290 NE 98 St (6)UU CAE`
BUT �a II G
PERMIT APPLICATION
WIG 9 r 130 Master Permit No.
FBC 2001
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle). Building Electrical Plumbing Mechanical Roofing
Owner's .Name (Fee Simple Titleholder) ELA/ IU C L�U c Phone # 3 5 757 -' / 95f3
Owner's Address 2.
Cityn/4r77 /S}/ODF. C State FL. Zip 33/3V
Tenant/Lessee Name A-)/ •1— Phone # A- /
Job Address (where the work is being done) 2. N E 9 g- sr.
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO }'
Contractor's Company Name 4 - /Zr,d C niv5TEUr 010
Contractor's Address / b rD S N � (7 7 - -z.e,
City P oen} Aril 1
Qualifier L f '
State Certificate or Registration No.
Architect/Engineer's Name (if applicable)
Total Fee Now Due $
(Continued on opposite side)
State
$ Value off Work For this Permit .0 C
�c erg
Submittal Fee $ J [� . Permit Fee $
Notary $ Training/Education Fee $
Scanning $ Radon $
Code Enforcement $
L
Structural Plan Review. $
C1/ -4+ t 4 a �
vo`-
Permit No.
Zip 33134'
Phone # 30,5- - 8' 2 - 6,-b 7
Zip 33r' S/
Certificate of Competency No.
Phone #
Square Footage Of Work:
Type of Work: ❑Addition ❑ teration ['New ❑ Repair/Replace Demolition
Describe Work: // N { c.�r, 01,/1--)0A � !2 d-
't �
* * * * * * * * * * * * * ** * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
:
Technology Fee $ 579
Bond $
A
CCF $ 1 / of Q CO /CC ��
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signatur
NOTARY
Sign:
Print:
Chc 05/13/03
Owner or Agent
trument was acknowled ed before
()b
The foregoing in
day of
who is personally
My Co ission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * *x
APPLICATION APPROVED BY:
to me or who has produced . who is personally know to me or who has produced 1 - J
As identification and who did take an oath. Sao's S0
It
************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
The forego
G1 6f
Signatur
as identifica
tnstru
Sign
Print:
NOTARY PUBLIC:
My Commission Expires:
_ nse
flctcvc ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Contractor
lent was acknowledged before me this
`
20 D by�e.",
N
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
O12
n and who did take an oath.
11
Commission #DD323870
Expires: May 26, 2008
t$F1illki* * * * * $ '6t
end * *
T i „ " Atlantic Bonding Co., Inc.
Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10 /15/2004
Applicant:
Owner:
JOB ADDRESS: 290 NE 98
Contractor ARCO CONSTRUCTION
Local Phone: 305 - 892 - 6507
Parcel # 1132060134150
Building Permit
Permit Number: BP2004 -1337
ST
Contractor's Address: 1665 NE 137 TERR
Permit Status: APPROVED Permit Expiration: 4/6/2005 Construction Value: $2,000.00
Work: INTERIOR DEMOLITION ONLY. REMODELING PERMIT PENDING BP2004 -897
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 1 & 2
BLK 31 LOT SIZE 103.560
Fees:
FEE2004 -10148
FEE2004 -10149
FEE2004 -10150
FEE2004 -10151
FEE2004 -10152
FEE2004 -10153
Description
Building Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Scanning Fee
Total Fees:
Amount
$100.00
$1.20
$5.00
$0.40
$2.50
$6.00
$115.10
Total Fees: $115.10
Total Receipts: $0.00
0..5'; /O
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: