284 NE 102 St (5)BUILDING
PERMIT APPLICATION
FBC 2001
Tenant/Lessee Name
10050 N.E.2nd Avenu
$ Value of Work For this Permit WOO
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
Tel: (3
rida 33138
8972
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) V U Q,IG Phone #
Owner's Address
City "if 47 64 State Zip
Phone #
Job Address (where the work is being done) 2_ N5 \ C S+
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name /#4 7g/' Phone # 3 g c-- -4 .?- 7 7 ( Q
Contractor's Address / 3 7eS A) t 7 ,--c'
City A/, !t4 r+ State C. Zip 3 '3 r 6 e
Qualifier M/c.rf(-5Z jf 4 c)
State Certificate or Registration No. e +CQ `5 5 Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
ter Permit No. 768
Square Footage Of Work:
Type of Work: ['Addition ❑Alteration ['New ❑ Repair/Replace
El Demolition
Describe Work: Dc)+ 1
Submittal Fee $ Permit Fee $ ��' CCF $ 1 .2-C) CO /CC 15 Notary $ C 7 Training/Education Fee $ D .40 Technology Fee $ 3 7.
Scanning $ 3 . 00 Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
--NCO sue— )3c
Permit No. BPQS '7P2)
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
conunenced 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.
************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
chc 05/13/03
Signature Signature
Owner or Agent
The foregoing instrument was acknowledged before me this The foregoing instrument was ac
day of , 20 _, by , day of , 20 by
who is personally known to me or who has produced who is personally kno 'n to me or who has produced T
As identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUB
Sign:
Sign:
Print: Print:
My Commission Expires: My C s ission Exp
Contractor
owledged be ore me
entification and who did take an oath.
a7
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(1 3
cD1, 7--
Plans Examiner
Engineer
Zoning
�m
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204
Printed: 10/4/2005
Applicant: JANET
Owner: VUKOVIC
JOB ADDRESS: 284 NE 102
Contractor MANGO AIR INC.
Local Phone: 305/409 - 7719
Parcel # 1132060134710
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Mechanical Permit
Permit Number: MC2005 -139
VUKOVIC
JANET
ST
Contractor's Address: 13785 NW 7 AVENUE
Permit Status: APPROVED Permit Expiration: 4/2/2006 Construction Value: $163.35
Work: DUCT WORK
BY:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 1 & LOT 2 BLK 35 LOT SIZE
Fees:
FEE2005 -13089
FEE2005 -13090
FEE2005 -13092
FEE2005 -13094
FEE2005 -13095
FEE2005 -13096
Description
Building Fee
CCF
Notary Fee
Training and Education Fee
Scanning Fee
Technology Fee
Total Fees:
Amount
$150.00
$1.20
$5.00
$0.40
$3.00
$3.75
$163.35
Total Fees: $163.35
Total Receipts: $0.00
CCT 0 PAID
Cyr cA,
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.