268 NE 102 St (14)MIAMI SNORES VILLAGE 61)
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date a \3 `d 5
Type Insp'n Rao! Wiefra‘te,
Permit No. P g o5
Name / j'G S U c
Address ( C6 4 iaQa sr
Company Xe7/ 1 //
Phone #
Inspection Date O( ` o f�
Approved
Correction ❑
Re- Insp'n Fee ❑
gR BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): ; wilding Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) /,kei 51 Phone # (• xa✓2zj5 . , :3/.
Tenant/Lessee Name i U f,Q •
Job Address (where the work is being done) , (06 N �
City Miami Shores Village County Miami -Dade Zip g343?
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address
City
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Type of Work:
Describe Work:
Total Fee Now Due $
(Continued on opposite side)
y 6 2 , i/a6VeyeePhone #
fir
State
e au ye, eeeO
iami Shores Village
Building Department
0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
,?7; 04a • od
❑Addition ❑Alt ati ❑New
(U 1 t3 'E, U31 ` - � "Tj(/1/ 1 , Gt
Submittal Fee $50 no Permit Fee $ 3?b ■
Notary $ I
3-- Training/Education Fee $ 1 4
Scanning $ "7' Radon $ T Zoning
Code Enforcement $ '�— Structural Plan Review. $
Zi p 3.30/1
yr Rep
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit No. 6965
Master Permit No.
Phone # ‘ 737 vj' %l
vs) er,e‘--W/
,e5 3,2/
Square Footage Of Work: 107
CCF $ a3 0 CO /CC
Technology Fee $
Bond $
❑ Demolition
5a
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Chc 05/13/03
U/A
Owner or Agent DL = S320_
The foregoing instrument was acknowledged before me this /
day ofJ6.hvary ,20 05 ,by I4ici hac( Stoc
who is personally known to me or who has produced
As identification and who did take an oath.
Signature
7 32/- d Con actor
The foregoing instrument was acknowledged before me this 1 D
day of 'X& ar y , 2005 , by e.ty � U G r r e,r 0
who is personally known to me or who has produced
as identific ion and who did take an oath.
NOT UBLIC: NOTARY P
• o
o' " ° Rosa I. Palacios •��",,,
1, . a
Sign: U _ .Z ,• . ^��n =Commission # DD080001 Si Y, . �YPU�,�- Commissi Rosa I Pala
# DD080001 os
28. m F ap 2005
OS ; �° Bonded Tluu Piro . LO A L.. Pei e l 9 Q��� Bond u
My Conunission Expires: i,l��j� `��� Atlantic BondingCa,IaC i� t o . hG HondingCD.,I1u.
I0 5 My Commission Expires: la g
05
APPLICATION APPROVED BY: i'' AAN 1 9 26115 Plan Examiner
xammer
Engineer
Zoning
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street/address: Ln TS 3 *1 elk 35 0f M ; aivvi i s h 0 re- S
5c 1 AmcL. Pb 10 P9 70
g-(0$ OE 10a 5f. ','�
2. Description of improvement: Fur r S Li c- Inst t.V 11 1 n d o f t3 s
3. Owner(s) name and address: ' Chae had , -oC k
Sam e Address as above
Interest in property: &;.0r12,r
Name and address of fee simple titleholder:
4. Concractpr's ame and address: ( D M ; I F 6 1 0,s s q �.) , el SOLO S `F &C W 84 S 1-.
1-110.1e0-1'N i FL 3301
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
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:
8. In addition to himself, Owners 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:
TAX FOLIO NO. 320 (o01 3
9. Expiration date of this Notice of Commencement: (the expiration
different d t is ecifi-.) ..
Signa ure of Owner 04\ Print Owner's Name �
Sworn to and subscribed before me this
3 )L s
32.0, - 567- 5
Notary PubI
Print Notary's fyame
My commissi n expires:
123.01 -52 PAGE 4 8/02
-51
zi-
day of , 20 _.
.gyp 0/07
Yt v' smom tivun
A �.
"_ E. Iblifire5 Dec. 28. 2005
«2 t Atlantic SandingCa.Inc.
l)�
jsr OF o f the
O F f .0Ft10A ,C O � f a e ° / da
50E. Of that on
i HEREBY CERTIFY
office �p 2 �
original file '�
nlfiWa� $eal.
11111111iiii111 I f ii IliiiIIIII IIIII IIII IBI
CFN 2004-R1131688
OR Bk 2241E F's 1386 U p s )
RECORDED 12/17/2004 15:05:33
HARVEY RUVIH► CLERK OF COURT
MIAMI -DADE COUNTY► FLORIDA
LAST PAGE
date is 1 year from the date of recording unless a
Prepared by q t CYlot% ( si G C K
Ad ress: 2t.
went y Sh'v (e S, Ft 33138
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 1 /27/2005
Applicant:
Owner:
JOB ADDRESS: 268 NE 102 ST
Parcel # 1132060134720
Signed:
Building Permit
Permit Number: BP2005 -69
Contractor YAMILL GLASS & WINDOW INC Contractor's Address: 480 W. 84 St. #107
Local Phone: (305) 826 -2121
Page 1 of 1
Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 3 & 4 BLK 35 LOT
Fees: Description Amount
FEE2005 -1165 Building Fee $320.00
FEE2005 -1166 CCF $16.20
FEE2005 -1167 Training and Education Fee $5.40
FEE2005 -1168 CO /CC $50.00
FEE2005 -1169 Scanning Fee $45.00
FEE2005 -1170 Technology Fee $8.00
FEE2005 -1171 Submittal Fee ($50.00)
Total Fees: $394.60
Total Fees: $394.60
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 7/17/2005 Construction Value: $27,000.00
Work: IMPACT WINDOWS
(INSPECTOR)
UJAN 2 7 PAID
In consideration of the issuance to me of this permit, 1 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 INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
• Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whet r herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor.. .if-gate- _ t`, `'-
Location and legal description of lot to be built on:
Lot Block U/ bdivision
2 GF
Street and Number where work is to be done ,� p
State work to be done and purpose of building (by floors) LJ Lt
Disapproved
(Signed)
Date. ...! .._._...._ ... ,19.�
No Z e.1 stre , .L D 2
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation ^ Roof Covering
Estimated Total cost of improvements $.G G O Amount of Permit 5�...S3`
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such s ntr ctor work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks_ (Signed)_ � %`"��' !a'
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him sta a are true.
Permit No.. __ Date l Z r r- Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector \M y Commission Expires
PLAN .NC BOARD DATE
Chairman Member
Mfcrnbcr Member
Member Member — _._..._
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- in.pcc•tion fee of $1.00 will be charged when such re- inspection is made necessary by Improper notice for inspevtitm or faulty
materials and /or workmanship.