RF-07-474 Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:*(305)756.8972
BUILDING
Permit No.
PERMIT APPLICATION `t" Master Permit No.
FBC 2004
Permit Type(circle): Building Electrical Plumbing .Mechanical CRRoing;;
Owner's Name(Fee Simple Titleholder) Ill I SC tCO. $� Phone#
, II
Owner's Address 1 I`"1 Ike 3 Q '
City State Zip
Tenant/Lessee Name Phone#
(�
Job Address(where the work is being done)
J ,
City Miami Shores Viliaaee County Miami-Dade Zip
FOLIO/PARCEL# I I naC 60 132;X f 10
Is Building Historically Designated YES NO
0i c � � 1
Contractor's Compan Name hone
Con or's Mdress
City
Y4641 ANa 11 State Zip
Qualifier Name l' Phone# 3s"
State Certificate or Registration No6r—C 05 t Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
Value of Work For this Permit$ �� e Linear Footage Of Work:
Type of Work: ]Add tion Alte ah QNew 06e pair/Replace ❑Demolition
Describe Work: ` e
Go
Submittal Fee$ Permit Fee$ b CCF$ l0 . CO/CC
Notary$ Training/Education Fee$ 2.X Technology Fee$
Scanning$ Radon$ DPBR$ `� _ INK
Bond$ Code Enforcement$ Double Fee$
Structural Review.$ Total Fee Novi-lbue i
See Reverse side-�
MIAMI SHORE�SUILLAGE
Bonding Company's Name(if applicable) 4'
Bonding Company's Address �' 3
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."
i
Notice to Applicant: As a condition to the issuance of a building ermit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencemen! construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy oecorded notice of commencement mast be posted at the job site
for the first inspection which occurs seven (7) days after the bUddi)hg permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be ch
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20_,by day of ,20_,by ,
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
APPLICATION APPROVED BY: e Plans Examiner
Engineer
zoning
(Revised 02/08/06)
9
188 Devon Dr. NOV 2 6 2013
Clearwater Beach, FL 33767 $Ir:
November 25, 2013
To City of Miami Shores Building Department:
This letter is in regards to permits on 9600 NE 2nd Ave. Please close the Permit RF 7-474 since
Permit RF-5-11-890 was open and finalized for the work that was allocated for RF 7-474.
help.
Than k y ou for your p.
Sincerely,
X
es Everett Ya
Franc
727-599-9079