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RC-11-1731s •� B DING PERMIT APPLICATION 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 Permit No. aC Master Permit No. Permit • , BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): toemei ativondit Phone#: 30r' C27-/ A if? Address: /O647 ,Ro fl ✓F City: Pi I147441 S #0e65 Tenant/Lessee Name: Email. JOB ADDRESS: State: Pt /4- 6Wi /rrer M'#,1 0 0✓ y r- L97.1D/t1 City: Miami Shores Folio/Parcel #: /9 /0-18-31 Is the Building Historically Designated: Yes County: Zip: 33/31 Phone#: Dade Zip: 3?/3-0 1 n -# 1/- 3 /0/- c9 y.-0060 NO Flood Zone: AIA. CONTRACTOR: Company ' N e: l? ! / ? €.S Phone#: Address: 7030 N City: l`197t.° -44 State: 7e` ej%21 Zip: 6-30/3-' / Qualifier Name: �'d� (240 Phone#: State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: rods Value of Work for this Permit: $ Sgaareliinear Foo of Work:✓ Type of Work: ®Addition ®Alteration ®New 'epairlReplace ❑Dem9lition Description of Work: r. 1 T i e 4 e 1 R 1V O d . / -- A" F 4 F. Iit1nt,..&, -Fin" cup() Se tl1n9 �6)56iarj h � hfkle`' r0vjI1 kt tise ri A Am 1l rwesl- Side of gropers -y C55 no, /0- o1- 2$'Z`� . C4-sE- nO. Zro� -3&fZ Submittal Fee $ Permit Fee $ /YQ J CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ Bonding Company's Name (if applicable) Bonding Company's Address City State Tip 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 the absence of such posted notice, the inspection will not be apprd and a reinspection fee will be charged AAA Owner or Agent ' Contractor The foregoing instrument was acknowledged before me this Di The foregoing in •' • ent was acknowledged before me this 07 day of ,20 // ,by , day of ,20 / /,by who is personally known to me or who has produced who is • i . y known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: as identification and who did take an oath. NOTARY PUBLIC: Sign: Print My Co ***************************************************************************** * * * *** *** * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06/10i2009XRevised 3/15/09) NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SIiE AT TIME OF MST INSPECTION PERMIT NO. ' —113 TAX FOLIO NO. STATE OF FLORIDA: \ OF MIAMI -DADE! fi rope ,DERSIGNED hereby gives notice that improvements will be made to certain real '. and in accordance with Chapter 713, Florida Statutes, the following Information Orovided In this Notice of Commencement. 1111 1111 111 111111111111 111111111111 11 1111 CFI J 2011R0663379 OR Bk 27846 Ps 4759; (1pa): RECORDED 10/04f2011 10:21104 HARVEY RUVINr CLERK OF COURT 11IAIII -DADE COUNTY. FLORIDA LAST PAGE Space above reserved for use of recording office Legal description of property and street/address: IS)-- u) C M)E M ( IgYvi l l i ifet7 s f: "33 CS?) aDescription of improvement:0-0W Xti?,Gu4,1 (' -.2,i rs . Owner(s) name and address: Interest in property: eicy & Name and address of fee simple titleholder 'r 6 Contractor's name, address and phone number r S 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number. Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florid'; designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 71.3.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NeTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND T -' =AIN FINANCING, CONSULT WITH YOUR LENDER QR AN ATTORNEY BEFORE COMMENCING WORK OR RE • • IN is OUR N )11 Sig = rsofOwn Prepared By L)(�1^&e/Y Print Name Title/Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The 'foregoing instrument was By ❑ Individually, or la as MENCEMENT. er(s)' uporized Officer/Director/Partner/Manager "-c j 24 Prepared By Print Name Title/Office acknowledged before me this ay of r \‘‘11111111114/1/4 4/// for jersonaliy known, or U produced the following type of Identificati Signature of Notary Public: d Print Name: (SEAL) VERIFICATION PURSUANT TO SgcTION 92525JLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director /Partner/Mana By ORIDA, COUNTY OF DADE By FY that this is a true c y of the ice on da y of -- P D ZJ fie )r :V1TN 1ARVEY Cours D.C. CrX - -11*** z. o ;v 2' O -�un1n11111�∎∎∎ • er who signed above: ItO 11 Adithnivc. Permit No: 11 -1731 Job Name: Septen .ber 28, 2011 Miami Shores Viiiage Building Department Building Critique Sheet 1) Provide all permit applications prior to any further reviews. 2) Provide detailed scope of work on plans. 3) Correct permit application with value of work. 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 A0D SMOKE/CARBON MONOXIDE DETECTORS ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS TO BE REPLACED. NO POINT ALONG COUNTER TO BE MORE THAN ?FEET FROM G.E.I PROTECTED RECEPTACLE. PUT DIW RECEPTACLE UNDER SINK. ALL FIXED APPLIANCES ON DEDICATED CKTS. NO POINT ALONG COUNTER TO BE MORE THAN 2 FEET FROM G.FI PROTECTED RECEPTACLE PUT DbV RECEPTACLE UNDER SINK. AU. FIXED APPLIANCES ON DEDICATED CKTS. D SMOKE/CARBON MONOXIDE DETECTORS. ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS TO BE REPLACED. ••■•••••■•••" 3 Miami Shores Village APPROVED BY DATE ZONING DEPT MIN= WITH ALL RULES AND REGULATIONS FEDERAL BLDG DEPT ntlfilFCT TO COMPLIANCE 'TAT-F AND COUNTY q-;- 1/ cr/-7// —Zs Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 166871 Permit Number: RC -9 -11 -1731 Scheduled Inspection Date: November 21, 2011 Inspector: Bruhn, Norman Owner: SMITH, JEAN Job Address: 9826 NW 1 Avenue Miami Shores, FL Project: <NONE> Contractor: CONTINENTAL BUILDER Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1131010240060 Building Department Comments KITCHEN REMODEL; ELIMINATION ANDSEALING; DISCHARGING WATER THROUGH HOUSE PERTUDING THROUGH WALL WEST SIDE OF PROPERTY. Passed ,7,e/4 /4://, Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments November 18, 2011 For Inspections please call: (305)762 -4949 Page 43 of 47 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 165822 Permit Number: EL -10 -11 -1807 Scheduled Inspection Date: October 26, 2011 Inspector: Devaney, Michael Owner: SMITH, JEAN Job Address: 9826 NW 1 Avenue Miami Shores, FL Project: <NONE> Contractor: MEGA ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1131010240060 Phone: (305) 828 -5205 Building Department Comments KITCHEN RENOVATION SERVICE REPAIR 4 SMOKE/CABON DETECTORS. Passed C� Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 2/2 G KGs -C %%i October 25, 2011 For Inspections please call: (305)762 -4949 Page 27 of 33 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 No. L. — // — //a,7 Master Permit No. l" 17-72J, Permit Type: Electrical j� OWNER: pName (Fee Simple Titleholder): t I IYfl� fl6fle (,� i Phone #: 365 - i�Z ' - 1081 Address: /I (- /VW l dAI#_. City: 14I'4rr►i 5 he t 1Q�, State: - Zip: 33 (CO Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 9 82 (O /YIN 1 (WC . City: Miami Shores County: Miami Dade Zip: 3 Z k S Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company p Name:��2�d. 1. ..tr►C.- Phone #: 301 - 8Z$ - 5'7 OS Address: 2.s 2- (k/ ' t 0 d+1/€44 (ie.. City: tali "t'ili Ld State: P 1. Zip: 3301 Qualifier Name: +7'{7 h Ct+�$ e. i !d Phone#: 0V -5 Q s � S �dY •� 3 g Z$ ZtaS State Certification or Registration #: 6"C. - 0 08 J'9 Z$ Certificate of Competency #: Contact Phone#: 30C $LS - S'2 OS Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 1600 Square/Linear Fo age of Work: Type of Work: ❑Address DAlteration ONew CJRepair/Replace ODemolition Description of Work: 5 (.4- W t.2 f Qfdl r arta ;A. Stilt d 1 tuA OT '4 s i bk L d.ta. ms . add 'G�Tci►,a.v ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees ** * * * * * * * * * * * * * ********** *** *** * *e *** * * **** Submittal Fee $ Permit Fee $ /, ' i CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ • 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 FLF,CTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOTT,F,RS, 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 va promise in good faith that a copy of the notice of commencement and construction lien whose property is subject to attachment. Also, a certified copy of the recorded notice for the first inspection which occurs seven (7) days after the building permit is inspection will not be approved and a reinspection fee will be charged. The foregoing i O ' er or Age ment was acknowledged before me this day of .