521 NE 94 St (3)10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (346) i 95.2204 Fax: (305) 756.8972
r
BUILDING 0 , . ' . ;' �' • - Permit No. 1
PERMIT APPLICATIOrst ' 111 6 3 aster Permit No.
FBC 2001 Q.
Tenant/Lessee Name
Is Building Historically Designated YES NO
Contractor's Company Name C N 4 Co t o cre TE
Contractor's Address 1 1 J 5 0 SSW 13.2, c1#
City pdyvt rr State F
Qualifier C o.,y me r' i-}e r �1Ci'►'1 de. z_
State Certificate or Registration No. 0/13500
$ Value of Work For this Permit 50
Type of Work: ❑Addition ❑Alteration
Describe Work: C/ �/� )
‘1
Code Enforcement $
Total Fee Nt "w clue $
(Continued on opposite side)
Miami Shores Village
Building Department
Permit Type (circle): Building Electrical P't ibing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) L V t Q 5 ca-Y 1 C) Phone # Q 05) 7-5 ? - 31
Owner's Address 5 k t NE 9 f4 54
City '► Guy-Y-.1 State pl., Zip 3'513$'
Job Address (where the work is being done) 6 2_ 1 NE C /kI 5 t'
City Miami Shores Village County Miami -Dade
Phone #
Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
❑N ew
zip 33)`35
Phone # - G
Zip 3,)1gc,
Square Footage Of Work: SO
Repair/Replace .❑ Demolition
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee -Cr2) Permit Fee $ ' CCF $ /� 01 0 CO /CC
Notary $ 5 Training/Education Fee $ / Technology Fee $ / f]
Scanning $ 3— Radon $ Zoning Bond $ 9O&
Structural Plan Review. $� e�
4/W1
Pry rn
( Lorne PIN -
re - el ,-
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. 1 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 : • • •ved and a reinspection fee will be charged.
Signature
s perso ally known to me o
The foregoi g instrument was ac Iw1ep_ed bef•4 e this
`_ r ►
who has pro duced
day of
NOTARY P
Si
************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
caner or Agent
ification and who did take an oath.
Signature,
The forego' instrument was ac
day of G/rAn , 20 _, b
who is personally know
NOTARY PUBLI
Sign:
Ginny HP6onei
Contractor
wledged before me his3 .
!C� (v CK-
me or who has produced
i
Prm I Ma
►mmi ssion #]�D 381
$'
My Commission Expires: �/ /'� Expires: Ma 6 » sion
�f' (,� b '� o► i�oP Bond,�
**** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * *4w. * * *ArmAr din o *I * * * * * * * * * *v., * G
mss
* * * * * * * * * * * * **
— 7 2125
tification and who did take an oath.
* * * * * * * * **
Plans Examiner
Engineer
3 Zoning
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT A
305- 795 -2204
Build Inspection Request
Date v �� :14'0
Type Insp'n
Permit No.
Name
Correction
Address
Company
Phone #
Inspection Date
Re-Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui1 ling Inspection Request
Datee_ n
Type Insp'n t o-htcr
Permit No (Pib FY-LCD
Name
Address
Company 6 at-4 ft Cc 1^
Approved
Correction
Re- Insp'n Fee
Phone # / 1
Inspection Date �J�(J '
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date J
Type Insp' n fa E C 9Cl c
Permit No. .► {� 1
Name rt l_s....0 ' n
Address � ( NC, 6
\\
Compan
Phone #
Inspection Date 3 3( 1
Approved
Correction
Re- Insp'n Fee ❑
Miami Shores Village
10050 NE 2nd Avenue
Printed: 3/22/2005
Applicant: LUZ ROSARIO
Owner: ROSARIO LUZ
JOB ADDRESS: 521 NE 94 ST
Contractor C M A CONCRETE
Local Phone: 786/287 -2049
Parcel # 1132060140860
Signed: (INSPECTOR)
Building Permit
Phone: 305 - 795 -2204 Permit Number: BP2005 -300
Contractor's Address: 12350 SW 132 CT
Page 1 of 1
Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 16 & 17 BLK 55 LOT SIZE 100.000 X
Fees: Description Amount
FEE2005 -3603 Building Fee $100.00
FEE2005 -3604 CCF $1.20
FEE2005 -3606 Notary Fee $5.00
FEE2005 -3607 Training and Education Fee $0.40
FEE2005 -3608 Technology Fee $2.50
FEE2005 -3609 Scanning Fee $3.00
FEE2005 -3610 Builders Bond $300.00
Total Fees: $412.10
Total Fees: $4 0
Total Receipts: $ .O
Permit Status: APPROVED Permit Expiration: 8/30/2005 Construction Value: $1,500.00
Work: DRIVEWAY CONCRETE STAMPED
oo
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
INO
12
13
2? Parkway
1errove Conc
f ep1a.ce w/
s. ,„ Cor,C.
11
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i (A 1
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9' Appha11 ALLEY
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14
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NEiirSTREET
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10
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8
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N /� �rr e 5h , l ''�
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FNp.I.P. � -- NO.w1/2"
6
13 ,, / /,i17 /
•
OW STORY Cdr
RE$ QENCE M 631
FFn 1 0 , &
30,86' 0
Plantar '
s'
i
t' conc. 10
24.00'
7
18
TBa
* 17.00'
Zoning
Appr•ved
2466'
100_00'(liiM) 6'Cono.Wilk
A6PMAGT
21' Aaphall
Gran
NE 94 STREET
1J.00 Yo'wi F:lW tBtBY P.AT)
1
6
p
1 . .
X4'20
Yit
1
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PI
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