The URL can be used to link to this page

EL-09-812 � �i/ nrfiir d 9 i s t Miami Shores Village 10050 N.E. 2nd Avenue � Miami Shores, FL 33138 -0000 d // assn `�ti :saws Phone: (305)795 -2204 s� ��, OR s Expiration: 11!10120 Project Address Parcel Number Applicant 500 GRAND CONCOURSE 1132060171440 PATRICK PENKWITT RAiami Shores, FL 33138 -2465 Block: Lot: Owner Information Address _ Phone Cell }` PATRICK PENKWITT 500 GARND CONCOURSE MIAMI SHORES FL 33138 -2465 Contractor(s) Phone Cell Phone LValuation: $ 260.00 JAFE CONTRACTING CO (954)921 -6360 Sq Feet: 0 Type of Work: PHONE, CABLE TV Available Inspections: Additional Info: Inspection Type: Classification: Residential Underground Rough Final Meter Box Alteration Relocation Fire Alarm Service Change W. W. Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $0.60 EL -5-09 -34815 $ 50.00 $ 50.00 $ 0.00 Education Surcharge $0.20 Permit Fee - Additions /Alterations $100.00 Scanning Fee $3.00 EL - 5 - 09 - 34828 $ 56.30 $ 56.30 Submittal Fee $50.00 $ O.00 Submittal Reversal Fee ($50.00) Check #: 5540 Technology Fee $2.50 Total: $106.30 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. May 19, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Mav 19, 2009 1 Miami Shores Village RE Gov Building Department MA 13 tuns 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING G Permit No. EL 01—V2, PERMIT APPLICATION Master Permit No.p —0,- --2�t0 4- FBC 200% Permit Type Electrical Owner's Name (Fee Simple Titleholder) CK VkWW1 Phone # � v Owner's Address �f� (�'Yjj`�YV�.� City 46 (� State Zip Tenant /Lessee Name Phone # E -MAIL: Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # ( 4 72.0 � (977 t V-. 60 Is Building Historically Designated YES NO Contractor's Company Name , 4 /C C4 w ro Phone # Pet Q Contractor''s Address y d /V City A // tN 0 a/ State Zip C52A Qualifier Name ✓'I f✓p Phone # Qj y State Certificate or Registration No. I © ?-S Certificate of Competency No. ®.S C E -MAIL: ©-C ec) 0 /170 Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ ..2 5 _ OZ) Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration [3<ew ❑ Repair/Replace !❑ Demolition Describe Work: _ ZMA-) — �/b J —f k a Gam' ��otJL-E /f i�cQ C&(b1&r V Fees%XY% Y%Y.%%%% XXiC%% 9: X%% % %Y]C % %XT' %'K % % % % %X�: % %�C % % %it V Submittal ee $ Permit Fee $ /o >G CCF $ CO /CC Notary $ Training /Education .Fee $ b.Z, 6 Technology Fee $ _ 90 Scanning $ ,X Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 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 Signature ner or Ag t Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this]-2-fl— day of , 20�, by r%A Y � 4 day of > 20 , by [� who i sonalt kno to me or who has produced w is personal] know me or who has produce As identi r�+EitleF ication and who did take an oath. Kathryn Anne Blakeman NOTARY PUBLIC: Commission # DD495143 NOTARY PUB Imo" °°•� Notary Public State of Florida Expires. NOV. 30 , 2009 . Sharon L Furtado Ronde . , Ate c Bonding 2 Inc. ` My Commission DD516594 OF a°"� 'res 02 I20 0 Sign: -s7 Sign: , Print: Print: / [� My Commission Expires: ��'� My Commission Expires: r.'; cxr,xrr.r.xa:x9:i:xxcx xi t r'.ati: cxxxi:i:x,Fr. xicx *aY aY Fxat i:acrzx�ic *�x� * *�xic ix r. die aYx *xxx>; icxrxxF xict xx9: icxc i:4: xac i:xxxi:i >: r. xet r,xr. i:xr. : r, a: ': APPLICATION APPROVED BY. Plans Examiner Engineer Zoning (Revised 02 /08/06)