ACT-11-981fI-
BUILDING
PERMIT APP
FBC 20
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Per DING ROOFING
0 : Name (Fee Simple Titleholder): Mk.R C
Address: 150 pi I o ( 5
City: M twit 51-coil-VS
Tenant/Lessee Name:
Email:
.1 w RMI
Permit No. NTT
Master Permit No.
75-277 -gSTS
JOB ADDRESS: 15° w l 0 1 51--
City: Miami Shores County:
Folio/Parcel #: 11 ' 3) ®► s 02-3 - b t i O
Miami Dade
Zip:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name:
3o Address: s
City: 1 °
—
Qualifier Name: ,�LP9N� 4-5111.L4+ ��PP r'
State Certification or Registration #: C� _ —lCP SID Certificate of Competency #:
Contact Phone #: 5 -T? 1 ' 3 � 5. email Address: p:)1
1•1c.4 b J ( L �� z--
DESIGNER: Architect/Engi 1 14eek. 12 Lcc._ Phone #: " bsi • 171 • 24429
Value of Wo , a 5ti , _` t: $ R°0°)----
° 0 Square/Linear Footage of Work: 6t 1
Type o. "+ r *1 .'addition ❑Alteration i iew ❑Repair/Replace ❑Demolition
D:escrip of Work: t S TULA— CW U 6'j N 1A) G
Phone #: 3)54'
State:
''i3 Z
Phone #: 3) S qcsi�
Submittal Fee $
Scanning Fee $
Notary $
Permit Fee $ CCF $ CO /CC $
Radon Fee $ DBPR $ Bond $
Training/Education Fee $ Technology Fee $
Double Fe-e-1 Structural Review $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable) /p
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) r k
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 notic' o commencement and construction lien law brochure will be delivered to the person
whose property is subject to aftachnzent. Als . a Certified copy of the recorded notice of commencement must be posted at the job site
for the first inspect' n 1i'�h occurs seve �(7) d ys after the building permit is issued. In the absence of such posted notice, the
inspection will no b; # q,4 ved and a rein/ ecti4 ; fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of in (
20 IA., by ncf'' j ,4 c - , day of 20 t , by
Signature
Contractor
The foregoing instrument was acknowled ed before me this g
who is personally known to me or who has produced' r. ►1r. (..'-'who is pe
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Ex
onally known to ' or who has produced
NOTA
Sign:
Print:
My Commi. sion Expires:
identification and who did take an oath.
BLIC:
,, { cry, MYRDIESPLUMMER
<•. .+r_ MYCOMMISSION #DD's:
�- ' EXPIRES: May 16, 2013
'1 �� " I liii'' Sandedmru Nob�ry PubUC Undenttlters
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
6 -28 -11
1730 Biscayne Blvd. Suite 201 H / Miami / Florida / 33132
PHONE: 305 - 694-2044 / FAX 305 -402 -2255
Email: PoincianaOodaroup.biz
CGC 049650
Re: Permit Application
150 NW 101 Street
Miami Shores, F133138
Dear Building Official,
Please cancel our permit application for the awning at the above mentioned address. Due to the
3' setback requirements, the Owner Mark Cicale does not feel it is worth putting up such a small
awning.
Respectfully
Daryl C
Director of Business Development.
Miami Shores Vivage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT W.) ,O b DATE: Act" (I — c1 6 1
contractor
❑ Owner
❑ Architect
Picked up 2 sets of plans and (other)
Address:
100 uD 101,c,;-)-
From the building department on this date in order to have corrections done to plans
And /or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Departme continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
:may
RESUBMITTED DATE:
PERMIT CLERK INITIAL: