PL-06-160Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATIO
FBC 2001
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder)
Owner's Address
Permit No. / P1-0&' - 1 ;O
Master Permit No.
Electrical
(- -t 5 fL_..
p 0 C_ u Phone # 3 07c
Mechanical Roofing
City M4 State
Tenant/Lessee Name
Zip ?3
Phone #
Job Address (where the work is being done) t ¢9--,* eV 6 S' r%
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name -6 /1 Phone # 3 0 s u-
Contractor's Address 5
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
Phone #
Square Footage Of Work:
Type of Work: ['Addition DAlteration DNew ❑ ' eplace ❑ Demolition
Describe Work:
r if
* * * * * * * * * * * * * * * * * **
* ** Fees* * * * * * * * * * * * * * * * * * * * * * * *** * * **
Submittal Fee $ Permit Fee $ CCF $ 0 • bQ CO /CC.
,,FF��
Notary $ r--' 0 (0 Training/Education Fee $ '0.2 C) Technology Fee $ 4.00
Scanning $3:00 Radon $ Bond $
Zoning
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
L_ Agent
The fore oing instrument was acknowledged before(( ethi �18
day of j) () , 2006 by ud (1 (7Je!k
who is personally own to me or who has produced
NOTARY
As identification and who did take gg oath.
Iiabek•19S:
00
Sign: t'
Print:
My Commission Exp
* * * * * * * * * * * * * * * * * **
************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
chc 05 /13103
,Co -,1s�6
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:
Print:
My Commission Expires:
********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
/ ~/
017ans Examiner
Engineer
Zoning
I t-- D-7 - ® 7
0-t( t-}-Q re-- V 1 L
(-o 1)-1 'L. [ s 0-7 L
cs &J t i'( �. W
MMOMEWMI
NOV 2 7 .2007 ,
BY:
t l S 1 i P-t E.
c-#v CGr'L_L_c / G- —Fats Tz- 1cTP
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Hit Pss o—c. L. S N-ta (Z s (5-1 ,o ee
INSPECTION RECORD
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
INSPECTION REQUESTS: (305)795 -2204
REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY.
POST ON SITE
Permit NO. PL -1 -06 -160
(
Issue Date: 1/19/2006
Plumbing - Residential
Parcel #1132060142110
Owner's Name: LOIS BUTLER
Job Address: 700 96 Street NE
Miami Shores Village, FL
Contractortsl
HOME OWNER
Phone
Primary Contractor
Yes
Owner's Phone: (305)905 -5236
Total Square Feet: 0
Total Job Valuation: $ 200.00
WORK IS ALLOWED MONDAY THROUGH SATURDAY,
7:30AM - 6:OOPM. NO WORK IS ALLOWED ON
SUNDAY OR HOLIDAYS.
Inspection Scheduling Code
ins i t1on
Final
Underground Sprinkler
NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS
THE PERMIT APPLICANTS RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER
THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION.
IF YOU INTENT TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.