437 NE 102 StMIAMI SHORES VILLAGE
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BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date g 1 f l
Type Insp'n / , CAA - EX5 , p
Permit No. g-cc — 15r1D---
Name --- 3C11`C e C1S'
Address t) Nt Ina 34-.
Company g-U I `G UQ r
Phone #
Inspection Date
Correction
Re -Insp' n Fee ❑
L VS-
MIAMI SHORES VILLAGE
BUILDING I3EPARTM
305- 795 -2204
Building Inspection Requ
Date 1 D-I30 Time �1
Type Insp'n 3\(S
Permit No. BP 03-16 .
Name 50«€K4
Address 43r) 1 , 1E.
Company r 1 Y G
Phone # 7S`"� O 1 2-
For Inspector: I-131 , Name & Date
Approved
Correction
Re- Insp'n Fee
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Otis Aa /1,2,1 At_
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Mechanical
Job
ERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/ i'1( aA, 33 /.7d'
? Ale loaZ Si 7' Tax Folio ,9 99 • ()Co / 702 O
G Historically Designated: Yes
S
No
47r n / g - tic. /S
Owner/Lessee / Tenant ,4C5 7 4i1/4/b2(30 2'C,1' Master Permit # , ( �J P w03- I S 1 a—
Owners Address 4 !l /f. `Oa1 /V( /4,4? . c- 1€f
Contracting Co. t�c�L._.<
Qualifier l � Lk P%,^,\ Ot>RC; SS# Phone ��C - -15 8<Sctl
State # Ci a ( S { 3 Municipal # Competency #
Address
Bonding Company Address
Amhitect Pct._ {TEn_
Address 5.5
Mortgagor Address
Permit Type (circle one): BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 1\,„7 cZe -,Mcs sC�
Square Ft. Estimated Cost (value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
laws regulating •motion and zoning. Furthermore, I authorize the above -named contractor
FEES: PERMIT RADON
O 00
CR. Tzo
APPROVED:
Zoning Building
Plumbing
C.C.F.
Signature o
ert 1
fires: C.R. CUR11S - —
Notary Public - State of Florida
My Commission Expires Apr 18, 2004
Commission # CC929384
•
do
/
: Owner- Builder
Date
1
Notary as to Con
My Commi`ssion
Phone 3 -IS -, Y8' a
NOTARY
DEC - 3 2003
Electrical
t
Ins. Co.
e in compliance with all applicable
the work stated
BOND
TOTAL DUE
Date
Engineering
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. 6P C73 "
Master Permit No.
Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) Phone #
Owner's Address
City State Zip
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name Phone #
Contractor's Address
City
Qualifier
State Zip
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit Square Footage Of Work:
Type of Work: ['Addition ['Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:
* * * * * * * * * * * * * * * * * * * * * * *** * ** Fees * * * * * * * * * * * * * * * * * * * ** * * * * * * ***
Submittal Fee $ c-® Permit Fee $ / / c l CCF $ ay , `[a
. b
Notary $ ^ Training/Education Fee $ 0, i lt2 Technology Fee $ A. 88
Scanning $ 6— Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite 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 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
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 _ , by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
State Certificate or Registration No.
Chc 10/14/03
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of ,20_,by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
(Certificate of Competency Holder)
Certificate of Competency No.
******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY: DEC ® 3 2003 Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 12 /5/2003
Applicant: PAUL
Owner: LARKIN
JOB ADDRESS: 437 NE 102
Contractor ROLLADEN INC
Local Phone: 954 - 454 - 4220
Parcel # 1132060170800
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2003 -1872
LARKIN
PAUL
ST
Contractor's Address: 550 ANSIN BLVD
Legal Description: MIAMI SHORES SEC 4 AMD PLAT
Page 1 of 1
Fees:
FEE2003 -7938
FEE2003 -7939
FEE2003 -7940
FEE2003 -7941
FEE2003 -7942
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Scanning Fee
Total Fees:
Amount
$115.00
$1.20
$0.40
$2.88
$3.00
$122.48
Total Fees: $12g�48��
Total Receipts: $0. 0
na ,
Permit Status: APPROVED Permit Expiration: 5/30/2004 Construction Value: $1,332.00
Work: INSTALL 8 OPENINGS REMOVABLE PANELS
PB 15 -14 LOTS 17 & 18 BLK 92
DEC 0 8 PAID L‘I\C)
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: