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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) 762.49449
BUILDING
PERMIT APPLICATION
FBC 20
Permit T < BUILDING ROOFING
OWNER: Name (Fe a Titleholder): Phone#: q -7310
Address: 610 A! a5 51—
City: MI (.a► -" State: L Zip /331'3e?)
Tenant/Lessee Name: Phone#:
Permit No.
Master Permit No.
APR 0,2 2012
i2-5s�
Email 73 e 60E166 � , Lpn
JOB ADDRESS: 5 10 i 016 ST
City: Miami Shores County:
Folio/Parcel #: 9 1 -3'.21)(0 9 614 0
Is the Building Historically Designated: Yes
Zip
Flood Zone 6L1' 0
CONTRACTOR: Company Name: ;•y ba'i (der Oc %t 1 P r! 2 Phone#: G1 - �6 t -Z')Q
Address:
City: State: Zip
Qualifier Name: Chi'. t, e Pew Phone#:
State Certification or Registration #: (L C16LTRY81 Certificate of Competency #:
Contact Phone#: -`8 - -b, 3G1 f Email Address:
DESIGNER Architect/Engineer. Phone#:
Value of Work for this Permit: $ 5J 500 Square/LinearFootage of Work: e
Type of Work: °Addition *Iteration °New XRepair/Replace T
Description of Work: l� -u1A -C .fit �E�c�`e. i [ ca r1 °4 r 'tee- A3 A comp, 1 L c+.il 1
°Demolition
kr
******* * * * * * * * *** * * * * * * * * * * * * * * * *** * ** *Fees *._,._� AL *** *** * * * * * * * * * * * ****
Submittal Fee $ Permit Fee $'-'- CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Douhle Fee $ Structural Review $
* * * * * * * ***
TOTAL FEE NOW DUE $
241
A
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 mad
commenced prior to the
construction in this jurisdi
WELLS, POOLS, FURNA
to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
suance of a permit and that all work will be performed to meet the standards of all laws regulating
on. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
, 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 • nstruction and zoning.
"WARNING TO
COMMENCEME
IMPROVEMENT
FINANCING, C
RECORDING Y
Notice to Applicant: As a
promise in good faith that
whose property is subject
for the first inspection wh
inspection will not be appr
Signature
OWNER: YOUR FAILURE TO RECORD A NOTICE OF
T MAY RESULT IN YOUR PAYING TWICE FOR
TO YOUR PROPERTY. IF YOU INTEND TO " OBTAIN
NSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
NOTICE OF COMMENCEMENT."
ondition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
copy of the notice of commencement and construction - en brochure will be delivered to the person
attachment. Also a certified copy of the recorde otie yv ement must be posted at the job site
ch occurs seven (7) days after the b ding s ' d In the abs e of such posted notice, the
a reinspection fee willbe s tged7�
The fore,, ac ,; ., wl:•
day of : %l. i , 20 y_ •y ] t sday of , 20 _, by
who is • nally known to me or who has produced V v who is personally known to me or who has produced
iT 1 • �Bl i ntification and who did take an oath. as identification and who did take an oath.
NOT NOTARY PUBLIC:
Sign:
Print:
oing'i trument
Signature
I
Ltigi li
Contractor
The foregoing instrument was acknowledged before me this
P LIC:
My Commission Expir
* * * * * *** * * * * * * * * * * **
APPROVED BY
Sign:
Print:
My Commission Expires:
// ati Plans Examiner Zoning
(Revised 07 /10/07)(Revised 06/1O/2009)(Revised 3115/09)
Structural Review Clerk
°
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
JOB ADDRESS: `�3
Miami Shores Village
la
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
FBC
Permit No.
Dom'
APR 0 2 2012
Y°
20
fi 12..--f;e0 1
Master Permit No.
t O Ai a ®l5 Si- :° 4'
J 2 '
City: Miami Shores
County: Miami Dade Zip: 3 3 1 eb
Folio/Parcel #7)
2-06 s ,.4 ... ®ca 3
Is the Building Historically
OWNER: Name (Fee S' ',pie
Designated: Yes NO Flood Zone: it16
Titleholder): Do a %r`L e Ht's �\ Phone #: ' -- f1- 13q.0
Address: 510 me,
4/5-- 5 -es—
City: imik e 0..44-1 i S Pe
2p,) State: FL- \ . ' zip: 53 (3 e
Tenant/Lessee Name:
` Phone #: q S'. 3 fl ®°13 'qo
Email: a- �� z:
,
4
l' P`v l vv5 1ir.A.' � CSC+
CONTRACTOR: Company
Address: 513 tU C
)
L,
Name: ` tazA te_a_ e..;,J t`) D a2 el d et Pc C. Phone #: l s q Pm 1 -1 13 76
cis 'e
City: Ilitkoi. - evi. c S
a State: FL— Zip: ?'S C3 9
Qualifier Name:
Phone #:
State Certification or Registration
Contact Phone #: e' S ci
#: 5b 20 6 7 Certificate 6f Competency #:
53, 1 -73 c m Email Address: all C c,s 1 a1- +,� k4 o . Co AI
DESIGNER: Architect/Engineer:
Value of Work for this Permit
Type of Work: ❑Address
Description of Work:
I Phone #: ', :-1S d( -1'
$ .+i ... 360 ,, j%P quare/Linear Footage of Work:
461teration ONew tepair/Replace DDemolition
* *** ** ** * * * * * * * * * * * * * * * ** * * * * * * * * * ** Fees * * *** * * * * * * * * * * * *, * * * * * *** * * * * * * * * * *** * * * * **
Permit Fee $ 412 CCF $ CO /CC $
Radon Fee $ DBPR $ Bond $
Training/Education Fee $ Technology Fee $
Structural Review $
Submittal Fee $
Scanning Fee $
Notary $
Double Fee $
TOTAL FEE NOW DUE $ 1'139410
Bonding Company? s;Name (if applicable)
Bonding Coi'bpany'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 COMMENCNT."
Notice to Applicant: As a condition to the issuance of alruilefng. permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of cd m inen ement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. so,� �rzii`%d copy of the recorded notice of commencement must be posted at the job site
for the first inspection whit seven days after the building permit is issued. In the absence of such posted notice, the
inspection will not be app ved and a ection fee will be charged.
Owner or Agent
The fore l oin 1, instrument was ac ' edged . fore - thi
day of ,y ,20IL I by
who is pe onall kno film: or who has produce
ification and who did take an oath.
NOT PUBLIC:
Sign:
Print:
My Commission Expires:
** * ** ** * * * * * * * * * * * * ** * * * *** **
APPROVED BY
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
*********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
'(- Plans Examiner
Zoning
Structural Review Clerk
(Revised3 /12/2012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
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: Electrical
JOB ADDRESS: , l (:) N1E c:/-6
Fcmgwq--11
ll1 a (1.2 2012 IV
BY:
FBC 20
Permit No. ) 12,--(00
Master Permit No. J)
City: Miami Shores County: Miami Dade Zip: 3 3 3 u
Folio/Parcel #: l I- 3 26 - p€ `2®
Is the Building Historically Designated: Yes NO Flood Zone: 6
OWNER: Name (Fee Simple Titleholder): • Da . , e
Address: a 1(t' /L3 4j S It-
- Phone #: GS �-1 - ! ) -7 3 5 a
City: M 6 lie) re D State: F t�
Tenant/Lessee Name: %> Phone #:
Email: a CrcL''_7- 6) 6_f5 i U 4t,j'lw'� a,
CONTRACTOR: Company Name: 6:DU n.st ?`h u 1 c! o ^) \ t h (6,1 ?ere ZPhone #:
Address: 616 G r 5 5-
City: M (0- hp cr' State: J L --
ap: 3 3 `t?
17.- 73 iO
ip: 33 ( 3 9)
Qualifier Name: Phone #a
State Certification or Registration #: C 6e" e / ' certificate of Competency #:
Contact Phone #: t,' 5-41 - e t 7.73' 6 Email Address: e re' 7-0 C litil
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit $ 2-00 Square/Linear Faotageof Work:
Type of Work: DAddress DAlteration UNew `Repair/Replace
Description of Work: Upao e y r. es-le (
DDemolition
** * * *** t****** **** * * * *** *** , , * ** , * *Fees** * * ** r * **** *,x *,r**** **** * * ** ** * * * * * **
Submittal Fee $ Permit Fee $ 15.-6" `'r' ‘° CCF $ C 1 /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bo d $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW D
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 tissuance of a permit and that all work will be performed to meet the standards of all laws regulating
eonstruction 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 issued. In the absence of such posted notice, the
inspection will not be approved and a reinspec ion fe Zvi t�l iirg�d ,- ,
Signature
The fore oin
day of k
who is p sonally known to me or who has produced
de tification and who did take an oath.
NOT
Sign:
Print:
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of ,20_,by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY 7
Sign:
Print:
My Commission Expires:
************************************ ** *** * * ** * * * * * * **** ** ** * * * * * * **
'7420/2— Plans Examiner
Structural Review
(Revised 07 /10 /07XRevised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk