RF-10-78551 {' I
-11N/A
Miami Shores Village
Building D epartment
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type (circle): Building Roofing
Owner's Name (Fee Simple Titleholder) BARRY UNIVERSITY
Owner's Address 11300 NE 2 AVE
MY 6 2o$[
BY:...
Permit No. I-1 r- 10 " /
Master Permit No.
Phone #
City MIAMI SHORES
Tenant/Lessee Name
State FL zip 33161
Phone #
Job Address (where the work is being done
City Miami Shores Villa • e
FOLIO / PARCEL # 11- 2136- 000 -0050
- Garner Hall
Is Building Historically Designated YES
NO
Contractor's Company Name INFINITY ROOFING AND SHEET METAL, INC. phone # 954 -917 -7107
Contractor's Address 1150 SW 10TH AVE STE 201W
City POMPANO BEACH State FL
Qualifier Name JOHN B MITALA
zip 33069
Phone # 954- 849 -4778
State Certificate or Registration No. CCC057467
Architect/Engineer's Name (if applicable) it*
Value of Work For this Permit $ 4/ 4Q0
Certificate of Competency No.
Phone #
Square / Linear Footage Of Work:
Type of Work: ❑Addition ['Alteration :New
Describe Work:
eplace : Demolition
REPAIR ROOF GARNER VALLEY
* * * * * * ******* *, * * ***** * ** ** ** * * * * * * * ** Fees**********, r***** **** ** * *,r** ** ****,r**** * * *,r**
Oct
Submittal Fee $(...1V .CDD Permit Fee $
Notary $ igaining/Education Fee $ )- 00
Scanning 40 • (V Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ U'T
720,
CCF $ ('op CO CC
Technology Fee $ '
See Reverse side -*
,Boling Company's Name (if applicable) N/A
Bonding Company's Address
City
State
Zip
Mortgage Lender's Name (if applicable) N/A
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
promise in good faith that a copy of the notice o co
whose property is subject to attachment. Also, a certified copy of the recorded notice o c
for the first inspection which occ s s, en (7) days after the building permit is issued
inspection will not be approved ' d - einspection fee will be charged
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 a ®, by gdf.a.m. r- S ,
c) I
Signature
ue exceeding $2500, the applicant must
rochure will be delivered to the person
mmencement must be posted at the job site
In the absence of such posted notice, the
1
The foregoing instrument was acknowledged before me this .5
day of '4 ' 20 !0 by JOHN B MITALA
Contractor
who is personally to me or who has produced who i
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
LINDA S. MITTS
Notary Public - State of Florida
My Comm. Expires Jun 16, 201
1
as identi
NOTARY PUB
or who has produced
tion and who did take an oath.
'nt:
614
eirz
--BMW Tbrouph Wippl NOW/ y Commissi
APPLICATION APPROVED BY:
(Revised 07/10/07)
Notary Public - State of Fula
My Comm. Expires Jun 10, 2013
Comm'se f5 9M M r
Engineer
Zoning