PL-07-74Permit N 1P 1 ) f —/ 7 4"
BUILDING _
,
PERMIT APPLICATION
FBC 2004
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder)
Owner's Address
City NMI
Tenant/Lessee Name
Contractor's Address
City kJ
Is Building Historically Designated YES
Qualifier Name
State Certificate or Registration No.
Architect/Engineer's Name (if applicable)
Value of Woik For this Per
Type of Work: ❑Addition
Describe Work:
Submittal Fee $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
State
V
❑Alteration
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit Fee $
Notary $ Training/Education Fee $
Scanning $ 500 Radon $
(A) V \i\JW Plumbing
lie NP
Job Address (where the work is being done) • , C t fre C l 1 Si kOlk, —&N. w N P C 1 1 � t�2
City Miami Shores Village
County Miami -Dade Zip
FOLIO / PARCEL #
Contractor's Company Name Phone # `30 7 17 8 3
� zip j3 /G
Phone # t G 7o l 7
Certificate of Competency No. ` 4
ono �� `9Ft fr :: W , t n
Sq re krinear".Footage-Of Wow'
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o o
DPBR $
Bond $ Code Enforcement $
Structural Review. $
Master Permit No.
Mechanical Roofing
Phone # '- tcj` c 2 Z — 1 - ) Iv
Zip 3 (e?
Phone #
iew
A 'r! . I AA-. • /.1Ag
AA4 a i ill a l
�►
❑ Repair/Replace
F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $ ✓ CO /CC
Technology Fee $ 130
Zoning $
Double Fee $
Total Fee Now Due $
See RCIAN T AI D
CAW
Imornewmi
JAN 1 7 2001 ID
❑ Demolition
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
Sign:
Print
Signature Signature
Owner or Agent
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this '
Y
da of
20 , day of 20 07 , by � 'I VS Veal ,
who is pepe s�known to me or who has produced who is ersonall known to me or who has produced
P Y p
NOTARY PUBLIC
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08106)
As ide 1 � l,anaw oltga4ItyEt
a° � • � `'� Ny Commission Expires Feb Florida 10 ors v Comm # DD 513850
" Bonded 8y Nattonat Notary Assn.
tic Gs &A t:o
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
as identification and who did take an oath.
,1�311f�e,� LUIS MONTERO
; 'r ° `� ; Notary Public - State of Florida
18'1. ' ` uiy Commission Expires Feb 2, 2010
ms s,• Commission # DD 513850
s,51 �n;,,: Bonded By National Notary Assn.
g-
*** ********************** * *********1* * ** *,r * *, * * *, *, ,r:,r * *, , ****, *, * *, ** * * * * * * * *, **, , * * *,r ***** * **,r**,r * *** * **
Plans Examiner
Engineer
Zoning
Return to:
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
'Bill To'
JAMES AND JACQUELINE BAES
941 NE 91 TERR
MIAMI SHORES, FL 33138 -3219
Date
..............
Fee Name
Wednesday, February 11, 2009
02/11/2009 Expired Permit Renewal Fee
Invoice
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Invoice Number: PL -2-09 -33942
Invoice Date: February 11, 2009
Permit Number: PL- 1 -07 -74
Bond Number:
Comments:
Fee Type
Calculated
Total Fees Due:
Fee Amount
$160.00
$160.00
Payments
Date Pay Type Check Number Amount Paid Change
02/11/2009 Check 1115 $160.00 $0.00
Total Paid: $160.00
Total Due: $0.00
Date
Payment Type Check Number
Permit Number: PL- 1 -07 -74
Invoice Number: PL -1 -07 -27244
Applicant: JAMES AND JACQUELINE BAES
Company Name:
Owner Address:
941 NE 91 TERR
MIAMI SHORES, FL 33138
Job Address:
941 91 Terrace NE
Miami Shores Village, FL
Monday, January 22, 2007
01/22/2007 Money Order 6379
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Amount
$167.80
Change
$0.00
Total Payment: $167.80
Page 1 of 1
N
E
9TH
A
V
E
N
U
E
1. ALL CAS PIPELINE CONSTRUCTION TO FO1,1.OW TECO PEOPLES CAS STANDARDS.
2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND C00RDINATED WITH THE
APPROR/ATE C,OVERNMENTAI. ACENCY.
3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR
CONDITION. UNLESS OTHERWISE SPECIFIED.
ATLAS
M3
SCALE:
NTS
DRAWN BY:
LM
NE 9151 TERRAC
�I kr) r r
CONSRUCTION NOTES:
NEW 3/4" PLASTIC
•
NEW RISER
N, R/W
SCALE GRASS
E.O.P
VEW 3/4" PLASTIC GAS SERVICE
941 NE 91ST TERRACE. MIAMI SHORES
•
•
.... .. •
• • • • •
0000 • ..
2" BSE CAS MAIN
SWAT ' GRASS
S. R/W
... •
• •
• • ..
• • •
.. • •
•
48 HOURS BEFORE DIGGING
CALL SUNSHINE 1- 800 - 432 -4770
SHEET:
1/1
J0 i 7420
•
• •
.. • • • •
.. .. • ..
•
•
• • . ▪ •
• 0000
• • ..
..
•
•000
• 000 •
DATE:
1/13/07
N
E
9TH
A
V
E
N
U
E
I. ALL CAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES CAS STANDARDS.
2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH THE
APPRORIATE GOVERNMENTAL AGENCY,
3. ALL D!STRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR
CONDITION. UNLESS OTHERWISE SPECIFIED.
ATLAS
M3
SCALE:
NTS
RA WN .B Y:
LM
CONSRUCTION NOTES:
GATE
NE 91,7 TERRA C,
r co - F
NEW RISER
NEW 3/4" PLASTIC
N, R/W
SWALE GRASS
E.O.P
(9 41)
2 2" BSE CAS MAIN
SWAIf
S. R/W
EW 3/4" PLASTIC GAS SERVICE
941 NE 91ST TERRACE. MIAMI SHORES
• •
• • ••••
• • • •
•• • • • •
•
•
•
•
•••• •• •
• • • • •
• • ••
•
••
• • • • •
•• •• • ••
•
• •
• • • • • • ••••
• •
• • •
• • •
•• • ••• •
48 HOURS BEFORE DIGGING
CALL SUNSHINE 1- 800 - 432 -4770
DATE:
1/13/07
SHEET:
1/1
.lot 7420
• •
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Issue Date: 1/18/2007 Expires: 07/17/2007
Owner's Name: JAMES AND JACQUELINE BAES
Permit Type: Plumbing - Residential
Work Classification: Gas
Job Address: 941 91 Terrace NE
Additional Information
Miami Shores Village, FL
Permit
Contractor(s)
TECO PEOPLES GAS SYSTEM
Phone
(305)957 - 3857
Primary Contractor
Yes
Type of Work: PLUMBING
Additional Info: GAS
Classification: Residential
Type of Piping:
Bond Retum :
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 responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Building Department File Copy
Applicant Signature
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PL- 1 -07 -74
Phone: (305)762 -6122
1132060030050
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 600.00
Required Inspections
Press Test
ROW
Final
Y
Fees Due
CCF
Education Surcharge
Permit Fee - New Construction
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$160.00
$3.00
$4.00
$167.80
Invoice Number
PL - 1 - 07 - 27244
Total:
Amt Due
$167.80
IAN 2 2PPAID
Amt Paid
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.