EL-09-709 >#<
......,,,
:•:.:::::;:::::::::.%%:.%:.%::.:;% Y:::::::::::: i:::::::%`.::::.::::::• r.••::::::::: i::::::::% :............................................. ...............................
p
8
Miami S :r:
Shores Village
C. ;• # # .
E
�. 10050 N.E.
2nd Avenue
a
nu
a� >%
NMV
I � -• ... ., Miami Shore : .::. : %%%%: �%%%%%%%%%: �%:-%%%%;%:.%:•%%:•%:%%-%%:•%%;:-»%: �: �%%%%:•%%:-%;%:.%:-%%%%:•%:.;%:•%::%:•%: ,;::. %:.;:• % %::• %:• %:. %:;::• %;:
es FL
« p 1
4 .<
Phone:
305 79
5-2204
H,
xr /
1
R
--
Expiration: 1 09/2009
3�9...
Project Address Parcel Number Applicant
.. ..... _ ........... .... .......,.. ........ ....... ......,... .......... . _ . _....._ , . ..... ::
29 98 Street 1132060131120
AURORA LOAN SERVICES
Miami Shores, FL 33138- Block: Lot:
<•A�••e�:•;xzi -.: ....... G?.�A>R..< ......... .... < >.::- . ........» 3:. 3. 2 �' o ':S >. >... »..: vii::. �. �C. �% e 4: L:.. v. �6`. i."»?:: ry. �> v4.'...... ; "o�:�l:....... »�: ...... .....
......
Owner Information Address Phone Cell
AURORA LOAN SERVICES 29 98 Street
Fl-
Contractor(s) Phone Cell Phone ;Valuation: _ $ 1,000.00
ELECTRICAL CO INC (305)655 -0972 Total Sq Feet: 0
'e . ,.. kkffisa<: �a•>.`.;t s:' 2: �:•' i..>:: �. 3< SiI&:+? u�:';......,.... ..r..re'eJo'.°ii'•@ti:' <. : :r.:':
Type of Work: ELECTRICAL Available Inspections:
Additional Info: BATHROOM & KITCHEDN REMODEL Inspection Type:
Classification: Residential Underground Rough
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
W.W.
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $0.60 EI- 4-09 -34668 $ 213.80 $ 163.80
Education Surcharge $0.20 ' , W.
Notary Fee $5 EL -09 $ 213.80 $ 213.80 $ 0.00
Permit Fee - Additions/Alterations $200.00
Scanning Fee $3.00
Submittal Fee $50.00
Submittal Reversal Fee ($50.00)
Technology Fee $5.00
Total: $213.80
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.
May 13, 2009
Authorized Signature: Owner t Applicant / Contractor ! Agent Date
Building Department Copy _
May 13, 2009 1
�. Miami Shores Village MCM
Bu D
uilding Department APR 2 1 2009
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 755.8972 BY
WWW.MIAMEHOMVMLAGE.COM oar«
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC20M
Permit Type (circle): wilding Roofing
Owner's Name (Fee Simple Titleholder) 'd r � !a �t�C. Phone # ` "/— � Se"' Yd�
Owner's Address A
City / hA_ State Zip ?Sl r
Tenant/Lessee Na rne Phone #
Email <S r
"fi n a1/�',
Job Address (where the work is being done) �� / �✓ / -A
City Miami Shores Village County Miami -Dade Zip 331.1 r-
FOLIO / PARCEL # ®10 / //•7�
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Narne H C6M 4 Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
Val :of Work For this Permit $ �► 00et Square / Linear Footage Of Work: l
o
Type f Work: DAddition DAlteration ONew Ff Repair/Replace
� El Demolition
Describe Work:
O A CX4 to
k�
a
Subttal Fee $ 5 .— Permit Fee $ CCF �
No t4 $ -� Training/Education Fee $ 2 . Technology Fee $
j �/
g $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Strgcural Review. $ +'ee Now Due $
3qq See Reverse 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, BEATERS, TANKS and AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is 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 X Signature
Owner or Agent Contractor
The foregoing instrument was &cknowle4ed before me this A The foregoing instrument was acknowledged before me this
day ofAaA , 20, by 1 O RC& day of , 20 by
who is rsonall known tome r who _has roduced
P 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: NOTARY PUBLIC:
Sign: r
Sign:
Print: Kat c Print:
My Commission Expires: 0'% / t o f a t I My Commission Expires:
P
qS KATHERINE
r MY COMMISSION # DD 628314
•., p ; - EXPIRES: January 10, 2011
��1P�i: *`'' ��d 7hru Notary Pubic UrMerwrttera
APPLICATION APPROVED BY 4Vd"r
- Plans Examiner Zoning
Engineer Clerk checked
(Revised 07 /10/07)
° y Miami shores Village
0 De
e Building Department
p
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
tOR Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No: 09 - 4s;k
Job Name:
el , 2009 Page 1 of 1
Building Critique Sheet
d) 4
d
- --•� /lam
r
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Norman Bruhn CBO
305 - 795 -2204
VILLA GE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: p �-'� r � v�dr6 DATE: ��
ADDRESS: 7 f J1 'i
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws
of the State of Florida, KS 489.103(7). And I have read and understood the following disclosure
statement, which entitles me to work as my own contractor; I further understand that I as the
owner must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor. You have applied for a
permit under an exception to the law. The exemption allows you, as the owner of your property,
to act as your own contractor even though you do not have a license. You must supervise the
construction yourself. You may build or improve a one - family or two- family residence. You may
also build or improve a commercial building at a cost of $25,000.00 or less. The building must be
for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a
building you have built yourself within one year after the construction is complete, the law will
presume that you built fof sale or lease, which is a violation of this exemption. You tnay not hire
an unlicensed person as a contractor. It is your responsibility to make sure the people employed
by you have licenses required by state law and by county or municipal licensing ordinances. Any
person working on your building who is not licensed must work under your supervision and must
be employed.by you, which means that you must deduct F.I.C.A and with- holdings tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction
must comply with all applicable laws, ordinances, buildings codes and zoning regulations.
Please read and initial each paragraph.
1. I hold title to the above property and I am planning on doing this construction
Myself
Initial A
2. I understand that as an owner - builder I must abide by all zoning ordinances and
building regulations in effect at the time of permit application. Inactive
permits for a period of over 180 days will become null and void (expired)
and a new permit will be required. to be issued for reinstatement of the
permit.
Initi
3. I have an understanding of the 2004 FBC & FRC and understand that this
department and its inspectors are there to help enforce and interpret the code.
There is a copy of the code in this office for review.
Initial
4. I understand that the building official and inspectors are not there to design,
alter or give advice on how to meet code — only if the structure meets the
minimum code.
Initial
5. 1 understand that as an owner - builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of an
attorney. The department will not mitigate any contract disputes.
Initial 4?v�
6. 1 understand that if I compensate any person or company for work performed
they are requited to have a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company or person.
.Initial G��%X/�
7. I understand that if any person gets injured on my construction project—they are
entitled to workmen's compensation. And if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
loss of wages during recovery from injury.
In itial
8. I understand that under state and local laws I can not do any Electrical,
Plumbing, Heating, Air & Roof work on my property with out first obtaining
the proper permits by licensed contractors.
Initial
Was acknowledged before me this day of A0nJ 2
By C, 0" 6 G6Aho was personally known to me or who has
Produced there License or T1 OL
4 •pL identification.
A
O
NOTARY �q4►�
p� ,... #,,,� $
Aeeaw
This Instru ent Prepared j
Name 1�cf ,l s � -- 14 1 e±�iS/� �^ ^� #� �� de
Address - . 1�C �� _ � /g.M+ JJ1j) t f L?
E.
� Permit No, Tax Folio No //
� NOTICE OF COMMENCEMENT _
e N STATE OF 94
�' COUNTYOF ��p,¢�
anew -�- G1
THE UNDERSIGNED hereby gives notice that improvement 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. Description of property: (legal description of property, a d street address if available)
Ott 5�.
n o w aw 2. General description of improvement:
3. Owner information 1Q
T .'�
11WN.0 C` C5
a. Name and address: b f,Iw 1 x elt+:o'140 - .f!'�
C
=C•a c y b. Interest in property: rr%
—:e . ° �j c. Name and address of fee simple titleholder (if other than owner):
W -4
W 0 a 4. Contractor:
' 0 � a. Name and address: a j.+(,,c nee
+-4 C .-•{ b. Phone number:
C. 0
r'" C-4 5. Surety
r a. Name and address:
µ
C14 W =` b. Amount of bond $
�
�
t �a1 � L5 c. Phone number.
C,4 q � i , 6. Lender
W % a a Name and address:
b. Phone number:
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 xa)7., Florida Statutes:
a. Name and address:
b. Phone number:
B. in addition to himself, Owner designates the following person(s) to receive a copy of the Llenoes Notice as provided in
Section
713.13(1)(b), Florida Statutes:
a. Name and address:
b. Phone number:
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is
specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
® CP COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART t, SECTION 713.13,
� ` m9 FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS YOUR PROPERTY. A
-4 WI TO A U NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
.�� INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF t`iOMMENCEMENT.
,us - 0 !�
- 3 n Signature of Qwner or Owner's Au ized Officer /Director -
�; A Partner /Manager r
Signatory's Title/Office_
N The foregoing ins ent was acknowledged before me this �2 0 day A r . %V `
p tip �C n �Q {name of person) as y J (Year) by � � of
authority, ...e.g. officer, trustee, attorney in fact) for {name of party on
M behalf of whom instrument was executed).
°a4t N,
KkNiSMEC Signature o Notary Public - ate of Florida
+: MY COMMISSION # DO 628314 Print, Typo, o Stamp Commissioned Name of Notary Public
tf �yi r +'' ' °= EXPIRES :Januarytt),2011 Commission Number
►y ''� f;�tk BWedTfuuNotaryPnt * tadtwlkets
n Personally Known X— or Produced Identification
Verification Pursuant to Section 92.525 Plorida Statutes
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated In it are true to the best of my
knowledge and belief.
Signature of Natural Person Signing Above
f s
04 'JoP
Miami Shores Villa e "
APPROVED gy 1 Y �.
ZONING DEPT 1 a ®� .1 tot -
_,
BLDG DEPT •'�
SUBJECT TO COMPLIANCE WITH ALL FEDERAL am
STAT
C r,4
a
eo
.._ ».v__....._,._...e__. - ...............P,.�«..,..,:.. ..tea..,._._...._.. ' ` .....•.....•,•.,.,. ,.,...._W......
•
• • i • • • i
Ir ...._.._..:...._ _. _ a -.. _ ...._.... „ .._ ,...._._.. __ _. a _,... • •, . i
i
t
t
3 `
v sss s.•s s f
• e rr•.
ss.. • sa• s ,
s• .r•
s s s s.• s
s .
s s
• •• et
rti as a. s
ltj
a
I
l3l
{
s • •
• •• • ••• •
• w s w•
L � t
d r
1
A
. o
a
* o l O.A t
� E �
ll�%'
r'
y
,•
0
a
5 r i�C
4 �
Do f f
S
1
w•
t
s
ss
s
•
ss•
w
•
•
s •Y•,
•
s
s e
•
M
•
•sw
•
es♦
•
•
•s
s•• ss
s
ww•
• •
ww•
r'
y
,•
0
a
5 r i�C
4 �
Do f f
S
1
i II
•s♦
•• s•• •
•s•••
• •• • • •
o l _ • s• • •s s••
•
s•s•• • • • s •••
•
• s •• is•
• 0 sees
• • • s• • sass
• •
•• • • •• • •
Z �
j
J42 N Al
/t
AFR 8
BY:
I LV
X-9
I L
IA-
APR
BY:-- .....
'2 1 c �� S�
M, s��s l �.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 112013 Pe Number: RC -4 -09 -652
Scheduled Inspection Date: July 21, 2009 Permit Type: Residential Construction
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: , Work Classification: Addition /Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 113206013112
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
INSTALL CABINETS AND APPLIANCES TO KITCHEN
AND BATHROOM REMODEL
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
_iii., m Anna For Inspections please call: (305)762 -4949 o =na 7 of an
Y Inspection Worksheet
Miami Shores Village Q�' —C1� • (,S'Z
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP 112850 PermitNumber: EL -4 - 09 - 709
Scheduled Inspection Date: July 15, 2009 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: , Work Classification: Addition/Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 113206013112
Project: <NONE>
Contractor: C&C ELECTRICAL CO INC Phone: (305)655-0972
Building Department Comments
GFPS IN BATHROOM AND KITCHEN ALONG WITH
SMOKE DETECTORS
Inspector Comments
Passed
Failed
Correction
Needed ❑ �'
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.�'`�
July 14, 2009 For Inspections please call: (305)762 -4949 Page 3 of 16
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Scheduled Inspection Date: June 22, 2009 Permit Type: Residential Construction
Inspector: Bruhn, Norman
Inspection Type: Framing
Owner: Work Classification: Addition /Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060131120
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspector Comments
Passed
0 1 WU07
Failed El
Correction
Needed
Re- Inspection a
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
June 19, 2009 Page 4 of 25
Inspection Worksheet
Miami Shores Village
r 10050 N.E. 2nd Avenue Miami Shores, FL
` Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP'- 1139'69 Permit Number: RC -4 -09i -6512
Scheduled Inspection Date: June 25, 2009 Permit Type: Residential Construction
Inspector: Bruhn, Norman
Inspection Type:. Insulation
Owner: , Work Classification: Addition/Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060131120
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspector Comments
Passed
Failed El
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
t__.. A• AAAA R��� A .2 ..'9
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INISPAI1 39'70 Permit Number: RC -4 -09 -652
Scheduled Inspection Date: June 25, 2009 Permit Type: Residential Construction
Inspector: Bruhn, Norman
Inspection Type: Drywall Screw
Owner: , Work Classification: Addition/Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 113206013112
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
f
Scheduled Inspection Date: May 18, 2009 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Rough
Owner: , Work Classification: Addition /Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060131120
Project: <NONE>
Contractor: C & C ELECTRICAL CO INC Phone: (305)655 -0972
Building Department Comments
4 6�.
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection a
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
e
�-
:' `:
......
Q.
�.
Miami m� Sh
ores Village a '"
100
50 N.E. 2nd
1 Avenue
,
..>
}
x
Miami i
m Shores, # ' ores F
L 331
.. 3 &0000
1
z mo
1
Q .
•G
Phone: H . (305)795-2204
95 -2204
•Y M
.4
. .J
~-- Ex iration:l'� f
Project Address Parcel Number Applicant
......,. .....,.. ......... ......... . ..... .............. . .......... .. .. . ,................... , ........ ........ .. ,,..,, .. ..... .. ....... ....... ...
29 98 Street 1132060131120 AURORA LOAN SERVICES
Miami Shores, FL 33138- Block: Lot:
Owner, Information dress Phone Cell
AURORA LOAN SERVICES 29 98 Street
.:.....
FL
: yam° "a •.' � : •' .... . . . . . . . . . . . .. . . .
Contractor {s} Phone Cell Phone
Valuation: 14,000.00
HOMEOWNER
...................................................... ............................... ° "
'; Total Sq Feet: 140 •
Approved: In Review Available Inspections:
Comments: Inspection Type:
Date Approved:: In Review Final
Date Denied: Framing
Type of Construction: KITCHEN & BATHROOM REMODEL Occupancy: Single Family Insulation
Stories: Exterior: Drywall Screw
Front Setback: Rear Setback:
Left Setback: Right Setback:
Bedrooms: Bathrooms:
Plans Submitted: Certificate Status:
Certificate Date: Additional Info:
Bond Return: Classification: Residential
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $ RC- 409-34590 $ 449.70 $ 399.70
Education Surcharge $2,80 = = = ->
Notary Fee $5 RC-4-09 -34590 $ 449.70 $ 449.70 $ 0.0()
Permit Fee - Additions/Alterations $420.00
Scanning Fee $3,00
Submittal Fee $50,00
Submittal Reversal Fee ($50,00�
Technology Fee $1 0.50
Total: $449.70
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.
May 13, 2009
Authorized Signature: Owner / Applicant / Contractor 1 Agent Date
Building Department Copy
May 13, 2009 ,
Miami Shores Village g p [ APR Buildin D e artment 2 8 2009
•
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B Y.. b � � s
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No.
PERMIT APPLICATION Master Permit N o. ,f ri m . A 2,
FBC 2001
Permit Type (circle): Building Elec� Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholde r) W0dQ Phone# '154 ;t 463D
Owner's Address--- N t~ Aq Sk
City M% nn% Shot vS S tate FL zip 33' M
Tenant/Lessee Name Phone #
Job Address (where the work is being done) g 2 g 14 6 Q l g
City Miami Shores Village County Miami -Dade . Zip 2 13
Is Building Historically Designated YES NO
Contractor's Company Name C & E I ed' % cal C In Phone # . 305 65 5 _0 /a
Contractor's Address �VJ 47� ` rcr ra C f.
City CA \ O►M ! State F Zip .33 6
Qualifier a) r d O T
ArchitectlEn eer's Name if applicable) R ^ " Phone # ,
$ Value of Work For this Permit 6000 ® a Square Footage Of Work:
3 +
Type of Work: ❑Addition ErAlteration ❑New ❑ ReliairMeplace n] Demolition
Describe Work: 0.', S i r' boi k r oo rn X {/ i P,fl 6.1,0 (1 Q y VJ I 4
Ae kec.�of ^s
.n;
APR 21 PAW Fees*
Submittal Fee $ Permit Fee ,� 04P CCF $ CO /CC
Notary ; 5,Q0 Training/Education Fee $ Q.Z_ Technology Fee $
Scanning $ • D Radon $ Zo�pin Bond $
Code Enforcement $ Structural Plan Review. $
Total Ike Now Due $ D V
(Contiri tgd on opposite de)
s;�'i
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
I
Mortgage lender's Name (if applicable)
Mortgage Lender's dAddress
City P 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 EMPROVEMENTS 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 posW notio. the
inspection will not be ap roved and a reinspection fee will be charged.
Signature L 1 ."We Signature
Owner or Age Contractor
The foregoirw instniment was ac owled V 20 efor a this � The foregoing instrument was aclmowledged before me this
day of � by of 20 by Pl L�,
who i personally kno'w'tn to me or who has produced wh is personally known to a or who has produced
3 &s identifi ation d who did take an oat 4+ asidentifi �1 � 81i1fiIdil�pA
NOT Y P i11fl� TARP PUB 41 Paula A. Myland
Sign: C�`'�'�� Si s: 1 AUG D
� Sign:
Print: � c sormnvc co.; tt�c.
__ h• ��,� Print:
My Commission Expires: My Commission Expires:
�Ia3
V P
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY: +' �.r%.��. Plans Examiner
Engineer
Zoning
Cho 12115/03
,sv Miami Shores Village
s gay
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000 fi
x, �a
rt
Phone: (305)795 -2204 ,
IF atlon.1 .11109/2009
Project Address Parcel Number Applicant
29 98 Street 1132060131120
Miami Shores, FL 33138- Block: Lot: AURORA LOAN SERVICES
Owner Information A ddress Phone Cell
AURORA LOAN SERVICES 29 98 Street
FL
Contractor(s) Phone Cell Phone Valuation: $ 800.00
MG PLUMBING & SPRINKLER SERVIC (305)525 - 9236
..:::: Total Sq Feet: 0
Type of Work: Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Return: Re Pipe
Classification: Residential Main Drain
Underground Rough
Heater
Water Service
Final
Water Main
Lavatory
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $ PL -5-09 -34728 $ 50.00 $ 50.00 $ 0.00
Education Surcharge $0.20
Permit Fee - Additions/Alterations $190.00
Scanning Fee $3.00 PL - 5 - 09 - 34804 $ 148.55 $ 148.55 $ 0,00
Submittal Fee $50.00
Submittal Reversal Fee ($50.00)
Technolo9p Fee $4.75
Total:'- ' $198.66
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
pertainingt(ereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting ! iitiis permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required fog 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.
May 18, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
Mav 18, 2009 1
1
Miami Shores Village
Building Department
f0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING _ Permit No. FL d
PERMIT APPLICATI a Master P ermit No. b 1 - ,/S FBC 2004 0
Permit Type: Plumbing
Owner's Name (Fee Simple Titleholder) pn a/ /1 / f s � /SH>ij� #
Owner's Address /U7l Q /F
Cit State ��� Zip �, �/ ?1d'
Tenant /Lessee Name / Phone #
E -MAIL: c ew / �/ �J l�
Job Address (where the wor is being done) C 1 ILI 6
City Miami Shores Villae County Miami -Dade Zip 2 J���
FOLIO / PARCEL # �o�-
Is Building Historically Designated YES NO
Contractor's Company Name /yl; / � /3..ca� � vre-F4 Se4Yzte - done # 3'--
Contractor's Address s2. 4,w'
,s Al 3
City State i= " Zip _7-J i
Qualifier Name _P- ,te =�s- kJ �y�. �,. Phone # 0 7.
State Certificate or Registration No. Gee 5 — � `f 20 Certificate of Competency No.
E -MAIL:
Architect /Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ Pv v Cl Square / Linear Footage Of Work: _
Type of Work: ❑Addition ❑Alteration ❑New [✓]/ Repair /Replace ❑ Demolition
Describe Work: _rZk1 r
Submittal Fee $ Permit Fee $�hh\\ CCF $ 0.6 b CO /CC
Notary $ Training/Education Fee $ e W Technology Fee $ 1
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ `
See Reverse side
t
i
lk
5�'LZ.
Bonding Company's Name (if applicable) It
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a cert ifled copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature ature X� S Si ature �J
Owner or Ag Contractor
The foregoing instrument was acknowledged before me thi The for going instrument was acknowledged before me th
day oM4k .20 ,by day of 20 =4
who is personally known to me or who rjl� who is personally known to me or who has produced
UCs
gjiDA
c�tifica$�l�e an oath. as iden�titifiF take an oath.
y O r,Ti11S9�OT1 ®C D ,
NOTARY PUBLIC: , Mr r .� 1111P ; r 12, 2012 NOTARf 1CF,1m1.1P sermons 4•..., v .> t s xntrtc Cfl�SSIOD # DD$3015
a��� �.�•` Expires. GIC'�.12.12
,. n�a
Sign: • Sign. �nA�
Print: Print:
My Commission Expires: My Commission Expires:
r
I'
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
(Revised 02!08106)
Inspection Worksheet
Miami Shores Village
µ 10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Scheduled Inspection Date: June 18, 2009 Permit Type: Plumbing - Residential
Inspector: Levrock, James
Inspection Type: Rough
Owner: , Work Classification: Addition /Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060131120
Project <NONE>
Contractor: MG PLUMBING & SPRINKLER SERVI Phone: (305)525 -9236
Building Department Comments
I or Comments
Passed
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid
June 17, 2009 Page 3 of 22
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
d.
duled Inspection Date: June 18, 2009 Permit Type: Plumbing - Residential
spector: Levrock, James
Inspection Type: Top Out
owner: , Work Classification: Addition /Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 1132060131120
Project: <NONE>
Contractor: MG PLUMBING & SPRINKLER SERVI Phone: (305)525 -9236
Building Department Comments
YZ In ctor omments
Passed
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re4nspection fee is paid.
June 17, 2009 Page 5 of 22
0 9
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 113388 Permit Number: PL -5 -09 -765
Scheduled Inspection Date: July 20, 2009 Permit Type: Plumbing - Residential
Inspector: Levrock, James Inspection Type: Final
Owner: , Work Classification: Addition /Alteration
Job Address: 29 NE 98 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 113206013112
Project: <NONE>
Contractor: MG PLUMBING & SPRINKLER SERVI Phone: (305)525 -9236
Building Department Comments
REPLACE TUB, WATER CLOSET, VANITY AND SINK
Ins r C ments
Passed
j s
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
July 17, 2009 For Inspections please call: (305)762 -4949 Page 7 of 32