935 NE 95 St (3)Dat
Type Insp'n
Permit No
Name
Address
Company
Phone #
Inspection Date
Correction
MIAMI SHORES VILLAGE ()\
BUILDING DEPARTMENT 07
305- 795 -2204
Building Inspection Request
\-1
6 /I � IID
o
Re- Insp'n Fee ❑
7-
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Contractor's Company Name
Miami Shores Village `' ('
City State
Qualifier PUN C
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit a•SZk )
fJG
Type of Work: ['Addition
Describe Wo :
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) ,K.40, - f - 1- c t;) L Phone #
Owner's Address ci J /� 9 "/-
City /1/4 /1/4 11 / 04- z•-•°!' State Zip 33 /7<'
Tenant/Lessee Name / YA1 Phone # /y/d.
Job Address (where the work is being done) q35 to 9`6"/1-7 S r kr e (T
City Miami Shores Village County Miami -Dade Zip 3S/3P
Is Building Historically Designated YES NO lr
Contractor's Address /WV/ /0 , 6
❑Alteration
/WA/
Total Fee Now Due $ ,5) `
(Continued on opposite side)
Permit No. 8PeaY-1 -- 3S 1
7 Master Permit No.
['New
Phone # 3 oT-- 3 /Q — 9 7 /
Zip 3 3/ 7
Phone # nY/a
Square Footage Of Work:
Repair/Replace
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
,„ a
❑ Demolition
Submittal Fee $ () . 0 0 Permit Fee $ /06 CCF $ 1,190 CO /CC
Notary $ ` Training/Education Fee $ CY b 0 Technology Fee $ ,i 50
Scanning $ 3 Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City / State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
/V /0
frfr
/9
it
State /VA
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 o" (7 !a s after the building permit is issued. In the absence of such posted notice, the
inspection will not b d pprove reinspection fe ' ' ill be charged.
Owner or Agent
The foregoing instrwnent was acknowledged before me this
day of , 20 _ , by
who is personally known to ry w}vosht�erprdi�ated
Co i suon 1S
id « g e t p w 1 • . ' e an oath.
NOTARY PUBLIC
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
Chc 12/15/03
Signature . `ij
Contractor
The foregoing instrument was acknowledged before me this
day of
who is personally known toraitp
as id'g1 chit ithisloo t an oath.
��ir e 1 %.e Expires
NOTARY PUBLIC:
Sign:
Print:
Zip
Zip i
My Commission Expires:
,20 _,by
2007
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
(Certificate of Competency Holder)
State Certificate or Registration No. ()(-, C- OS 6
Certificate of Competency No.
***************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
MAR 1 2004
Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2004 -351
Printed: 3/19/2004
Applicant: RUTH
Owner: POLLEY
JOB ADDRESS: 935 NE 95
Parcel # 1132060143110
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Building Permit
POLLEY
RUTH
ST
Contractor RAS CONSTRUCTION & DEVELOP INC Contractor's Address: 10400 SW 153 CT #8
Local Phone:
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 20 & 21
Page 1 of 1
BLK 76 LOT SIZE 100.000 X
Fees:
FEE2004 -2859
FEE2004 -2860
FEE2004 -2861
FEE2004 -2862
FEE2004 -2863
Description
Building Fee
CCF
Technology Fee
Training and Education Fee
Scanning Fee
Total Fees:
Amount
$100.00
$1.80
$2.50
$0.60
$3.00
$107.90
Total Fees: $7.90
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 9/11/2004 Construction Value: $2,500.00
Work: SWIMMING POOL REPAINTING AND REFINISHING
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.
BY:
• fr-4i @GZ,
PERMIT APPLICATP TiA 7? `fie y ;E
Date la } - O Job Address F N q T G4 4
Legal Description 4 r 1 / _ _ No
Owner/Lessee / Tenant / 'R\j cj .
Owner's Address ` /t L e
Contracting Co. 1C / ' �
Qualifier
State # Municipal #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MEC . r v AVING FENCE SIGN
CO (Ci'C I
WORK DESCRIPTION F XA 1 Cy\-- 13 ("'Easy p(-- G' 1C1 (r21 d6
Square Ft, Estimated Cost (value) goo .
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL 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. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of crsper and/or ondoPresident
FEES: PERMIT
Date
RADON C.C.F.
-1 -:mo
Signature ofZentEaster .of er Date
Notary as to Owner and/or Condo President Date Notary as to Contr
My Commission Expires: My Commission E
P
v - ty
7c ct- 3 7 �
ii ei 11:67N0TARV sz .� Date
s 2,:A ^GACITA MONflEL
i( C`
co, _s9ow NUMB
g -/00
.}r , y
NOTARY BOND
TOTAL DUE
APPROVED:
Zoning Building Electrical
Mechanical Plumbing
Structural Engineer
J
4
PERMIT APPLICATION FOR MIAMI SHORES VILI
Date 7 - ( 1- Do Job Address q3 F5 I'1 k = ' E Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant X lj t "> - c 7 -?D1\ / ib s tha (1?Master Permit # [ / ,9
Owner's Address °.iE6 K c ") � -- Phone 3a5 - ? 5 ' - 6 tf7l 0
Square Ft. Estimated Cost (value) 3
Contracting Co. ) 0 Vc. f f- ([_ (� Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION pn I (�}-I r 3 -W f : If
r ct
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL 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. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President • Date Notary as to Contracto4r Owner- Builder Date
My Commission Expires:
My Commission Expires:
FEES: PERMIT S P
APPROVED: • j/ � � J �
Zoning l� � i Building
RADON
Mechanical Plumbing
-4 �L =�mg 4i 2 - 2 - O
%tAR. TA'AOiTm L
ri`i r C 797277
r °7V C7:7:1EVON EXPIRES
C.C.F. t) NOTAR o ' L�> BOA � c � ... •
7/a/Z.
1 C)Aort2 E ` YU ij
Signature of Contractor or Owner- Builder Date
c .091-- a
Electrical
TOTAL DUE
Structural Engineer