Loading...
DEMO-11-351 � 7 Miami Shores Villager < 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 xpir E ation: 01/ 1/2 Project Address Parcel Number Applicant 165 NE 98 Street 1132060132330 GILBERTO MEJIA Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell GILBERTO MEJIA 165 NE 98 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,400.00 EMERGENCY SERVICES 24 (561)241-1227 Total Sq Feet: 1500 Type of Demo: Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning: 1 Fees Due Amount 'Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# DEMO-3-11-40200 DBPR Fee $2.00 03/01/2011 Cash $111.80 $0.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $111.80 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated. March 01,2011 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy March 01,2011 1 Miami Shores Village N Building Department MAR 0 1 2011 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 13Y............... .... BUILDING Permit No. 1- (j PERMIT APPLICATION Master Permit No. / t -2,0� FBC 20 Permit Type: BUILDING 1 �- OWNER:Name(Fee Simple Titleholder): t L 17aro EJ,A Phone#: Address:1kir�Wr�S T� �t City:- m ds State: �`t Zip: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 3!31300 Folio/Parcel#: Is the Building Historically Designated:Yes NO V'' Flood Zone: CONTRACTOR:Company Name: I'k�6. �� 1Ch ?_(4 Phone#: 5Q14`(3'3 3 IV Address: '1110 �6 L�R'�d 2 Q City:R(,F4' State: J' Zip: ��7 Qualifier Name: Phone#: State Certification or Registration#: Certificate-of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: Phone#: OO Value of Work for this Permit:$ Square/Linear Footage of Work: (5-00 5(3L PI- Type of Work: OAddress DAlteration ONew ORepair/Replace orn of Worm rn e Ao I ( - 6 a o ttf t 11C >(emolition ������ U prs�' COL U +fir.:xm RC) ON 7 IROGI W] QUIRED acknowledged by: Submittal Fee$ Permit Fee$ OL-0 � 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 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. Signature Signature `Owner A ent Contractor The foregoi 2strument was acknowled efo me this The foregoing instrument was acknowledged before me this& day of ,20 LL,by `C` day of '20t 1 ,by A4rt � ho is personall known to me or who has produced c vne who is personally known to me or who has produced P. C As identification and who did take an oath. as,identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: 4.� za Print. Print: My Commission Exp "1% Notary Public-State of Florida My Commissio '� �°: Notary Public•State of Florida s My comm.Expires Dec 14,2014 N• •er My Comm.Expires Dec 14,2014 Commission#EE 49027 +�FOF f OQ�� Commission#EE 49027 Fbn.� ham�a APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)(rev6/4/10)