RF-11-1386 Miami Shores Village cElv��
`G`► Buildin g Department
artment
A
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax:{305)756.8972 BY:
I A INSPECTION'S PHONE NUMBER:(305)762.4949
BUILDING Permit No. E:: 1
PERMIT APPLICATION K f 2A Master Permit No.
FHC 20
Permit Type:BUILDIN ROOFING
OWNER:Name(Fee Simple T-itleh ]der to Phone#:
Address: t 0-6 Af6 Ll I
City: 44"1590PW5 State:
Tenant/Lessee Name: qp Phone#:
Email: P&NA-K-1 Q ik RCST MAXI.. 5-01V\
JOB ADDRESS: ® C 1 T6 0
City: Miami Shores County: Miami Dade Zip: ?z� ?z
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
CONTRACTOR:Company Name: Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ ot 0 0` Square/Linear Footage of Work: d
Type of Work: DAddition Q.UAllteraat ion ONew Nl ot�epair/Replace ODemolition
Description of Work: LOPL U - 5 d Oa 0 F�90M QCC>f°— ®N 'T14C
TO MAT R
o,
Submittal Fee$ Permit Fee$ Q 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 or Agent Contractor
The foregoing instrumentt was acknowledged before me this The foregoing instrument was acknowledged before me this
day of (lr�} �,20 ,by day of ,20_,by ,
who is perso ly 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:
V Leo
Sign: Sign:
Print: RR��� _ . Print:
My Commission Expires: Cp���S 59Q1 O My Commission Expires:
0016 :®�
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
y 224 ,2zi2 L
Arlenis Silvera
From: Blade Shore <miamiblade @hotmail.com>
Sent: Tuesday,August 14, 2012 3:33 PM
To: Arlenis Silvera
Subject: request for permit extension
Permit - RF-8-11-1386
Address - 1130 N.E. 91 Terrace
Miami Shores, FL 33138
To whom it concerns
I hired and paid a contracter to repair the area of my roof that needs fixing. I was told 2 months after I paid
the contracter that they won't be able to start my job until after thanksgiving because they are in the middle of a job
presently. I would appreciate it if you woulod be able to give me an extension on my current permit. Please E-mail me
back with your response or leave me a message at (305)758-8385.
Thank You for your time Paul Gallat
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