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1001 NE 96 St (3)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date e e /1(UJob Address I 00 I P✓' 9 ( ) 4—. Tax Folio // 8 / 1 J7 '/® Legal Description /2V /Lf 0s? .9/G2" / Lessee / Tenant 'Tit/M/4') . N-g-P4 `' Master Permit 4k, 3370 Owner's Address 7 c r7 S , .. -A-kA I G4-._ c ovci th Q. Phone 38Y b 9 9 Contracting Co. 6rNnro- /1v "1) c..c Address Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one WORK DESCRIPTION APPROVED: Fire ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN /1 •.) �- ^ c;.1- Square Pt. Estimated Cost(value) S w 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. OWNER'S AFFIDAVIT: I certify that all the foregoing informatio s accurate and that all work will be done in compliance with all applicable laws regulating co tr ction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Signature of Con Date: Date: It/ 4 , / Notary as to Owner and /or Condo President / Not d ry as to Con ltXlaFoo�ra is My Commission Expires: My Commission Ex ally known DOR Produced LD.� ype and n bqy o I . produced: DID r an o ** * * * * * * * * * * * DID N01 takeia or n oath. * ** FEES: PERMIT \" t RADON C.C.F. 1' NOTARY 5164 TOTAL DUE r 4111 : 15 Other Zoning Building Electrical Mechanical Plumbing Engineering Date ``0 - I o - ( 14 Job Address \ , ■ c‘1/4.9 S4- Tax Folio PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Legal Description Historically Designated: Yes No ✓ Owner/Lessee / Tenant e- Q.4 - 3ft, - T" -- Cp AT , p Master Permit # Owner's Address V.3 O \ )J 6 i s;-. :, S 1 ,31) 1), Phone 70, < Contracting Co. Oc e2 f f /t...-. Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle on LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN • WORK DESCRIPTION , Square Ft. a 1 .s 0 \\ o Cfl D \y' 3 a 3 p Estimated Cost (value) 7o o . 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. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable law egulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signs tu�te- of owner and/or Condo President Date Signature of Contractor or Owner- Builder Date C( - rO - S6 Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date My Commission Expires: My Commission Expires: TEES: ,`pnY'hO a: Y• SEAL FFICIAL NOTAR O .. �� SCCTT W DAVIS * )); COMMISSION NUMBER • CC255237 �r ' c P ZOMMISSION EXP. F OF AC) : ;. ;, . 26.1997 "yo.rD ON C.C.F. .5D NOTARY TOTAL DUE yo ..moo APPROVED: `,, Zoning Building �/� Electrical Mechanical Plumbing Engineering tiv ///V/ BUILD] MiA -to r A- PERMI' FBC 2001 Permit Type (.....c): Building Electrical Owner's Name (Fee �le,Titllehol Owner ddress City f/I(CM ) Tenant/Lessee Name City i - State Miami Shores Village Is Building Historically Designated YES NO Type of Work: Addition ❑Alteration Describe Work: ° (L4r; Submittal Fee $ �D 0• Permit Fee $ Miami Shores Village Buildinc 1 )epartment liami Shores, Florida 33138 72 Job Address (where the work is being done) /00 / /0 �(O - County Miami -Dade Zip Contractor's Company Name Contractor's Ad s City 1 ) Qualifier State Architect/Engineer's Name (if applicable) Phone # A $ Value of Work For this Permit // 0,9 •' osAlwayvadOesigign wa5 4 5 callA __.astir Permit No. Plumbing Mechanical ❑New Zip Phone # Zip 33) Square Footage Of Work: qa.R.) CCF$ Notary $ Training/Education Fee $ Scanning $ � Radon $ Zoning `r- /Z- 7 c11 1 4.-O / Permit No. el 6U -32 Roofing Phone # M/177 -330= 3 ❑ Repair/Replace ❑ Demolition Technology Fee $ Bond $ CO/CC 0-.so Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ ' (Continued on opposite side) NOTARY PUBLIC: Sign: Pe c.f. Alba Gaona My Commissi ir254Vas Juy 26, 2007 Chc 12/15/03 (tete' )te- Print: • My Commission UU224106 G NOTARY PUBLIC: Sign: Print: My Commission Bonding Company's Name (if applicab eb ) Bonding Company's Addresp 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 AM 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 •mmencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is i . ued. - absence of such posted notice, the inspection w , of be approved and a reinspection fee will be charged. Signs go , � ± -, (0% � ��� I� ' Signature Owner or Agent �/ Contractor The forego instrument was acknowledged before me this/'2 The forego in;instrument was acknowledged before me this .—> d `- b day of/ ' 1� 20 , y y o 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. "Y 4 11. Alba Ganna My Commission 00224106 or�t� Expires July 26, 2007 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************** * * * * * * * * * * * * * * * * *, * ** * * * * * * * * * ** ************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: � %f �����c /®.vowm4" Plans Examiner Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: EL2004 -329 Printed: 11/30/2004 Applicant: PATRICIA ANN BROGGI Owner: BROGGI PATRICIA ANN JOB ADDRESS: 1001 NE 96 ST Contractor ADT SECURITY SERVICES INC Local Phone: 305 - 628 -7434 Parcel # 1132060143740 Electrical Permit Permit Status: APPROVED Permit Expiration: 5/14/2005 Construction Value: $1,050.00 Work: SECURITY ALARM SYSTEM Signed: (INSPECTOR) Page 1 of 1 Contractor's Address: 7747 NW 48 ST 160 Legal Description: 5 -6 53 42 MIAMI SHORES SEC 3 PB 10 -37 LOT 17 & 18 BLK 82 LOT SIZE Fees: Description Amount FEE2004 -11840 Building Fee $100.00 FEE2004 -11841 CCF $1.20 FEE2004 -11842 Training and Education Fee $0.40 FEE2004 -11843 Technology Fee $2.50 FEE2004 -11844 Submittal Fee ($50.00) Total Fees: $54.10 Total Fees: $54.10 Total Receipts: $0.00 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: MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date2 Type Insp'n Permit No. Name Address /©d/ Company Phone # --- ' / 6'/ Inspection Date ,73 1 :3 `-' 94-471- 7 Approved Correction Re- Insp'n Fee fr..e2).7'10