RF-12-2148Feb. 18, 2013
To: 'ami Shores Building Department
From: 1 arlos Perez - Stable
aria Almanzar
59 NE 104 Street
ami Shores, FL 33138
#73 Fita .
43J2 - L
Subject: ' e will no longer need the permit for roof work for our home at 359 NE
04 St and would like to remove it from the Miami Shores Building Department.
tank You
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PERMIT AP
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Permit Type:
JOB ADDRESS: 359
City: Miami S ores County: Miami Dade zip: 33138
Folio/Parcel#:
is the Building Designated: Yes NO Flood Zone:
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: (385) 762.4949
LICATION
DING
E 104 Street
NOV 10 2012
FBC 20 ID
Permit No.
Master Permit Noe- f Z I
ROOFING
OWNER: Name (Fee S
Address: 359 NE 104
City: Miami Shores
„ , le Titleholder): Carlos Perez - Stable and Maria M. Almanzar phi 305- 758 -8565
-treat
State: FL zip: 33138
Tenant/Lessee Name: ,-1 Phone#:
Email as1m4630 @bei south.net
CONTRACTOR: Co
Address: `
City:
Qualifier Name:
y Name: DoublebI
21
ctlon Inc.
Phone#: 786.346.7663
Yvv- State: a�
ere,
Zip:
Phone#:
State Certification or Rea suction #: C ( c 705. / Certificate of Competency #:
Contact Phone# : - g - Pmail Address: ®rte.
DESIGNER: Archi . tngineer Phone#:
Value of Work for this ' ermit: $ AX--6° � Square/Linear
Type of Work: UAdditi °New
Description of Worms -
°Alteration
e of Work: cht..
epair/Replace °Demolition
Color t
* * *** ***a ** * *** **s* *********** er ******** ***114s***** *** **************o
Submittal Fee $ II Permit Fee $ . CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Educatlon 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
commenced prior to the issuance of a permit and that all work will be performed to meet the s
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL W
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
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD
COMMENCEMENT MAY RESULT IN YOUR PAYING
IMPROVEMENTS TO YOUR PROPERTY. IF YOU
FINANCING, CONSULT WITH YOUR LENDER OR AN ATT
RECORDING YOUR NOTICE OF COMMENCEMENT."
work or installation has
of all laws regulating
RK, PLUMBING, SIGNS,
in compliance with all
NOTICE OF
TWICE FOR
TO OBTAIN
RNEY BEFORE
Notice to Applicant: As a condition to the issuanceiofa building permit with a-n estimided dle exceedin $2500, the applicant must
promise in good faith that a copy of the notice of ccmmencemen stmicc_MStrUctioie inrricbw'e 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 r ,sense of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature 7-
The fore
day of
who is
or Agent
by
%% Contractor
me this 1 ' The foregoing instrument -was ackno ged before me this I"'!
y _20 7re �7u4?e�
r
y known to me or who has produced
identification ai yi;ho +id -take an o
NOTARY PUBLIC:
Sign:
Print
My Commission Exp'
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oF onro 4218E8: ��lSSjQN�A/NO
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kit, sow
4sflid -y mown to me or who has produced all7
as identification and who did take an oath.
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NOTARY PUBLIC.
Sign:
Print
My Commission Expires:
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2 r / Z Plans Examiner
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APPROVED BY Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /1O/07)(Revised 06/10/2009)(Revised 3/15/09)