715 NE 92 St (3)Miami Shores Village
BUILDING
PERMIT APPLICATION
FBC 2004
Tenant/Lessee Name
FOLIO / PARCEL It
Is Building Historically Designated YES NO
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): Building ic Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) X e (� i // �iv� -eicia Phone #
Owner's Address 71.r ..(`.= 2 5"7
City /44,441 S4-5 State EL Zip
Job Address (where the work is being done) 1 t E cizal
City Miami Shores Village County Miami -Dade
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:
4 0 yv ca a,
Phone #
Permit No. Z
Master Permit No.
Zip
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ 2&:)D CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
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 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. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged 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. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning
IBiII To 1
MCGILL ENTERPRISES INC
71592 Street NE
Miami Shores Village, FL 33138-
I Return to: I
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Date Fee Name
05/23/2006 40 Yr ReCertification Fee
Tuesday, May 23, 2006
Permit Invoice Report
Invoice Number: RCRT -5 -06 -24912
Invoice Date: May 23, 2006
Permit Number: RCRT -5 -06 -1363
Permit Type: 40 Yr ReCertification
Fee Type
Fixed
Total Fees Due:
Fee Amount
$250.00
$250.00
Payments
Date Pay Type
05/23/2006 Check
Check Number
I $250.00 $0.00
Total Paid: $250.00 I
Amount Paid Change
4905
U.S. Postal Service.In
CERTIFIED MALTM RECEIPT
.. „ • Mail Only; No Insurance Coverage Provided)
■0050 N E. 2..D AVENUE
F L O R I D A
33138
' TIFIED MAIL
0001
X7005 1160 0000 5203 6325
Aundrea D McGiII
715 NE 92nd Street # 1
Miami, Fl 33138
MI FL Z` 0
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3NIl 031L00 1V 0101'8838008 N8111311 3H1 AO
11401113141 013d013AN3 d0 1011V H3H0113 3081d
SENDER:
• Complete items 1 and/or 2 for additional services.
• Complete items 3, 4a, and 4b.
• Print your name and address on the reverse of this form so that we can return this
card to you.
• Attach this form to the front of the mailpiece, or on the back if space does not
permit.
• Write'Retum Receipt Requested' on the mailpiece.below the article number.
• The Retum Receipt will show to whom the article was delivered and the date
delivered.
3. Article Addressed to:
5. Received By: (Print Name)
W
cc
6. Signature: (Addressee or Agent)
X
PS Form 3811, December 1994
Aundrea D McGill
715 NE 92 Street # 1
Miami, Fl 33138
7. Date of Delivery
Certified Rail Provides:
■ A mailing receipt (esie ley) Z0o ednr .
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oose 11Od Sd
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delivery. To obtain Re Receipt service, please complete and attach a Retum
follov Receipt (PS Form 3811) to the article and add applicable postage to cover the
extra fee. Endorse mailpiece Retum Receipt Requested ". To receive a fee waiver for
redulpled to return receipt, a USPS postmark on your Certified Mail receipt Is
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addressed to t POs and
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8. Addressee's Address (Only if requested
and fee is paid)
Domestic Return Receipt
February 28, 2006
Aundrea D McGill
715 NE 92 " Street # 1
Miami, Fl 33138
Dear Owner:
' 1 ,
Building Department
Re: Mandatory 40 Year Re- Certification for Property at:
715 NE 92 " Street
Miami Shores, FL
Folio # 11- 3206 - 014 -1570
Il'I iami Shores Village
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2207
Fax: (305) 756.8972
Certified Mail # 7005 1160 0000 5203 6325
Notice of Required Inspection /Certification
The Village has been notified by Metro -Dade Building & Zoning Department that the above
referenced property has a building or structure that is forty (40) years old or older. In accordance
with Miami -Dade County Chapter 8 Section 8 -11, the subject property must be inspected by a
Florida Registered Architect or Engineer and a report furnished to this office.
A report and a fee of two - hundred fifty dollars must be submitted to this office within ninety (90)
days of receiving this Notice of Required Inspection/Certification.
If you would like a copy of Minimum Inspection Procedural Guidelines for Structural and Electrical
Recertification, or if you have any questions, please call my office at 305- 795 -2204.
Sincerely,
Claudio Grande, Building Official
305- 795 -2204