DEMO-07-2035Project Address
1122 NE 97 Street
Miami Shores, FL 33138-
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
PETER ROSSI
1122 NE 97 ST
MIAMI SHORES FL 33138 -2558
Valuation:
Total Sq Feet:
$ 1,000.00
250
Type of Demo: Building
Additional Info: demolition
Classification: Residential
II
OCT I
/�l�k 8 2007 _
MIAMI SHORES VILLAGE
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$5.00
$100.00
$6.00
$2.50
$114.30
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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL 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. Futhermore, I authorize the above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
adding
Status APPROVE
Expiration:
Parcel Number
1132050170170
Block: Lot:
Applicant
PETER ROSSI
Available Inspections:
Inspection Type:
Final
1
October 05, 2007
Date
Friday, October 5, 2007 1
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BUILDING
PERMIT APPLICATION
FBC 2004
FOLIO / PARCEL #
Describe Work:
Permit Type (circle): Buildin Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) fj (XL Phone # j 0 S"-- 7 "7 - oYiSd � J Owner's Address (ta E `
City i (tV4 Shpt State 41.- Zip 3) 3p.
Phone #
Tenant/Lessee Name
Job Address (where the work is being done)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
rte.
City Miami Shores Village County Miami -Dade Zip Y513'
Is Building Historically Designated YES NO t/
Contractor's Company Name 0Wl'`R-r Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. \ Certificate of Competency No.
Architect/Engineer's Name (if applicable) J JA
Value of Work For this Permit $ CU40
Type of Work: ['Addition
['Alteration
Square / Linear Footage Of Work:
❑New
A 7'q;
Permit No. Q1 2O55
Master Permit No.
Phone #
❑ Repair/Replace
OCT 0 i 2001
Demolition
. %r
Submittal Fee $ Permit Fee $ ; ' ' CCF $ 0 ' 60 CO /CC
Notary $ 0 Training/Education Fee $ .•�1 ®.- ' ec logy Fee $ 1'50
Bond $ Code Enforcement $
Structural Review. $ Total Fee Now Due $ / 14 ° VO
MIAMI SHORES VILLAGE SeeReverseside
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 Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 , by , day of , 20 , by
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.
NOTARY PUBLIC:
My Commission Expires: My Commission Expires:
Sign: Sign:
Print: Print:
APPLICATION APPROVED BY:
(Revised 02/08/06)
NOTARY PUBLIC:
/O/O4 7 Plans Examiner
Engineer
Zoning
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SUBJECT TO COMPLIANCE WITH ALL FEDERAL
STATE AND COUNTY RULES AND REGULATIONS
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