46 NE 92 St (10)\` MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Req
Date
Type Insp'n
Permit No. PC04
Name jen n3.
Address 4 `0 M CI t
Company l`e 0 VI fl
Phone # 'i,c( z q0 — -?(°66,
Inspection Date S Z-3
Approved
Correction
Re-Insp'n Fee
g zto
Date (g l 0� d�
Typelnsp'n Q'Uc)
Permit No. K-1 C 09 3
Name 3TQ_ ez- X t n.-S •
Address L } & u 9 2 6r
Company 7 C ?w
Phone # ` 7 �� c9-Q& - 7
Inspection Date
Approved
Correction
Re-Insp'n Fee
MIAMI SHORES VILLA
BUILDING DEPARTME
305- 795 -2204
Building Inspection Request
c� ( 3 Zoe
4 6,c 4
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing ((``
Owner's Name (Fee Simple Titleholder) 1 •TLAN._. S Phone #733 S ' q 3) 1.
Owner's Address b t.J- l k•' r�
City s \ \o S State C.... Zip 3 ' j) �'� P
City
City
Qualifier
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
Miami Shores Village
Is Building Historically Designated YES
Contractor's Address
State Zip ?3/
/ '
/9?2/-e 7
Architect/Engineer's Name (if applicable) Phone #
$ V ue of Work For this Permit
Type of Work:
Describe Work:
CI, C; I
Submittal Fee $ 5 C QC)
mpany Name _ C// // 7q/C Phone # f-� 1- // z e- 76 EI'
y� $ /S 7'
Addition g, ❑Alteration
1Viiarni 31101 V 111age
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
/"D- Oa
NO x
['New ❑ Repair/Replace ❑ Demolition
j■1 Cr tt't agi5T/NC,
Permit Fee S
Notary $ Training/Education Fee $
t
D
Scanning $3 e 0 Radon $
Permit No. 1`[C2e0q"5(..)
Master Permit No..fF ?ZC T: ` cj C /
Mechanical
County Miami -Dade Zip S l 3
Square Footage Of Work:
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF$ . 4
Technology Fee $
Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ — ,? 0
(Continued on opposite side)
Roofing
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 AI4I0AVIT: 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 will not be approved and . reinspection fee will be. charged. •
Sign c 11
Owner or A_ 3 t Con
The foregoing instrument was ackn. ledged before me this The foregoing instrument was acknowledged before me this
day of , 20 _ , by , day of , 20 by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Ori� 13a61Iflr �"
Sign . , � ACNA M RV R rcintta 1�
Print: - E EO LJOP.TDA
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * ** * ** * **** * * * * ** ************************************** * * * ** *** * * ** * * * * * * * * * * * * * * * * **
State Certificate or Registration No.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 10/14/03
Engineer
Zoning
AF
Sign:
Print:
(Certificate of Competency Holder)
Certificate of Competency No.
f ..-6 X o J ' o 2
��jj11I I��I OW)
'1 •. IP24 LJ
My Commission Expires:
as identification and who did take an oath.
NOTARY PUBLIC: r; _ `,rl. ".►, __.._�
/IA I .1 /. P1414.194!'3` r' .e }ti.s Ci;, °.i'- • :j
NM CCM:7i
G��C- r�i.�e _4 ale
:2. -01
Plans Examiner
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/7/2004
Applicant: BARBARA
Owner: JENKINS
JOB ADDRESS: 46
Contractor TECHNO A/C INC.
Local Phone: 305 - 412 -7666
Parcel # 1132060130040
NE 92
Signed: (INSPECTOR)
Mechanical Permit
Permit Number: MC2004 -36
JENKINS
BARBARA
ST
Contractor's Address: 8345 SW 105 STREET
Page 1 of 1
Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & E1/2 LOT 8 BLK 1
Fees:
FEE2004 -2513
FEE2004 -2514
FEE2004 -2515
FEE2004 -2516
FEE2004 -2517
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Scanning Fee
Total Fees:
Amount
$100.00
$0.60
$0.20
$2.50
$3.00
$106.30
Total Fees: $16.30
Total Receipts: $0.
5 ,,3D
Permit Status: APPROVED Permit Expiration: 9/6/2004 Construction Value: $150.00
Work: REPLACE WALL UNIT IN EXISTING HOLE
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: