CC-11-959Miami Shores Village
0/24 12_ mickeite 3 11,.1% st-)(1 Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
1) �ry�� 4 2 — 1 ' "AIMti Tel: (305) 795.2204 Fax: (305) 756.8972
4 '-2 INSPECTION'S PHONE NUMBER (305) 762.4949
Permit No.
Master Permit No&,( (1- 'x%0_32
B ING *A
PE ICA►TION
FBC
RECENED
APFt 1x2012
Permit Type: BUILDING `' ?
OWNER: Name (Fee Simple Titleholder): �(� `��� Phone#: 3 !7 ? 37� %
Address:
City:
State: T ( Zip: 33 ( 3
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 452)1 "4.52K-/K 6 Z44
City: Miami Shores County: Miami Dade
Folio/Parcel #: 11-324 43 -6t3"' 3g6C
Is the Building Historically Designated: Yes NO Flood Zone:
Zip: 3313+
CONTRACTOR: Company Name:
Address: c? Z ((€2"1- S'1i�.:e67'� etatrE 21
City: /g'i%/l i State: Fr
Qualifier Name: 1 - Fi*(Ee
State Certification or Registration #: ,rc 7337 Certificate of Competency #: , ,, ,/1
Contact Phone#: 7510"' 28 Email Address: �v rexesv2e e-iiE�► L con
DESIGNER Architect/Engineer:
/� �f G�P LL- Phone#: 3D4' r 7c4 ''..Z3/8.
Value of Work for this Permit: $ / Square/Linear Footage of Work: _
Type of Work: °Address °Alteration °New °Repair/Replace
Description of Work: c cow C (- ,'f"
Zip: g3/ 7Q
Phone#:
°Demolition
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
Submittal Fee $
Ai
Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ `'i: ( - J l/
R
1?tanding 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 pennit 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 WITII 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspe n fee will be charged.
Owner or Ag ' .Contra r
The foregoing instrument was acknowledged before me this -1 tb'' The foregoing instrument was acknowledg,
day of jix,■\_, 20 R, by ,., :r >r fir r day of 1 20a, by
who is personally known to me or who has produced who is nee send] 1_ noun, tome or who has p ude
>,I•t-
NOTARY Pi`) 1 y1Y COMI SSiO19 DO 911207
`• �' EXPIRES: July 27, 2013
j If ' Rotel��
Sign. L ,i ,
Print %i a
take an oath.
My Commission Expires:'?) laor5
My Commission Expires: -7
**$, , , , *** * *,a,t * *, ** r * **** **.* ** * * **** **,, *** «, * * ***** ******,e *** ** r** + ***
APPROVED BY
Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /12/2012XReviscd 07 /10/07)(Revised 06/10/2009XRevised 3/15/09)
a °
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Miami Shores
Viiiage
Building Department
RECEIPT
PERMIT DATE:
I,
o Contractor
o Owner
Architect
Picked up 2 sets of plans and (other)
Address: q S-0 (
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
From the building department on this date in order to have corrections done to plans
And /or get Coun mps.1 u erstand that the plans need to be brought back to Miami
Shores V' age Building Depart ent to continue rmitting process.
Acknowledge
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
PERMIT CLERK INITIAL:
Permit No: 12 -959
Job Name:
April 23, 2012
Miami Shores Village
Building Department
Building Critique Sheet DEMO REV
1) Provide approval from Miami Dade Fire.
2) Provide approval from Miami Dade County DERM.
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Norman Bruhn CBO
305 - 762 -4859
3— A34 9,5)5