- e 20 t', by Q.,el 1 r'1,9 �o4o a4 who is personally known to me or who has produced 0-- t 1� As identification and who did take an oath. \�,onIto oo,,,,� NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY sal\a ..•�� 4)./ \ I oAl S `'��\ exceedin brochure will mmence nt m In the a' ence $2500, the applicant must delivered to the person be posted at the job site sucl posted notice, the Signature Contractor The foregoini. instrument was acknowledged before me this $ D day of 5ei , 20 li , by A.nSii Ct s 8$,- Gdiuitiex who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: yy Acosta M lln A '•ce C0MM1SSI0N #DD849375 /Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) �. ac Sign: V, "'..: cFxPIRFS: JAN. 05.201 °'+•,,m ° o Print: o WWW.AARONNOTARY.com My Commission Expires: Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 kt I 2dOl l �� INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. 17L.- 1(— 9 F1 PERMIT APPLICATION Master Permit No. 1,t - (3 t FBC 20 Permit Type: PLUMBING yy y� OWNER: Name (Fee Simple Titleholder): Nv! 10+1e,,. 1`'(endo2it "`67 ✓4N4ck hone #: ?0- C'S27- ltag Address: l 1)6 6 `1 di) & %ve 66 ( City: 1,A ( k State: 1 Zip: .1 ) Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: q 8 2-C iv k PTV 2 City: Miami Shores County: Miami Dade Zip: 33 1 SD Folio/Parcel #: Is the Building Historically Designated: Yes NO i./ Flood Zone: CONTRACTOR: Company Name: 14/ ‘4, , S® Phone #: 7 ?) -/ t i'/ `''7 Address: L/41 70 5"4/ 5 r City: ,/!// >4" ` State: Qualifier Name: ‘-"leg i Te" lv i v i) State Certification or Registration #: C f G / I/ 2. 63 X Certificate of Competency #: dr_�v//7 Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Zip: 3 5 / L/ Phone #: 3 QS '7- Value of Work for this Permit: $ Type ork ❑Address. Desert' n I f Wdi "f'" ' Square/Linear Fogt°age of Work: ONew fidRepair/R- dace S k ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ 0 (5)_1,41 Permit Fee $ /C'Q CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ 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 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 ours seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approv t1`�d a reinspection fee be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 01 The foregoing instrument was acknowledged before me this A 7 day of 1 // , 20// , by , day of �r"'D' , 20 // , by who is pe onally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: If /I' tmmpue 1 ;,,' , r ill (� Cam • ;1392 ' Bonded TMtr up *Ilona Wary Mw. ** ** * * * ** * * * *** * * * ** * ** * * *** * * * ** ****************************************** * ** * * * * *** * * ** * * * * ** * * * *** * * *** APPROVED BY g /0`17' -r /Plans Examiner Structural Review (Revised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTE MONROE STREET TALLAHASSEE FL 32399 -0783 NOVO, ROBERTO NOVO & SONST INCORPORATED MIAMI FL 33134 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better , For information about our services. please tog onto www.rnyfioridaficense.com.- There you can find more information about our divisions and the regulations that . impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficieethy-, Regulate Fairly, We constantly strive to serve you better so that you can serve your CustOmere. Thank you for doing business in Florida, and congratulatlans on your now license! DETACH HERE (850) 487 -1395 • STATE OF FLORMA Lt, DEPARTMENT OF BUSINESS Al PROFESSIONAL REGULATION CFC1426337 06/21/10 09048' CERTIFIED PLUMi3YN0 CONTRACT°: NOVO, ROBERTO NOVO & SONS INCORPORATED 1*• • CER1'XFX D ender the PraviriQns of Ch.‘ tetpiratiott date. AIM 31. 2012 _ 1006210C • 4.4 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L1006210 t)ATE CATCH NUME3Cf2 06 21/2010 090487585 CFC14 6337 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chaster 489 FS. Expiration date: AUG 31, 2012 NOVO; ROBERT° NOVO & SONS INCORPORATED 4470 SW 2 ST MIAMI FL 33134 CHARLIE CRIST GOVERNOR Z0 39t+d mica' AV AC pMrit IIDFr1 RV t MA/ CHARLIE LIEM INTERIM SECRETARY T 6T :TT TTOZ /0V0T i 030056 -6 HIM 30!lktt IC 447A SW 2 ST 33134 MIAMI THIS IS NOT A BILL — D4 NOT PA'( u POSTAGE PAM 11141111„ FL PINEfCNO =I RENEWAL STATEI►26337 83+0056 -6 Owe NOVO SONS INC 198 MIAs CONTRACTOR I�ORMt1.1 tsril is aiur * t- alum -00 1401Alt Ma' MiliMilleallifflimmEr MIMI UM nit ma wow ¢ COMM. ROA zwr 'vow= tt�s, ""t° Eliggewrmi 6009000 •00045.00 SEE Onim NOE E0 30Vd 00 NOT PQNWARD NOVO 0 SONS 1NC ROBERTO NOVO PRES 4470 SW 2 S7 MIAMI FL 33134 } sr}} si, �}' ss�t�. lts } }tt }ttlsst } }s }t }ttr }s }t }r } :} „tai }tt �Fi3i T 61:TT TTOZ /0Z /0T ktvADA Miami Shores Village \Buildin g Department artment 1 io9) c? 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit No. NOV 2 8 AN BY: LA • . Master Permit No. e "C Permit Type (circle): (Building Roofing Owner's Name (Fee Simple Titleholder) 6 ' -''1 den Ai Phone # (5L( 31 & ` P1' �d Owner's Address CI? tO 71,) LAJ ) / tl E City S�°°t �a 6'(' s state - L- Zip 3/ 5 c Tenant/Lessee Name Phone # Job Address (where the work is being done) 9 i We City Miami Shores Village County Miami -Dade Zip 3 3 /5-6 FOLIO /PARCEL# /i 3fc)? —b2y `—D® C. C>. Is Building Historically Designated YES NO 1_---"" Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Phone # Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ '') CUO Square / Linear Footage Of Work: Type of Work: ['Addition fl Iteration DNew Repair/Replace ❑ Demolition Describe Work: . * * * * * * * * * * * * * ** ** k* * * *t �: *********F„******************************************** Submittal Fee $ J- Permit FEe $ k ' y�� CCF $ 0 (00 CO /CC Notary $________ • Training/Education Fee $ 0 - I.:0 Technology Fee $ 5:1S S Scanning $ i0 'CO Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ // __ cc Structural Review. $ Total Fee Now Due $ ' l(S 'SS See Reverse side -* Bonding Company's Name Of 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 reinspection fee will be charged. Owner or Agen The fore :oin_ instrument was ac owl c)ged fore me this day of `�,'�'ir , 20Cn, by 3 , day of , 20_, by , who is person ly known to me or who has produced 'l ,,;;1 who is personally known to me or who has produced Ob —0-1 ti Sj As identification and who did t ti4,�. as identification and who did take an oath. c... • :0 s 4t. 0, � NOTARY PUBLIC: Signature Contractor The foregoing instrument was acknowledged before me this NOTARY PUBLIC: Sign: Print: My Commission Expires: Sign: My Commission Expires: * * * * * * * * * * * * ** :***********•x**** *** * ** **** * * * *a:*** * ****•x****** * ********** ****** * * * ** * *** ** **** ** ******* *** APPLICATION APPROVED BY: (Revised 07/10/07) ry l ✓ (7 Plans Examiner Engineer Zoning VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: S Jai f f JEA j" DATE: ADDRESS: q l&i I A ki crref 3 3) Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two - family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with- holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I hold title to the above property and I am planning on doing this construction Initial 2. I understand that as an owner - builder I must abide by all zoning ordinances and building regulations in effect at the time of permit application Initial 3. :I have an understanding of the 2004 FBC & FRC and understand that this department and its inspectors are there to help enforce and interpret the code. There is a copy of the code in this office for review. Initial 4. I understand that the building official and inspectors are not there to design, alter or give advice on how to meet code —. only if the structure meets the ininimum'code. Initial 5. I understand that as an owner - builder, that any contractor disputes with sub- contractors and myself must be handled in a civil court with the advice of an attorney. The department will not mitigate' any contract disputes. Initial 6. I understand that if I compensate any person or company for work performed they are required to have a business license in the county. If for any reason they do not posses a business license I will be responsible and liable for any wrong doing from this unlicensed company or person. Initial 7. I understand that if any person gets injured on my construction project—they are entitled to workmen's compensation. And if they do not posses a workmen's policy I could be held liable for all doctor and related cost which could include loss of wages during recovery from injury. Initial 8. I understand that under state and local laws I can not do any Electrical, Plumbing, Heating, Air & Roof work on my property with out first obtaining the proper permits by licensed contractors. Initial Was acknowledged before me this 1 day of t\IOV , 2001 By Sal -S,"-VV\ Produced there License or who was personally known to me or who has as identification. 'au at NOTARY IIC01YOF FLORIDA ° "....,, Claudia V. Cubillos �a. ; Commission SEP. 23, 2011 BONDED 7984 ATLANTIC BONDING CO., INC. 0 OOOOOO 000000 • • 00000 •.... • • ..... • • .•.••• • ..• *•• • 000000 o C5 • • • • • • • • • ....•. •• •• • •• • • • • • • • •.•.•. r• .••• • • • • ...... • • ...... • •. • • ••• • • • • 000000 • • 6 r► 2Y `1 J ce, NOV 2 8 2H7 � Miami Shores Village APPROVED BY DAIS ZONING DEPT ��// "'-��I WITH ALL RULES AND 7c.=n,'I ' EOERAL -!!„'c AI BLDG DEPT SUBJECT TO COMPLI'I�,CE STATE AND COUNTY • • OOOOOO •••• • ;-- .••• • • • • • • .... • • •• •• • OOOOOO ••• • •..... • .• . ••. • • ..... •••• • • •• OOOOOO OOOOOO ...... ... • . • • • • • .. • • ••• Oe 1' • • O o C �J7 ►�� art_3 L 3 1 i. .. • • • ••• • • • • 0•••o• • • • 0 • e 000000 •••• t • •0.000 • • •• •• • • ••• • • •i•0•• • • • •0.00• • •• 00.00 •••• •• • • • • ••0t• • • • • •• •••• 0000.• • 0000•• • 0 • • •••••. •0..0• 0000•• • •• •• • • • • • • • • • •••••• ••0••• Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 05/31/2008 Applicant 9826 NW 1 Avenue Miami Shores Village, FL 1131010240060 Block: Lot NADY ALPHONSE Owner Information Address Phone Cell NADY ALPHONSE 11020 NW 19 ST PEMBROKE PINES FL 33026 Valuation: Total Sq Feet $ 1,000.00 0 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN Stories: CABINETS Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $6.00 $3.75 $165.55 Available Inspections : In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit 1 assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhemiore, 1 authorize the above -named contractor to do the work stated. December 03, 2007 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date Monday, December 3, 2007 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 3313 8-0000 Phone: (305)795 -2204 Parcel Number Expiration: 05/31/2008 Applicant 9826 NW 1 Avenue Miami Shores Village, FL 1131010240060 Block: Lot: NADY ALPHONSE Owner Information Address Phone Cell NADY ALPHONSE 11020 NW 19 ST PEMBROKE PINES FL 33026 Valuation: Total Sq Feet: $ 1,000.00 0 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN Stories: CABINETS Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : ON gt Bathro Certifi t Additional Info: Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $6.00 $3.75 $165.55 Total Amt Paid I Amt Due $ 0.00 Payment Type: $ 0.00 $ 0.00 Available Inspections: Inspection Type: Drywall Final 1 Applicant Copy For Inspections, Requests must be received by NOTICE: In addition to the requirements of this permit, there may additional restrictions applicable to this property that may be found the public records of this county. Call (305) 795 -2204. 3 pm for following day inspections. be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER in GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Monday, December 3, 2007 2 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Protect Address 9826 NW 1 Avenue Miami Shores Village, FL Parcel Number Expiration: 05/31/2008 Applicant 1131010240060 Block: Lot: NADY ALPHONSE Owner Information Address Phone Cell NADY ALPHONSE 11020 NW 19 ST PEMBROKE PINES FL 33026 Contractor(s) HOME OWNER Phone Cell Phone Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN Stones: CABINETS Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Exterior. Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $6.00 $3.75 $165.55 Available Inspections; County Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Monday, December 3, 2007 3 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Project Address 9826 NW 1 Avenue Miami Shores Village, FL 1131010240060 Block: Lot: NADY ALPHONSE NADY ALPHONSE 11020 NW 19 ST PEMBROKE PINES FL 33026 Valuation: Total Sq Feet: $ 1,000.00 0 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN Stories: CABINETS Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : Occupancy: Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $6.00 $3.75 $165.55 Total Amt Paid I Amt Due $ 0.00 $ 0.00 Payment Type: $ 0.00 Available Inspections : Inspection Type: Drywall Final Finance Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Monday, December 3, 2007 4 INSPECTION RECORD Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 INSPECTION REQUESTS: (305)795 -2204 REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY. Permit NO. POST ON SITE C -11 -07 -2390 lal : ti+�n n Cab'. Issue Date: *3/2007 Residential Construction Expires: 05/31/2008 Parcel #:1131010240060 Owner's Name: NADY ALPHONSE Job Address: 9826 1 Avenue NW Miami Shores Village, FL Owner's Phone: Total Square Feet: Total JOb Valuation: 0 $ 1,000.00 Contractor(sl HOME OWNER Phone Primary Contracts r Yes WORK IS ALLOWED MONDAY THROUGH SATURDAY, 7 :30AM - 6:00PM.,NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. Inspection Scheduling Code ins �K R „ . Iomrlk ass Date Drywall Final I y ham: ® ■�Ti1fN ANN nr�a evr�:sr ok UI J�'1 AT TIME OF 1NS'FC TION NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS THE PERMIT APPLICANTS RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTENT TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. 5 0 Info: c) .., .. 0 • * • • • • • • •• • ,* • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • ••• • • • • • • • • 0 0 • • • • • • 4/00 • • • •• • too * • • • • • • • • • • • 0 • • • • • • * : • • • • s • • • • • • 0 • * • • • • • • • • . • so • - • • 0 • • • • . 4, o • • • (f cokteiu, e L./7e ft drovekre/p__ •=00e kee7-- AlIFfi 'e a p/zarr fr IIt ae,7- /7 7924, r Ale-04/%tv IMOMEIM NOV 2 2001 BY: 00//,:e/5•12--- .?"" E R P,,,1 T 77.4'-':: ' . 90— Miami Shores Village APPROVED BY DATE ZONING DEPT _ l i A I AWA r E WI FFI ALL RU1 FE AN7 • i'ff ., ' EDERAL BLDG DEPT SUBJECT TO COMPLIAN \ND COUNTY ,PL) olt_s eL ,33 73e, • • 1040 •• *• • • • • • 0 • • • •• ••• • O * - • • • • • 0 • 00141 • • • • •10 • • • • • • • • 1•0 • 1 • • I: e: • • • • • • • l* 1 • •• • • • ••0 •00 00 • • 0 • (4- P K-- • • • • • * • • 1S • • • • • • * • 0 1•46 •• • • • • 0•1 41. • \ \Gtserver \Gino Drawings \000 MISC (2) \61473.dwg, 8/7/2007 12:59:21 AM C/L NW 99TH STREET co 12.97' FOUND 1/2" I.P. NO I.D. 30' N is //.22.1' / / / // ai N LOT 15 BLOCK 1 j ONE STORY STRUCTURE g PLATTED LOT LINE 0 N. co N 0 SYMBOLS: (- X )METAL FENCE (- _ )OVERHEAD WIRES ( o ❑ )WOOD FENCE SCALE: 1 " =20' JOB NUMBER: 61473 DATE (DESCRIPTION 06 wo U o �9p j/ Z = 59• Ll.. z x . _____ x FOUND 1/2" I.P. NO I.D. in 45.5' A PORTION OF LOT 17 BLOCK 1 x otx 113.00 06/26/07 (FIELD LOCATION OF IMPROVEMENTS AC ADJ NB ASPH BCR BOW BM C CA C/L CB CBS CE CHATT CONC CM COL = AC = ADJACENT = AS BUILT = ASPHALT = BROWARD COUNTY RECORDS = BACK OF WALK = BENCHMARK = CALCULATED = CENTRAL ANGLE = CENTERLINE = CATCH BASIN = CONCRETE BLOCK WALL = CANAL EASEMENT = CHATTAHOOCHEE = CONCRETE = CONCRETE MONUMENT = COLUMN DE (D) E/P EL EOW EP ESMT FF FND INV IP IR L LAE LF LME = DRAINAGE EASEMENT = DEED = EDGE OF PAVEMENT = ELEVATION = EDGE OF WATER = EDGE OF PAVEMENT = EASEMENT = FINISHED FLOOR = FOUND = INVERT = IRON PIPE = IRON ROD = LENGTH = LIMITED ACCESS EASEMENT = LOWEST FLOOR = LAKE MAINTENANCE EASEMENT POB POC PRC PRM PT P/L R RGE. ROE RP RPN SEC S/W TOB TYP UE REMAINDER OF LOT 17 BLOCK 1 FOUND 1/2" I.P.. NO I.D. 30' = POINT OF BEGINNING = POINT OF COMMENCEMENT = POINT OF REVERSE CURVATURE = PERMANENT REFERENCE MONUMENT = POINT OF TANGENCY = PROPERTY LINE = RADIUS = RANGE = ROOF OVERHANG EASEMENT = RADIUS POINT = RIGHT OF WAY = SECTION = SIDEWALK = TOP OF BANK = TYPICAL = UTILITY EASEMENT M ME NGVD N/D N/G NR NTS N.T.T. ORB P PB PBCR PC PCC PCP PG. PI EASURED = AAINTENANCE EASEMENT = NATIONAL GEODETIC DATUM =NAIL AND DISC = NATURAL GROUND = NON RADIAL = NOT TO SCALE =NAIL AND TIN TAB = OFFICIAL RECORD BOOK =PLAT =PLAT BOOK =PALM BEACH COUNTY RECORDS =POINT OF CURVATURE =POINT OF COMPOUND CURVATURE = PERMANENT CONTROL POINT =PAGE = POINT OF INTERSECTION MAP OF BOUNDARY SURVEY LEGAL DESCRIPTION: LOT 16, AND THE NORTH 18.50 FEET OF LOT 17, BLOCK 1, BONMAR PARK, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 17, PAGE 11, OF THE PUBLIC RECORDS OF MIAMI COUNTY, FLORIDA. PROPERTY ADDRESS: 9826 NW 1ST AVENUE MIAMI, FLORIDA 33167 FLOOD DATA: ZONE: X COMMUNITY NUMBER: 120652 COMMUNITY NAME: VILLAGE OF MIAMI SHORES PANEL NUMBER: 0093J CERTIFICATIONS: 1) FREEDOM LAND TITLE AGENCY 2) JEAN SMITH 3) STEWART TITLE 4) CENTURY PACIFIC MORTGAGE, ITS SUCCESSORS AND /OR ASSIGNS AS THEIR INTEREST MAY APPEAR . GENERAL NOTES: 1. LEGAL DESCRIPTION FURNISHED BY CLIENT. NO SEARCH OF PUBLIC RECORDS WAS MADE BY THIS OFFICE. 2. ANY ELEVATIONS SHOWN HEREON ARE PER NGVD (NATIONAL GEODETIC VERTICAL DATUM) OF 1929. 3. NO EXCAVATIONS WERE PERFORMED AS TO DETERMINE UNDERGROUND ENCROACHMENTS. 4. DISTANCES AND ANGLES ARE FIELD MEASURED AND CORRESPOND WITH RECORD DATA UNLESS NOTED. 5. THIS SURVEY WAS PREPARED FOR CONVEYANCE, TITLE AND MORTGAGE FINANCING PURPOSES IT IS NOT INTENDED FOR CONSTRUCTION USE. PERMITTING FOR ADDITIONAL CONSTRUCTION ETC. MAY REQUIRE ADDITIONAL INFORMATION WHICH CAN BE OBTAINED FROM THIS OFFICE. 6. IN SOME INSTANCES, GRAPHIC REPRESENTATIONS HAVE BEEN EXAGGERATtD TO MORE CLEARLY ILLUSTRATE RELATIONSHIPS BETWEEN PHYSICAL IMPROVEMENTS AND /OR LOT LINES, IN ALL CASES, DIMENSIONS SHOWN SHALL CONTROL THE LOCATION OF THE IMPROVEMENTS OVER SCALED POSITIONS. 7. ADDITIONS OR DELETIONS TO THIS SURVEY MAP BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT THE WRITTEN CONSENT OF THE SIGNING PARTY OR PARTIES. (CHAPTER 61G17-6.003 OF THE FLORIDA ADMINISTRATIVE CODE PURSUANT TO SECTION 472.027 OF THE FLORIDA STATUTES) GT SURVEYING SERVICES, INC. 1860 OLD OKEECHOBEE ROAD SUITE NO. 501 WEST PALM BEACH FLORIDA 33409 OFFICE: 561 - 688 -0553 FAX: 561 -688 -9579 E -MAIL: gtmn2g @aol.corn I HEREBY CERTIFY THAT THIS SURVEY HAS BEEN PREPARED BY THE OFFICE SHOWN HEREON AND THAT I AM THE SURVEYOR OF RESPONSIBLE CHARGE FOR NONE OTHER THAN SAID OFFICE. ADDITIONALLY, THIS SURVEY MEETS AND /OR EXCEEDS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH IN CHAPTER 61 G17 -6 OF THE FLORIDA ADMINISTRATIVE CODE PURSUANT TO SECTION 472.027 OF THE FLO:: DA STAT . . S. SIGNED: GINO FUR 0 SUR YOR AND MAPPER FLORIDA ENSE ".:5044 FLORIDA CERTIFIC -TE OF AUTHORIZATION NO.: 6026 NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF THE FLORIDA LICENSED SURVEYOR/MAPPER NAMED ABOVE. ■ATk s %'CG, MC. Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33 138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATIO FBC 2004 Permit Type: Electrical �i / / Owner's Name (Fee Simple Titleholder) 5I1d J t ( r 10 ayt.) Phone 3 l , —$Lacsq Owner's Address e3 a 1l Citylm%cywr State f L Zip C�j 3 1 3 Tenant /Lessee Name Phone # E -MAIL: Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Permit No. 11-71'�2 -- Master Permit No. RU 1,- Z, -t° Is Building Historically Designated YES NO Contractor's Company Name `ilA 7,77 Phone # ? /6 747?-4- Contractor's Address -b G,J 13 3 )447-ii City / / ji ,1 State / aa. (ualifierName RiLZ ea� State Certificate 4 Registration No. tg 1'3GG1 ,4a sic, E- MAIL Zip 33147 Phone # Certificate of Competency No: eAr . / /g?Z qk Architect/Engineer's Name (if applicable) ,' Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ❑Addition ['Alteration ONew Lf Repair /Replace O Demolition Describe Work: / ******* * * * * * * * * * * * *.... * * * * * * * * * * * ** Fees** **Y*********'°' ti' tir'° '°'Y'°x /(',n,,��'Y ***************' *** Submittal Fee $ Permit Fee $ %4''me�p CCF $ 0' (/l_J coicc Notary $ Training /Education Fee $ 0- Technology Fee $ ° • S Scanning $ Radon $ DPBR $ Zoning $ Bond $ Structural Review. $ Code Enforcement $ Double Fee $ Total Fee Now Due $ See Reverse side -4 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Leader'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: 1 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 nd a reinspection, fee will be charged. Signature ��. Owner or. The foregoing instrument was acknowledged be ore me this 1,0 day of MW , 20 , by jai $'IfuTi who is personally known to me or who has produced rtb Le. (o 2.070 As identification and who did take an oath. NOTARY PUBLIC: My Commission Expires: Signature Contractor The foregoing instrument wasaacknpwtejlged before me thisZ$ day of �( SV , 206' , by 9tar )(,' � who is personally known to me or who has produced n. �dd LI6 S!? ' as identification and who did take an oath. NOTARY PUBLIC: tl�Z MpgS1CA�SS��p A83995 Sign: L j ", cl\,.. , M� C ®MM�Sactobet20,20 Print: mts \ 7,: My Commission Expi,� xle *xxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxxx x x xxxxxxx srxxxxxxxxxxxxx APPLICATION APPROVED BY: (Revised 02/08/06) 'YPlans Examiner Engineer Zoning Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 05/31/2008 Applicant 9826 NW 1 Avenue Miami Shores Village, FL 1131010240060 Block: Lot NADY ALPHONSE Owner Information Address Phone CeII NADY ALPHONSE 11020 NW 19 ST PEMBROKE PINES FL 33026 :��'°3�;;9D).h /iiiiu.�w kcCe.+�l0 / / / /� /d /�YUS`a11� .J :�/r/Gk .�.•iiin. Contractor(s) FELLO ELECTRIC INC Phone CeII Phone (786)290 -7576 Valuation: Total Sq Feet $ 1,000.00 0 Type of Work: ELECTRICAL Additional Info: KITCHEN CABINETS Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $3.00 $3.75 $162.55 Total Amt Paid I Amt Due $ 0.00 $ 0.00 Payment Type: $ 0.00 Available Inspections: Inspection Type: Final Relocation Service Change Meter Box Underground Rough Alteration Fire Alarm W. W. In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. December 03, 2007 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date Monday, December 3, 2007 1 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 9826 NW 1 Avenue Miami Shores Village, FL Owner Information Address 1131010240060 Block: Lot NADY ALPHONSE Phone Cell NADY ALPHONSE 11020 NW 19 ST PEMBROKE PINES FL 33026 Contractor(s) FELLO ELECTRIC INC Phone Cell Phone (786)290 -7576 Type of Work: ELECTRICAL Additional Info: KITCHEN CABINETS Classification: Residential THIS MUST 0 JO `,; iJ Ti E 3F INS!Ec 1 Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $3.00 $3.75 $162.55 Total 1 Amt Paid Amt Due $ 0.00 $ 0.00 Payment Type: $ 0.00 Available Inspections: Inspection Type: Final Relocation Service Change Meter Box Underground Rough Alteration Fire Alarm W. W. Applicant Copy For Inspections, Call (305) 795 -2204. Requests must be received by 3 pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT the public records of this county. DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Monday, December 3, 2007 2 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 05/31/2008 Applicant 9826 NW 1 Avenue Miami Shores Village, FL 1131010240060 Block: Lot NADY ALPHONSE Owner Information Address Phone CeII NADY ALPHONSE 11020 NW 19 ST PEMBROKE PINES FL 33026 Contractor(s) FELLO ELECTRIC INC Phone CeII Phone (786)290 -7576 Valuation: Total Sq Feet: $ 1,000.00 0 Type of Work: ELECTRICAL Additional Info: KITCHEN CABINETS Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $3.00 $3.75 $162.55 Available Inspections: Inspection Type: Final Relocation Service Change Meter Box Underground Rough Alteration Fire Alarm W. W. County Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Monday, December 3, 2007 3 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 05/31/2008 Applicant 9826 NW 1 Avenue Miami Shores Village, FL 1131010240060 Block: Lot NADY ALPHONSE Owner Information Address Phone Cell NADY ALPHONSE 11020 NW 19 ST PEMBROKE PINES FL 33026 Contractor(s) FELLO ELECTRIC INC Phone CeII Phone (786)290 -7576 Type of Work: ELECTRICAL Additional Info: KITCHEN CABINETS Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $3.00 $3.75 $162.55 Total Amt Paid Amt Due $ 0.00 $ 0.00 Payment Type: $ 0.00 - -I Available Inspections : Inspection Type: Final Relocation Service Change Meter Box Underground Rough Alteration Fire Alarm W. W. Finance Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Monday, December 3, 2007 4