RC-11-9644( AAA,
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: BUILDING
OWNER: Name (Fee Simple Title lde U/(93
Address: /0 ( 30 s /44Q1-C)') / e726,62.-e
v a s
IMCMEMElif
JAN i s zun
BY:
City: ,(, yl 1 s� l.C�� State:
Tenant/Lessee Tam:'
Email: c 2 e l d ��Y ✓� .
se•
Co 971 7q z
r-
Zip: 4sy
Phone #:
City: Miami Shores 'IL ' County: Miami Dade
Folio/Parcel #: // � I f OD&
Is the Building
City: ILL. -'�iI/ , State: Zip: 3/ 29'
Qualifier Name: (/ ( _
State Certification or Registration; #: Certificate of Competency #:
Contact Phone #:
DESIGNER: Architect/Engineer: Phone #:
ac- 6sao V5 3
Email Address:
Value of Work for this Permit $ 2/ Oe Square/Linear Foyage of Work: 1 0 G- UnaN £4
Type of Work: OAddress �� �DAlter.1tom S i ❑New ���� Rrpair/Replace ,,,\ ❑Demoliti ®on
Description of Work: ='�� ' �< 1r e7, -t C�/�.Lzri r ' .i/ >` t./ ,
lu
dp !di
r
COLOR TH e ROOF TILE IS REQUIRED acknowledged by:
**** aye * ***** * *** ** ** ** xp****4**** eee * *eFees******** *** * * **** * ******* ***** * ****a ***axe **
Submittal Fee $ Permit Fee $ /�i dd CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ i, Training/Education Fee $ Technology Fee $
Double Fee $ - Structural Review $
TOTAL FEE NOW DUE $
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
uo277gag-r Gue
v14- Zip 23J"5- GO((,e
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signa re J,
Owner or Agent
Contractor
The foregoing instrument was acknowledged before me this _II''7 The foregoing instrument was acknowledged before !f. this
day of .3cL1i- , 20 11 A , by t � U Idlte 7 - - 7 - - L day of J (LO , 20 11 , by a
who is personally known to me or who has prod, a' who is personally known to. 4 d
As identification . , . w •' a .3: -, a an oath. 4, \ Sj 1 At .4c• -•' .rid who did take an oath.
NOT '' PUBLIC: al' �
; rg�
ARLETTE TEJEDA Vr
- - _ / ,
% , }Si_ if , � � MY COMMIS910N # 00873349
arch 30.26i$n: 111,1 1.E . �
x-
,
Print Idle-- eryservs. , n
ETTE 'JEDA
ON # 00875549
My Co
APPROVED BY
xpires: My Commission Expires:
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/l0)
Plans Examiner
Zoning
Structural Review Clerk
Permit No: 11 -96
Job Name:
January 21, 2011
Miami Shores Vivage
Building Department
Building Critique Sheet
1) Provide plan showing locations and square footage of repairs.
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 - 795 -2204
Swimming Pool .
22,001.
22ft.
Family
Study
Bedroom
Dining
F/P
Living
Covered En + 3
13.SXio
09x
ores Village v 8
APPROVED BY DATE"
ZONING DEPT
StJI H CT [0 COMPLIANCE WITH ALL FEDERAL
STATI= AND COUNTY RULES AND REGULATIONS
Subject Damage
10130 N Miami Ave
Sales Price $201,394
Gross Living Area 1,842 •
Total Rooms 6
Total Bedrooms 2
Total Bathrooms 1
Location TRAFFIC
View RESIDENTIAL
Site 14,400 Sq.Ft.
Quality CBS /AVG
Age 72 YEARS
Subject Damage
f2 oia(
/di S-774--(C.C- 0
Subject Damage
Subject Damage
10130 N Miami Ave
Sales Price $201,394
Gross Living Area 1,842
Total Rooms 6
Total Bedrooms 2
Total Bathrooms 1
Location TRAFFIC
View RESIDENTIAL
Site 14,400 Sq.Ft.
Quality CBS /AVG
Age 72 YEARS
Subject Damage