1287 NE 96 St (6)RECEIVED
AUG 2 62004
BUILDING
PERMIT APPLICATION
FBC 2001
Owner's Address l Y 1L ,.t- ‘,/
;
City /ir »' / State /7_
Contractor's Address ;tC" -' N , / 4/i /1/1
City �'l %'�` � State
Qualifier //' / /_ �'F, / F✓l/�✓
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Contractor's Company Name w lC ' 1 1 /7/ 2 - - - h2O,y 6 . f'.4.
Permit No. I AC0/1 l
Master Permit No. /51
Permit Type (circle): Building Electrical Plumbing C" Mechanical Roofing
GLF jr, Phone #
` '
Owner's Name (Fee Simple Titleholder) �� i� /;
;3?
Zip
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 1%4 /{ i 7/r ,,'!
City Miami Shores Village County Miami -Dade Zip % V
Is Building Historically Designated YES NO
Phone #
Zip •
State Certificate or Registration No. e FL: / ` . j L -t /5 7 Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 2 Square Footage Of Work:
Type of Work: DAddition Xlteration ew ❑ Repair/Replace ❑ Demolition
Describe Work: NE4 ! F �/
-4%4 * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ SO, ( .Permit Fee $ / C t' -- CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. 5
Total Fee Now Due $
(Continued on opposite side)
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
The foregoing instrument was acknowledged befo
b rGc / L �/
who is personally known to me or who has produced /
As identification and who did take an oath.
day of
My Commission Expires: `` r 1 4/., Ciznen L3mberRazgin
* * * * * * * * * * * * * * * * * * * * * * * *lj�4i ire • ��LQ��>� * **
• !�� : lres Not 17, 2007
: Aaron Notary
I �r l
to` 1- 8003545161
********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Chc 05/13/03
Owner or Agent , / Contractor
lis - The foregoing instrument was acknowledged before me this j;/t4 --
, day of i r� 1 , 20Cx/ by at-4.,,k (i•
who is personally known to me or who has produced
as identification and who did take an oath.
I. 20 0 +/, by
APPLICATION APPROVED BY:
Signature
NOTARY PUBLI
Sign:
Print: \ -440e/1 ZA,,n Lam' " -L) , e" 2 --
My Commission Expires:
,�11111�
*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *Ie ``, >.40,AR
• Y w !l�7 , llHk �f M
' OF � O Aaron Notary
Plans Examiner
Engineer
Zoning
spection Number: INS -1875
03 -153
Inspection Date: 06/05/2006
Inspector: Perez, JanPierre
Owner: BRODSKY, MARK
Job Address: 1287 96 Street NE
Project: <NONE>
Miami Shores Village, FL 33138-
Contractor: TROPICAL AIRE AND HEAT
Building Department Comments
Wednesday, May 31, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: Mechanical
Phone Number
Parcel Number 1132060143770
Lot:
Phone: 305 -882 -1037
Page 2 of 2
Passed
Inspector Comments
Zi&O O
/VPItio /
Failed Fa
Correction
Needed
,
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
spection Number: INS -1875
03 -153
Inspection Date: 06/05/2006
Inspector: Perez, JanPierre
Owner: BRODSKY, MARK
Job Address: 1287 96 Street NE
Project: <NONE>
Miami Shores Village, FL 33138-
Contractor: TROPICAL AIRE AND HEAT
Building Department Comments
Wednesday, May 31, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: Mechanical
Phone Number
Parcel Number 1132060143770
Lot:
Phone: 305 -882 -1037
Page 2 of 2