ACT-13-125 Miami Shores Village
Buildin g Department artment JAN 2 3 2013
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax: (305)756.8972 G-Q�
INSPECTION'S PHONE NUMBER:(305)762.4949
Aj - FBC 20 IT�7'
B ING Permit No. c l
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: -7 7 WA. 14p®1A f'
City: Miami Shores Co Zip: —R31-AR
Folio/Parcel#•
Is the Building Historically Designated: r.. NO ✓ Flood Zone:
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OWNER:Name(Fee Simple Titleholder): TX9e � iC'L 91'� Phone#: CIP17J fZd- OYfZ
Address: 77 ofVC-. ~ -% jr•
City: "4�4604er State: fL► Zip• -a3136,
TenanV1,essee Name: Phone#•
Email:
CONTRACTOR: Company Name: ®ei' Y'�P g-nV't ,moo" .�G Phone#:.
Address: -5'5'9'0 (;?,a ZZ ST
City: -gl*AW State: re- Zip:
Qualifier Name: Phone#•
State Certification or Registration#: C G-C/S I Z Z-CS Certificate of Competency#:
Contact Phone#: OPS a°'.'25-?8 Z Y Email Address: ®J4 P 9t'"OW Cgi> YOJ$7qP, COPV7
DESIGNER:Architec gin a A-7939 tvaC c .Z t?i/.i Phone#: 9XY e7Y X yz f
Value of Work for this Permit:$ 4,400-6! ` e/Linear Footage of Work: ZOO p*-r'�
Type of Work: OAddition OAlteration JIDJVIReplace ODemolition
Description of Work: cA901' ' /j4!''xW
Vw-
Color thru d1e:
Submittal Fee$�� Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee S Structural Review$
TOTAL FEE NOW DUE$
Bonding Company's Name(if applicable)
Bonding Company's Address A 9A i
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: , FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN Y PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROP U INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR 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 certijied 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 for
The foregoing instrument was acknowledged before me this./&0 The foregoing' ent was acknowledged before me this/
day of�,20 / ,by �j'^T&I p day of .20)_,by 6X)N +L�C3 ��If
who is personally known to me or who has produced who is personally known to me or who has producedJe*C-4-0
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC: ``,��a+++Arl
`
Sign:
Print: { r' Print: _
My Commission Expires: •'" ' um My Commission Expires: ' ,�'�O�°� ��•`
* * W COMMISSION 1 EE 035417 %,O,c�'•.,s9 '� : �.�
EXPIRES: S
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised SM012)(Revised 3/12/2012))(Revised 06/10/2009XRmised 3/15/09XRevised 7/10/2007)
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A9,12 lleje ,ne Road,Suite 203,Coral Gables,Florida 331416
Office 305-661-2700,Fax 305-397-1188 D • M I N 1 •
WWW.CIOI-IliliOlIDUlilCI.COII-) - ,'awlitli
September 23, 2013
Miami Shores Village
Building Department
10050 NE 2nd Avenue
Miami Shores, FL 33138
Re: Permit # FW12-2183
9901 NE 13 Avenue
Miami Shores, FL 33138
Dear Building Official:
Please approve our request to void the permit that was pulled to install a chain link fence. We initially
intended on removing the existing concrete block perimeter wall and replacing it with a chain link fence
to secure the site for safety reasons. The concrete block wall was instead left in place.
Kindly close and void the permit so that we may continue closing out the other work that was
completed.
Feel free to contact me directly with any questions or additional requirements.
Sincerely
Mar G �mignani
Presid nt
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/Z-L-/3- CA- 7-a Cewe,-U
AMERICAN INDIAN OWNED SMALL DISADVANTAGED` BUSIN SS
LICENSE#:CGC1516478 CAGE CODE:69KH4 NAICS CODES: 236116 236116 236118 236210 236220 / `