
Signed:
(INSPECTOR)
Electrical Permit
Page 1 of 1
Contractor's Address: 7747 NW 48 ST 160
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 W4OFT OF LOT 6 & LOT 7 BLK 25 LOT SIZE
Fees: Description Amount
FEE2005 -3768 Building Fee $100.00
FEE2005 -3769 CCF $0.60
FEE2005 -3770 Technology Fee $2.50
FEE2005 -3771 Training and Education Fee $0.20
FEE2005 -3772 Scanning Fee $3.00
FEE2005 -3773 Submittal Fee ($50.00)
Total Fees: $56.30
Total Fees: $56.30
Total Receipts: $0.00
A , 0
tier
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: