269 NE 99 St (7)BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building) Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) CL l/� e° 4 • s"; ° mss.' Phone # ��f) 7s /— 3417
Owner's Address ZG 9 �� 9'T
City #%9sV/ - sn'v'cf State Zip ,3 3/)8
/ Tenant/Lessee Name /t//4 Phone #
-
Job Address (where the work is being done) 245 A— 99 Sr
City Miami Shores Village County Miami -Dade Zip 3 3 (38
Is Building Historically Designated YES NO
Contractor's Company Name Ca 412 Q ,202))/24 6a et 6. c.
Contractor's Address 6 rev 8 'sr. 7e 22 30
City # 7''.•3 r-// State Zip 3 3 /36
Qualifier 2d L L 2. 1200 6 u e z
Architect/Engineer's Name (if applicable) A> /4
$ Value of Work For this Permit
Describe Work:
�i
,./4 Submittal Fee $
. Notary $
Scanning $ 3—' Radon $
Code Enforcement $
Total Fee Now Due $ ) 0 73
(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
D Od
Master Permit No.
Phone # (oe
Phone #
Square Footage Of Work: .Z14.
Type of Work: DAddition ❑Alteration ❑New g Repair/Replace ❑ Demolition
** Q * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * ** * * * * * * * * * * * * * * **
Permit Fee $ CCF $ . ,� c � o 7 /CC
Technology Fee $ 3./ 5
Training/Education Fee $
Zoning Bond $
Structural Plan Review. $
Permit No ?ZOOS J 1L)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) /WO
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 pennit 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.
Signatur
Owner or Agent
The foregg g i instrument was ac edged before me this 7 `"
day ofl� 200/, by asd_.�'f 024/.1 ,
who is eersonally known to me or who has produced
As identification and who did take an oath.
• 'b)
NOTARY PUBLIC:
My Commission Expires: Sc/
A it-41 -41
APPLICATION APPROVED BY:
Chc 12/15/03
PEREDA
COMMISSION 0 CC939208
ez a C3 �i9XPIRES 8/4/2004 8/4/2004 B LADED THRU ASA 1488 - NOTARY 1
�
2-4
NOTARY PUBLIC:
(Certificate of Competency Holder)
Contractor
The foregoing instrument was acknowledged before me this ? N
day of YC/6 , 20 oC , by Cg u/ "`fig //G
who is erQ r orally 'claw icung or who has produced
as identification and who did take an oath.
Print: f..r+t �-�! 2•
My Commission Expires:
RO
REDA
OF F
r
State Certificate or Registration No. Certificate of Competency No.
*****************************:****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * AAA ** *i* * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
Contractor RODRIGUEZ, CRUZ R
Local Phone:
Parcel # 1132060134570
Building Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2004 -314
Printed: 4/27/2004
Applicant: ROBERTO RODRIGUEZ
Owner: RODRIGUEZ ROBERTO
JOB ADDRESS: 269 NE 99 ST
Permit Status: APPROVED Permit Expiration: 9/5/2004 Construction Value:
Work: DIVISION OF WALL IN BATHROOM
Contractor's Address: 360 OCEAN BLVD
Legal Description: MIAMI - SHORES SEC 1 AMD PB 10 -70 LOT 20 & 21 BLK 33 LOT SIZE 100.000
Fees: Description Amount
FEE2004 -4186 Building Fee $150.00
FEE2004 -4187 CCF $3.00
FEE2004 -4188 Training and Education Fee $1.00
FEE2004 -4189 Technology Fee $3.75
FEE2004 -4190 Scanning Fee $3.00
Total Fees: $160.75
Total Fees: $160.7A
-- sue.
Total Receipts: $0.00
- 11Di?S
4.*
$5,000.00
Page 1 of 1
Signed: (INSPECTOR)
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:
Miami Shores Village
Building Departmept
BUI DING CRITIQUE SHEET
9-\ \Noki
tak--
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No. 1 3/9-
Job Name
Type Insp'n
Permit
Name
Address
Company
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Da +,3
Phone # 30c ^ ' 1Gt
Inspection Date 5 1 D \f
Approved
Correction ❑
Re- Insp'n Fee ❑
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF 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: 9 -' Q ter' Sr i ' # -f' 5'x/o✓as F 3 9
L r 20 e 2 / 33 �AF- �
2s//7e, / 0
2. Description of improvement:
3. Owner(s) name and address: 2; 6 fo </ i2o.92/cuee- " _5c/% 4,/,ie4.,p(ai uec
Interest in property: /Dd �o
Name and address of fee simple titleholder: . 5--- 40 , 1 4 = 7-
4. Contractor's name and address: e #7e taxi cro rZ.
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address: At/
Amount of bond $ WITNESS my hand and Official S
/5 4s��. HARVEY RUViI�► CLERS(Q
7 ?/r /eel) • /V V g 3r
6. Lender's name and address:
P 6f -31Lf TAX FOLIO NO. /fez s gai z /s
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: z l2 (�.o44 ccL&
-�l 0 Cce-01 ( C - e 4 ,• / Go
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address: Al/4
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
n
Signature of Owner /,!„:::-______
Print Owners N e 20 f 1 Re i t i -uz
Sworn to and subscribed before me thi • ay of , " 7 /0.7
r
Notary Public_, �• �'` �--�C�
Print Notary's Name L. ' Li;:, /9L'7L-&G'P'a
My Commission Expires: fr‘/Cf /04/
NOTICE OF COMMENCEMENT
0 4 " , 5 7 ( / / / e 1 7 2 . 2 . 3 , /2130 _. 3.9/3
S I A I L L.H. FLORIDA, COUNTY OF DADE
I HER Y CERTIFY that this is a true copy of the
original f ed in this office on 11
, to z pc
OR SK 22307 PG 0964
LAST PAGE
d'y of
nd County Courts
D.C.
