1084 NE 97 St (6)BUILDING
PERMIT APPLICATION
1 +13C 2001
Permit Type (circle): k 1 Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) e ��1 j 1r, ,z , ,, „ki. Phone #
Owner's Address
'Tcnanl /Lessee Name Phone #
.lob Address (where the work is being done)
City _ _ _Miarni Shores Village County Miami -Dade
is Building Historically Designated YES NO
contractor's Company Name T. L . ��1 \� J U+j� ►lv'1l tilt Phone #_tt .1
r . }t.
Contractor's Address �. e'f' `. }e� � a �
Stale
Qualifier ( LiLi ( 1r '1 `
Slate ('e►tificate or Registration No. Certificate of Competency )c
Architect /Engineer's Name (if applicable)
S Value of Work For this Permit L► +% �y
Type of Work: ['Addition
Describe Work: \ 9�r � r �•�
Submittal Fee S
Notary S
Scanning 5
Total Fee Now Due $
(Continued on opposite side)
lvliami mores v mage
Building Department
State ) Zip •S
❑Alteration
)1'xv b ,
***** * * * ** *** ***** *** * *** *F * ** ***
Permit Fee $
Training/Education Fee 5
Radon $
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
El New
('ode Enforcement 5 Structural Plan Review. 5
Permit No
Master Permit No.
Zip .'3`,51, �) z
Phone #
Square Footage Of Work:
❑ Repair /Replace ❑ Demolition
Technol
gy
ee $
Zoning Bond $
Zip
c9
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Mortgage Lender's NI
Mortgage Lender's A4'
City
Application is hereby
commenced prior to
construction in this ji
WELLS, POOLS, FI,
OWNER'S AFFIDA L.,,�a
applicable laws regulating construction and zoning.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
Chc 05/13/03
State
Zip
Gregory E Lopez
President
GEL INTERNATIONAL
2248 SW 57th Avenue. Miami, Florida 33155
Main 186.388.0312 • Fax 786.388.0366
Cellular 786.229.3611 • greg_gel @bellsoutr.net
CGC1507553
Zip
indicated. I certify that no work or installation has
'med to meet the standards of all laws regulating
d for ELECTRICAL
CIONERS, ETC
and that all work will
WORK, PLUMBING, SIGNS,
be done in compliance with all
"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 mist
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
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 64
day of , 20 , by , day of i.' rJ , 20C, by
who is personally known to me or who has produced who is personally known to me or who has produce
As identification and who did take an oath. as oenti'cation and who did take an oath
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
*************************,************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **************
Plans Examiner
Engineer
Zoning
****************************************************************************** * * * * * * * * * ** * * * * * * * * * ** * * * * **4•+
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