EL-13-267Miami 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
1
BU
DING
PERMIT APPLICATION
FEB 0 8 2113
FBC 20 1C'
Permit No. FU
Master Permit No.
Permit Type: Electrical
JOB ADDRESS: (:,/ /1/t 9,6 f4
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: /1°c9O( -00 (°- ®o( 0
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER Name (Fee Simple Titleholder): X x,-64 le. o :-a.e a Phone#:
Address: 9/".... ,/E 95 1 4
City: if,./),;:q.0., p° "V.10 1-e...5 State: /'-L- Zip: 3 /32"
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: tp 0 CGt Co S �- �. Phone#:. 5 —11'8 - 5103
Address: to o N E V)-5 A-l-t 5 *r��
City: --LLB b Zip: 331 (01
Qualifier Nam Coi- a V i a � 7; ` Phone#:l e °'a66 t- f 8/ 7
State Certifi ` T Certificate of Competency #:
Contact Phon ` niib Email Address: Dui./ is a Egvcc.� cov Q „cow. cr- Co'i'C)ccrl • ?� pccacolr
DESIGNER:' fP ¶gineer: NON e. Phone#:
Value of Work for this Permit: $ %, 0b 0 Square/Linear Footage of Work:
Type of Work: DAddress DAlteration DNew tepair/Replace ODemolition
Description of Work: Ch 5 —m4aI( /parrs 4 /4cG ? Xture
******** * * * * * * * * * * ** * * ** * * * * * * * * * * * * * ** gees************* * * * * * * * * * * * * * * * * * *** * ** * * * * * * **
Submittal Fee $ v ‘,9 Permit Fee $ 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 commenc
whose property is subject to attachmen
for the first inspection which occurs s
inspection will not be approved and a re x e on ee will be charged.
law brochure will be delivered to the person
ommencement must be posted at the job site
sad In the absence of such posted notice, the
Signature
Owner Yr Agent
The foregoing instrument was acknowledged before me this )
day of , 20 /3 , by Eu4.A,.,v42. ',
who ' rsonally kno me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Contractor
The foregoing ins t ent was acknowledged before me this 478
day of , 201.x, by (bare' &a'Cth ,
who is ; o ly known ; o me or who has produced
as identification and who did take an oath.
NOTARY PUB
Aidde,/
OrdtS
Sign:
Print:
7Fe [y4hoeen/
My Commission Expires:.
*ak+R+k+6* HRH+H4tA+A******** * **+kRtKtEe4t*ff ***
APPROVED BY Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10107)(Revised 06 /10 /2009)(Revised 3/15/09)
6RESTE INNOCENTI
Notary Public • State of Mold*
Sly Comm fapites!aa, Id, 201S
Commtss,O
** *****i ********
Zoning
Clerk
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
Permit Type: PLUMBING
JOB ADDRESS: 7/2 AM 96 f '
FEB 082013
FBC 20 t 0
Permit No. 1 i■ (a to
Master Permit No.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: /1-- 5 2 06—c 0I 00 / 0 01 11
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): g ct Y+it,, .e -5L .4-Pe — Phone #:
Address: 7 / 2 . .9).., �I
City: /A.420/,' IVAlorti, State: FL Zip: 33 /30
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name: Ept . crYft r Phone #: 305 7,A75-/ Q 3'
Address: C)'
City: q py a State: 11— L Zip: /°"‘e %
Qualifier Name: "12-1.4..";-- Dad/ Phone #: 305 X$5., 0
State Certification or Registration #: l s- Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ /000,. 0 0 Square/Linear Footage of Work:
❑Alteration °New itepair/Replace °Demolition ,
Description of Work: q� ®�, r' e)011-1
Type of Work: ❑Address
Submittal Fee $
Scanning Fee $
Notary $
Double Fee $ Structural Review $
Permit Fee $ CCF $ CO /CC $
Radon Fee $ DBPR $ Bond $
Training/Education Fee $
Technology Fee $
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 occurs seven (7) days after the building permit is issued. In t absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Owner or Agent
The foregoing instrument was acknowledged before me this
dayoffR,‘p ,20 i3 ,by P r,M . $44
who is Eerso known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: Z' $ - 13
My Commission Expires:
**t** * ** ** ** *1l** *** *** * ***
APPROVED BY
Signature
tor
The foregoing ins ment was acknowledged bef me this
day of , 201.3 , by
who is personall_ y known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:'
Print: i ll1('en'ZO rvNO
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Structural Review
(Revised3 /12 /2012XRevised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09)
Zoning
Clerk
Jun 12 2013 141003 4044927730
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-> 1 000 605 7530 Matthew Bradley Page 002
EPOCA. CORP
CERTIFIED GENERAL, ELECTRICAL & PLUMBING CONTRACTORS
6-11-2013
To whom it may concerti,
Property address 912 NE 95 Street, Miami Shores Florida 33138 our Client and property
owner Katherine Shafer is selling the property and would like to cancel all work. Please
close out permit EL2-13-267 and PU-13-266
David Scott
GC1 519904 CFC1428594
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