The URL can be used to link to this page

DEMO-11-960Miami Shores Village Building Department 10050 N.E.2nd Avenue, Muni Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1NSPLCTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: ROOFING OWNER: N`ame S le Titleholder): (`�1 Address: "t • ' ( ■ CWQ. City: Miar61 State: VL Zip: l3� Tenant/Lessee Name: Phone#: Email: AUG 1 7 2011 Permit No. Master Permit No '160 Phone#: 205 -156-3111 JOB ADDRESS: (1501- q5L5 N . G-. City: Mani Shores County: Miami Dade Folio/Parcel#: \ \SOS 0 \ Y OO Is the Building Historically Designated: Yes NO / CONTRACTOR: Company Name: Address: \ Y f �. City: ISA (`A(YM\ Zip: :33134 Flood Zone: !�", °J Phone#: �.r. " M r state: V L Qualifier Name: \ Y''1 ciPkfr State Certification or Registration #: O Contact Phone#:9(b - ?,1,.1© -454+ 'S Email Address: DESIGNER: Architect/Engineer: M(IN aiYi��, T \ Value of Work for this Permit: I (90 Type of Work: DAddition Cl/kite/anon AI, x:11' Ellx 33110 Phone#: nos-'lgto -1$00 of Competency #: AIIr.. .r• As i.Vill• •1g Phone#: SO &--)6(4 -Q3 5 5os S2-- °3 °37 $ Square/Linear Footage of Work: ONew LlRepair/Replace Description of Work: p Y1. Si 0 a 0✓e., 0 aL f /CC. c t L,(. _ rn9et. U"_ twee ) c--- • r 1 L Y . • Bondi Company's Name (if applicable) Bonding Company's Address City State Zap Mortgage Lendei*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, BEATERS, 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 %v r a,S= , ed"and riei zspection fee will be charged was acknowledged before me this The foregoing instrument was acknowledged before me �thnis,5� 20 -V� by 6 d� t sE reS �c cc r''1 a , day of 2(i , by qe y known to meter who has produced who is y known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign Print: ******** APPROVED BY .A G 5: ) : IL Plans Examiner rah a My Commission Expires NOTARY Ptt111,1e4Tt OP FLORIDA Yaniv Offr COMMISSIOD #DD795680 ° Expires: AUG. 22, 2012 :O .gr Zoning Structural Review Clerk (Revised 07 /10i07)(Revised 06!1012009)(Revised 3/15109)