BP-04-999 �- Miami Shores Village . c�r�oVE®
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Building Department JUL 16 2004 O P, III Its-
10050 N.E.2nd Avenue,Miami Shores,Florida.3313
Tel:(305)795.2204 Fax: (305)756.8972 -----�T---- °®
BUILDING Permit No ® �
PERMIT APPLICATION Master Permit No.
FBC 2001
Permit Type(circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simpl Titleholder)Parry Real Estate, Inc. Phone#(305) 758-9691
Owner's Address 9628 l E 2nd Avenue, Suite A
City Miami Shores State Florida Zip33138
Tenant/Lessee Name S t eYen K. Baird, P.A. Phone# (3 0 5) 757-6755
Job Address(where the work is being done) 179 NE 96th Street
City Miami Shores Village County Miami-Dade Zip 33138
Is Building Historically D Is ignated YES NO
Contractor's Company N e N Phone#
Contractor's Address
City State
Qualifier
State Certificate or Registration No. Certificate of Competency No.
i
Architect/Engineer's Nam (if applicable) N/A Phone#
S Value of Work For this Permit $10.0 0 Square Footage Of Work: 6.3 s f
Type of Work: ❑Addiiion ®Alteration []New ❑ Repair/Replace ❑Demolition
Describe Work:Change name in existing window sign (white stick—on lettering)
from Pierce H1 Mullally to Steven R Baird Tine reading "Let us be your
title will be removed. Everything
Submittal Fee.S Permit Fee S.---a-r u CCF S v CO/CC
Notary S training/Education.Fee S (1e n 0 Technology Fee S 6?/ �
Scanning S Radon S Zoning Bond S
Code Enforcement S Structural Plan Review.S
Total Fee Now Due
(Continued on opposite side)
' 1
Bonding Company's Name(if applicable) N/A
Bonding Company's Address
City State Zip z
Mortgage Lender's Name(if applicable) N/A
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 than 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 WrM 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 constructs n lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recur of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building) a ssued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be char IL
i � Si Lure
S gna N A
Owner or Agent // Contractor
The foregoing instrument was lac edged bXre this/ltd �e foregoing instrument was acknowledged before me this
day o 0 ,by day of ,20 by
who rsoi own to a or o has uced who is personally known to me or who has produced
identifica ' and o did take an oath. as identification and who did take an oath.
NOTARY P IC: NOTARY PUBLIC:
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Sign: a`��° ��ANN O°O°� Sign:
Print: / • Print:
My Commission Expires: ;�,U oer24, 9; y My Commission Expires:
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APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
Cho 05/13/03