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RC-10-14941c1/1A- Z.0 t Of, RC- - 1 6 - to h ex (-- . 1-(1',' wrQrv) tj° e- -11X11`- .f-Afc. )),Ott dka kU \V S \ eA\ eX e E r.,,,,,„, c„, k- A 25?-0 NE / tta frHNn Pc ecy) 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 BUILDING PERMIT APPLICATION L AUG 2 0 2010 , 4 BY:. V �„•� Permit No. c Master Permit No. FBC 20 Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) . 'OAS 4`(\ 6 • QreiFs-- Phone # 009 11Sg— Owner's Address 230 N E ten 'II^ ST-- City Vl.z NA 4,O(C S State -I' Zip 33 i if, Phone #. Tenant/Lessee Name Email a Job Address (where the work is beings ne): City Miami Shores Village,-�.:''' County Miami -Dade Zip )` 1 j 6 c Gtr FOLIO / PARCEL Is Building , Historically Desigiiated., YES Contractor's Company Name ''D Yv� e ou.) N e NO Contractor's Address Flood Zan Phone # 9 City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # 500 .50 `I- � Value of Work For this Permit $ Square / Linear Footage Of Work: © Type of Work: GAddition . ❑Alteration GNew 12 ( Repair/Replace Describe Work; Q \0.01_ )6 le \ooC5 , c4r,j- &.&.k 4.f Ore-A" Vs/ y6,.( ‘jow0( '\;ork 0 Demolition *******; * * * * * * * * * * ** * * * * ** ** * * * * * ** * * ** Fees**** e********* * * * *.** * * * * * *x * * * * * ** * * * * * * * * ** Submittal Fee $ Permit Fee $ ore- Master , CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 56-s(:) See Reverse 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. 1 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 relating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO ` RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PASO .'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 pptlicant As a condition to the issuance of a, building permit with an estimated value exceeding $2500, the applicant .mutt promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment.' Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the . inspection will not be approves% / a reinspection fee will be charged. Signature: Owner or Agent The for going ins day of ,20 Z: bt nt f ss.. • wledged b tire' R his ,C by JUI ter, who i per u ally known to me or who has produced dentiflcation: and ''who did take an oath. 1I i )O. NOT °Y Sign: Print: UBLIC ",1 My Commission Expires: * 'i **'X * ignature The foregoing ins day of Contractor ment was acknowledged before me this 20_,by who is personally known to me or who has produced as identification and who did take an oath NOTARY PUBLIC; Sign: Print. My Commission Expir [k 4r'k** * :+CiSt�Y3r5i'3r*yF 7k *Y'(*** APPROVED BY '�- �``+�t!°�► Plan's Examiner Engineer is 0 *7 /i{Ji07X1tevised 06/10/2009) Clerk checke Miami Shores Village a m v Building Department AUG 2 0 2010 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 BY: .... Permit No. tJ f —14C% Master Permit No. jG I --1414 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) N1atr' n (• QreYr• Phone # (' oS) 'S$ - S -113 Owner's Address 2Yr° 14. E . lot-11'` ST' City '6'kiZ care S state- - Tenant/Lessee Name tit\ Email Mte61/40 e_ 2'i'r. "e Job Address (where the work is4ie}`done) SC Me QS City Miami ShoreA a County FOLIO / PARCEL # �) � ZL3I — (2)1. — O LIG° Zip 331 b Phone # tlxzve Miami -Dade Zip Is Building Historically Designated YES Contractor's Comp wry Naine Contractor's Address'-- NO Flood Zone No MeowINa Phone #' City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone Architect/Engineer's Name (if applicable) Value of Work For this Permit Type of Work: Describe Work: ❑Addition E -mail Phone # %iii,, /500 ❑Alteration Firs Square / Linear Foota a Of Work: ± boo ONew air Repair/Replace 0 Demolition 7' * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 4,4"—a ` ® CCF $ CO /CC $ Notary $ > Training/Education Fee $ I �l Scanning $ 1- J Radon $ DPBR $ Double Fee $ Violation date: (`� Structural Review. $ Total Fee Now Due $ 106 40 Technology Fee $ Bond $ See Reverse 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 re- inspection fee will be charged. Signatur The fo day o who is Owner or Agent egoing trument was 2010,by er nally known to me or w ei o w le d ge 0 NOT Sign: Print: 'liejor this ALAAP c2 rOw i. i as identifiti<n- nd oduced /L who did take an oath. Y ' UBLIC: iI� My Commission Expires: * * * * * * * * * * * * * * * * ** APPROVED BY „0K't!e 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: f.. Sign: Print: My Commission Expires: ***** * * * * * * * * * * * * * * * * ******** ******* ************ ** ****** * * ********************* s)1;24' Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Owner's Name (Fee Simple Titleholder) Owner's Address City TV-C V.)- pg1711v35 AUG 2 0 MO TI BY:...Y,..,,.da"..ua.."' Permit No:0 10-" VP5 Master Permit No .PC 0- 141+ \tatki n 6 • Vet Phone # (s' Lk - S-1 413 no 0.S. 1601" Si Sole) State — Zip \ to 1 Tenant/Lessee Name Email (N\yie.to d� 2 . Job Address (where the work is be City Miami Shores V' FOLIO / PARCEL # Is Building Historically De Contractor's Company ..T Contractor's Address' City d Phone # done) Z IA/IL AC Z Y V C, County Miami -Dade 013- 0420 YES NO 40 M.e. cc YIP-( Zone f4 0 Phone # Qualifier Name State ,'Phonp # State Certificate orRegistration No Certificate or Competency No Contact Phone Architect/Engineer's Name (if applicable) Value of Work For this Permit $ E -mail Type of Work: ❑Addition ['Alteration Describe Work: A/2.1 %JQ,( rv\ Phone # Square / Linear Footage Of Work: -� /00 [New I epair/Replace ❑ Demolition *,� r **** ees *+ Submittal Fee $ 'Perm t Fee $ Notary $ Scanning $ Raa on $ Double Fee $ 10'® Training/Education Fee $ Structural Review. $ CCF $ CO /CC $ DPBR $ Violation date: Technology Fee $ Bond $ Total Fee Now Due $ 10S(0E) • See Reverse 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 MR 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 The foregoing ins day of who is p �� /•. vas produced &on and who did take an oath. Signature Contractor The foregoing instrument was acknowledged before me this day of ,20,by ho is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOT Sign: Print: My Commission Expires: ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY 47,100 °cau®0 . ****************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Sign: Print: My Commission Expires: Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009)