Prepared by: Aoirferf .44
Address: 2‘4 »L 9q S
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Miami Shores Village
Building Department
1 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING �'� ; `�'
PERMIT - APPLICA ON
FBC 2001
Permit Type (circle): Building \ Electrical \ Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 6O OP2l LLB . Phone # c30> '7/1) — OO,z
Owner's Address a6 ? LUG= qq £r
City /►ii4x1/ 'M tees State d 4
Tenant/Lessee Name -4-1/4
Job Address (where the work is being done) 26 g ,V c9
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO X
Contractor's Company Name /91/,f,¢r9 Z AgiG
Contractor's Address / S ,c) -e, • /95' 5r 4- zes-
City r-9 9.4,0 State
Qualifier 7 'OCR of /7, 20
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
.5"oo • s.r
❑Alteration
❑New
Master Permit No. 606A- 33 1 )
Zip ,33/3 '
Phone #
Permit No.* et -CEO — '71
Zip 03 i.3 8
Phone #3
Zip 330 SS"
Phone #(, Sj 78� -- 93 9Z
Square Footage Of Work: 43/4•
® Repair/Replace
Type of Work: ❑Addition
Describe Work:
3 J rv. ttl C, �r. ;t'T' �- al'P�er'eic .Fcfr�r�iys• ��oc.��i��
Ce.7)ys'jc l..co//he_ 1 �eyee •
❑ Demolition
Pu t C( Q. \C.. \ • * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ 6 .CO Permit Fee $ / CCF $ f , a CO /CC
Notary $ Training/Education Fee $ 0 Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ � i / 1
(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 approve and a reinspection fee will be charged
Signature
Owner or gent
The foregoing instrument was acknowledged before me thi
day of , 20 by e SeiTo of �/u 6cee
who is pelsoltally know tamp or who has produced
entification and who did take an oath.
NOTARY PUBLIC:
RO PEREDA
NOTARY PUB �LUFllUy
Print: AA zn . d?� d'� coMMi 2D086
cnlMCa eunoo.
My Commission Expires: i/d /x 5 BONDED THRU ASA l.888•NOTARY
Chc 12/15/03
Contractor
The fore instrument was acknowledged before me thi '
day of , / by 'I %: 1 //f % �,/ /t,°'
who is personally k ' to me or who h produced Pow
as identification and who did take an oath.
NOTARY PUBLIC: - ----- "
Sign:
Print:
4 . ^'
My Commission EE
********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
,./ i1
!te T
,*14, MY COMMISSION # CC 919611
�•, EXPIRES: March 28, 2004
kck* * eoed.d:3be: Matmy kits hindeBwiyit *
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
********************** * * * * * * * * ** * * * * * * * * * * * * * * * * * ** <47/
2
APPLICATION APPROVED B Y: - - ;,,/Plans Examiner
Engineer
Zoning
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
7'
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS .
5(
CENTRAL HEATING
DISHWASHER
RECEPTACLES
Jr
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AhPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
Ti .
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
J'
UNDERGROUND TANKS
LAVATORY
OVEN
i
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
l
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES -
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
7
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
1
°HEATER -NEW INST.
GENERATORS TRANSFORMERS
I
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
.SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
L
DRAINFIELO, 4' TILE/RES.
VIOLATION
PUP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER.SET (GAS)
GAS PIPING
_
. ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
t
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/27/2004
Applicant: ROBERTO
Owner: RODRIGUEZ
JOB ADDRESS: 269 NE 99
Parcel # 1132060134570
Electrical Permit
Permit Number: EL2004 -71
RODRIGUEZ
ROBERTO
ST
Contractor AABAA ELETRICAL CONCRACTORS Contractor's Address: 4955 NW 199 ST
Local Phone: 305 - 620 - 7864
Legal Description: MIAMI - SHORES SEC 1 AMD PB 10 -70 LOT 20 & 21 BLK 33 LOT SIZE 100.000
Fees: Description Amount
FEE2004 -4182 Building Fee $100.00
FEE2004 -4183 CCF $1.20
FEE2004 -4184 Training and Education Fee $0.40
FEE2004 -4185 Technology Fee $2.50
Total Fees: $104.10
Total Fees $1
Total Receipts: $0.00
- S `L, lr
Permit Status: APPROVED Permit Expiration: 9/5/2004 Construction Value: $1,500.00
Work: 3 BATH INSTALL 4 LIGHTS FIXT. TEST ELECTRICAL SYSTEM RELOCATE OF WASHER AND DRYER
Page 1 of 1
Signed: (INSPECTOR)
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: