344 NE 102 St (7)MIAMI SHOReS VILLAGE
BUILDING DEPART
305- 795 -2204
Building Inspection Re
Date s/27
Typelnsp'n i n O 1
Permit No.
Name LL)t`UQ (
Address 3 -1 "f 1 v ( v 2 `� 1
Company °Le I G3
Phone # 305 — t 5 I
Inspection Date O
Approved `� '� 4 5, Z Q, o cf
Correction ❑
Re- Insp'n Fee ❑
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
SA-(0 VAIY s —
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing � Ntechanical Roofing
Owner's Name (Fee Simple / Titleholder) //vim - 1/(3'72. Phone #
Owner's Address 3 `�` /V /669 S 7
Cit Al! /4l/ S/1 s State
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 341 ACC /6 a- S /
City Miami Shores Village County Miami -Dade Zip 3 ./ 3 g
Is Building Historically Designated YES NO
Contractor's Company Name /5 { O N / C
� S ` Phone # 36S " a 35-7a-t_.3
Contractor's Address 4 - 7,96s Se A) /0 g'
Total Fee Now Due $
/ State Zip 3 / 5 7
City
Qualifier __)/ /6- t,'
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 6 Square Footage Of Work:
Type of Work: ['Addition
Describe Work:
(Continued on opposite side)
•
['Alteration .' %� ❑New 1:1 Repair/Replace El Demolition
Permit No.
Master Permit No.
Zip - /..Se
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
�c y -1
.. ^.r. {.. i. ". n : - l
e ✓
Submittal Fee $ Permit Fee $ �i� CCF $ .. ,'0 0 CO /CC
Notary $ Training/Education Fee $ 1 , D V Technology Fee $ 3 , --S
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
1 .. 7 1n
`ri i�il L d fl04
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 LMPROVEMENTS 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 ochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of co 1 ncement must be posted at the job site
for the t inspection which occurs seven (7) days after the buildi g p re mit i3''i ued e, absence of such posted notice, the
inspection will not be ap roved einspection fee will be charge%.
Signature Ni
The fore oing instrument was a,c owledged before me this The foregoinstrument was ackno ledged before e this
day of 2( , by t C f U%.. ) J Y , day of , 200 by • AA edr ' v 9
who is nerd known to me or who has produced
as identification and who did take an oath.
J^r'
Owner or Agent
Who is nerscu ly known to me or who has produced
NOTAR PUBLIC:
Sign
Print
rt. baton • DD292
Myt�111 a $ Ex
Chc 12/15/03
As identification and who did take an oath.
Si
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Contractor
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY: , 2 S (3• U 4- O —Zee' Plans Examiner
Engineer
Zoning
Mechanical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: MC2004 -70
Printed: 5/14/2004
Applicant: JOHN
Owner:
JOB ADDRESS: 344 NE 102 ST
Contractor BRADLEY DE MOSS AIR CONDITIONING Contractor's Address: 18720 SW 108 AVENUE
Local Phone: 305 - 235 -7213
Parcel # 1132060135140
WEAVER
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOT 7 BLK 38 LOT SIZE 50.000 X
Fees: Description Amount
FEE2004 -4930 Building Fee $150.00
FEE2004 -4931 CCF $3.00
FEE2004 -4932 Training and Education Fee $1.00
FEE2004 -4933 Technology Fee $3.75
Total Fees: $157.75
Total Fees: $157.75
Total Receipts: $0.00
Permit Status: APPLIED Permit Expiration: 11/8/2004 Construction Value: $4,870.00
Work: A/C CGANGE OUT
Signed: (INSPECTOR)
Page 1 of 1
MAY 2 0 PAID
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: