347 NE 98 St (2)BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
Miami Shores Village
Building Department
Electrical
Owner's Name (Fee Simple Titleholder
Owner's Address
City State Zip
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 3yru r, ot --
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Qualifier
State
Permit No. gP 03-78
Master Permit No.
Plumbing Mechanical Roofing
Phone #
Phone #
Architect/Engineer's Name (if applicable)
Architect/Engineer's Address
City
Zip
$ Value of Work For this Permit Square Footage Of Work:
Number of: Bays Stories _ Families Bedrooms Baths
Type of Work: ['Addition ❑Alterati ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:: / ;; A � 4'o
*************************** ******************************
County Escrow Fee $ Permit Fee $ Notary $
Education/Training Fee $ Tech $ Scanning $
Code Enforcement $ Bond $ _ Struct. $
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
3
Radon $
Minus Plans Check Fee $ Total Fee Now Dui (Continued on opposite side)
Bonding Company's Name (if applicable)
Bon
City
Mor
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City
App
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Signature
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whose property is suojecr ro arracameni. Iaiw u
for the first inspection which occurs seven (7) days after the building permit is
inspection will not be approved and a reinspection fee will be charged.
Signature
d
Owner or Agent Contractor
issued. In the absence of such posted notice, the
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 _ , by
day of , 20 _, b
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: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
*************'*:*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *** 3 *,.* 1 ' J * * * * * * * * * * **
J APPLICATION APPROVED BY: Plans Examiner
chc7/7 /03
Engineer
Zoning