1096 NE 97 St (4)Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2005 -83
Printed: 1 /28/2005
Applicant: DOUGLAS PALEY
Owner: PALEY DOUGLAS
JOB ADDRESS: 1096 NE 97 ST
Contractor YAMILL GLASS & WINDOW INC Contractor's Address: 480 W. 84 St. #107
Local Phone: (305) 826 -2121
Parcel # 1132050170180
Signed:
Building Permit
Legal Description: REV PL MIAMI SHORES SEC 8
Permit Status: APPROVED Permit Expiration: 7/18/2005 Construction Value: $9,100.00
Work: FURNISH AND INSTALL IMPACT WINDOWS AND DOORS (15 OPENINGS)
(INSPECTOR)
Page 1 of 1
PB 43 -51 LOT 6
Fees: Description Amount
FEE2005 -1261 Building Fee $250.00
FEE2005 -1262 CCF $6.00
FEE2005 -1263 Training and Education Fee $2.00
FEE2005 -1264 Technology Fee $6.25
FEE2005 -1265 Scanning Fee $30.00
FEE2005 -1266 Submittal Fee ($50.00)
Total Fees: $244.25
Total Fees: $244.25
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:
BLK 181 LOT
Contractor's Company Name
Contractor's Address
$ Value of Work For this Permit
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
/Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING 4; Permit No. C ���
PERMIT APPLICATION
FBC 2001
/ Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) V h t ' . i ? r p Phone #
Owner's Address 1 '� '' °a "' '�
City 0 ,r._l State 1 Zip 7..): >1 =1a y-._';
Tenant/Lessee Name Phone #
Job Address (where the work is being done) =
City Miami Shores Village County Miami -Dade Zip ; ! •
Is Building Historically Designated YES NO
City t _ Y; State Zip ( F'
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect /Engineer's Name (if applicable) Phone # :� fir; •L -9 6
Type of Work: ['Addition ❑Alteration New RepaitaReplace ❑ Demolition
Describe Work: `�`,� �. t" ., <; n C.!: f.�(
VI
Total Fee Now Due $
Master Permit No.
Phone #
Square Footage Of Work:
1 ****************************Fees******************************
Submittal Fee ' Permit Fee S ) �f CCF $ — CO /CC
Notary $ Training/Education Fee $ ,, " Technology Fee $ W
Scanning $ Radon $ Zoning -- Bond $
Code Enforcement $ Structural Plan Review. $ ""`
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 1-
Chc 05/13/03
N
Owner or Agent
The foregoing instrument was acknowledged before me this
day of i:r,.3 , r , by 1` .ci, : '.41.a'
who is personally known to me or who has produced F _1
P'::: 11 As identification and who did take an oath.
NO,C PUBLIC:
Sign'. g,A�
Print s L
My Commission Expires: ' I
APPLICATION APPROVED BY:
NOTARY PUB
Rosa L Palados
r . ` -�
- •o!`"mG: CeTrmiecion * DD080o01 Si grir
r • Ex Dec 28, 2005 °
'nom rte* r�onded T hni Print: N.S' :.74;x=
•4 s u „ i i• Athuitttc Bonding Co., Inc.
Contractor
rd
The foregoing instrument was acknowledged before me this /' /
day of , 20 C. r , by i �� s u;r
who is personally known to me, or who has produced
as identification and who did take an oath.
3 212&1►
m S�
m � '`� °� ;,(' F misslou a=m001
E pices Dec. 28, 2005
°° a
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� r3oR0 : : :d Trft
My Commission Expires:: , ,`j' ; Ath itc Boaeing Co., Div..
Rosa I. Palacios
* * * * * * * * * * * * * * * * * * * * * * * * * * * *, tic *********** *, tic **** * * ** *,t ******** * ** * ** *** * *** *** ****,t**** *****,t *** *,tic *,t* *,tic * **
*************************** * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** *************** * * * * * * * * * * * * * * * * * * * * * * * * * ** * * **
Plans Examiner
Engineer
Zoning
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. ¶AX FOLIO NO. II .5 POS G g 70.10
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street/address: 109 ( €. c r.? s h
L.0f (9 81 k IS 1 of ted PL B awl% Shores Sec g Fb f
2. Description of improvement:
3. Owner(s) name and address: Dc oc ;cifle 1 t e II c I °eq
S US � C �9 -? S f I 'I Snores F C - 351 52. 2 35(o
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: 0 oisii d ( Glass a U.) i tnsriow S
Li&O W ¶ S4 . 107 decA I Pc 530
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address: !° gjf
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided
in Section 713.13(1)(b), Florid Statutes.
Name and address: A;
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
diffe t date is specifi
D
Signatu a of Owner
Print Owner's Name i Alt
Sworn to and subs,ribed before me
, n
Notary Public // +
ry ♦ j
Print Notary's N : me P •
My commissi• expires:
123.01 -52 PAGE 4 8402
P Irk 1S 4 — La's -11-(M 8&0t1S o
JJ 's d day of cbecN.nn6
CA � VOL O C u v S , �99999Q ro Rosa 1. Pat riOS
01 2) > ° °`�R ' . Commission DINBen01
tl .Qo ESpire Dec. as, z005
▪ `4- Bonded Thru
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ss►a99 Atlantic Bonding
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OR Bk 22918 Ps 1385; (fps
RECORDED 12/17/21104. 15.205 11';
HARVEY RUVIldo CLERK OF COURT
FlIANX: -DADE COUIdTt'e FLORIDA
LAST PAGE
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