Loading...
MC-10-681k4- BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) CATHERINE COI RI N Phone # * ) , ' ` 6 � 1 ` IS C Owner's Address 140 NE 104 ST city MIAMI SHORES Tenant/Lessee Name E - MAIL: Job Address (where the work is being done) 140 NE 104 ST City Miami Shores Villa e County Miami -Dade Zip FOLIO / PARCEL # 1121360130770 Is Building Historically Designated YES City PLANTATION State FL Qualifier Name GRETA B. SMITH State Certificate or Registration No. CACO58160 E -MAIL: Miami Shores Village Building Department (0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 State FL Zip 33138 Phone # Contractor's Company Name ALL YEAR COOLI Contractor's Address 6781 W. SUNRISE BLVD NO Permit No. Master Permit No. ApR • 10 - '(0)S1 Phone # 954-5664644 4 1 /1 10.441 4 .- .. Architect/Engineer's Name (if applicable) Phone # .0 V 5 9► Value of Work For this Permit $ © Square / Linear Footage Of Work: O 7j Type of Work ❑Addition ['Alteration ❑New Repair/Replace ❑ Demolition Describe Work REPLACE CENTRAL NC ***** * * * * * * * * * * * * * * * * * * * * * * * ******* a gas** ***** **** * * ** ** *** x ***** **** **e******** Submittal Fee $ J.:a:11Z Permit Fee $ /' It, DD CCF $ 3'a) CO /CC Notary $ Training/Education Fee $ 1.20 Technology Fee $ 4-K0 Scanning $3.0 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 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 FT.RCTRICAL 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such po ted notice, the inspection will not be approved and a reinspectio _ :e will be charged _ day of nally known to me or who s produced persona�i� nhfication and who did take an oath. PUBLIC: OTARY P me or Signature The fore oing instrume day of who is pe. *. NOTARY Owner or Agent acknowledged before me thi. e Contractor J wledged before me this has produced tion and who did take an oath. ' s• I �j 11 ♦1 � �n�'J wl" i � � �� 1 A � To ;'' a� ereaaaen ..:, Sl_� ���$ �,I 7 .a�` 1� ►'�, t 1r (LA_ S l °�� Ni , t '1 � 1 Print::. t £ � y� , '1.:7:,.:;t1 , i f. My Commission Expires: . z�e•ers.n•enneeae•eeee•'uenfRR' •ae COmm1SSl,n Expires: ** ********* ******** **** 9 �hN��ktl�********** ****d�d��M .1! S lf!k ****MN�� *** ***** ******** + SUN +�k+d�d� *�NK.d�d�d.Q�q�**** ** o y F :45C,°�iawym.,.- •+r,.am: - . - .+.—..may.... .t..,�,: '' . li" V APPLICATION APPROVED BY: Ck (Revised 02/08/06) Plans Examiner Engineer Zoning AO