WS-13-1957 Miami Shores villa e c
Ne
ob\\� Building Department AUG 2 8 is
'WONE21"Vemm,Miami ROM Florida 33138 .BY:
Tel:(303)7952204 Far.(305)756.8972
INSPEC'TION'S P80NE NUMBER:(305)76U949
BUILDING FBC ZO
PERMIT APPLICATION Permit No.
Maeber Pat*No. S 13 • ) �S �--
Permit Ihn: BUILDING ROOFING
JOB ADDRESS:
City: mm;rtl,.,n..
�� County: usa.ra Dub_
Is the llwmb*Mstaiwly DedMted:Yes ,._._._._..Awd Zia:
OWNER;Name(Fee Simple Z WchoWw):__ u K y Awl
®�
Address:
A4 r A
Zi
Ted Name: ': N 3
CONPRACTOR:Company Name• A •'& '
j F
e AFB
Qua Name• ----_'_' r•
--
State Ceadfia =or Ragistretien :
filcat of COmp"My 0:
Contact �. a
Ate• a
b �1 :=A�pt+ecdBnginea:_ S� � �A�P � �'• t�®k'�'� tee• t°19 17°���
Valae dwork Por fbis Permko s
OA
Type oy Wotrla ddidon O : �SgwraPlilaear.Foobge atworlG
aeon ONew
of Worki OD don
Ar 1<
—to t
. - 4f#tt«sMMaMyr�p�y�pq#t# s
sbmbtal Fee s,513 .cy permit Fee$
Radon Fee s $
Notary s------ Fee$
F
Doable Fee s Te�taology
Struebmi Review s
TOTAL FEE NOW DUE$
Boadtos Company's Name(if applicable)
Bonding Company's Address
City state ZIP
Mortgage Lender's Name(if applicable)
Mortgage Leer's Address
C iti State ZiP
Application is hereby made to obtain a permit to do the work and moons as indicated. I cm*that no work or won has
•commedroed 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 undastand that a separate permit must be secured for ELBCTRICAL WORK,PLUMBING,SIGNS,
WF.U S,POOLS,FURNAM,BOU4RS,HEATERS,TANKS and AIR CONDMON13RS,ETC:....
OWNER'S AFFMAVIT: I cer*that all the foregoing infatuation is accurate and that all work will be done in compliance with all
applicable laws regulating consOuction and zoning.
"WARMING TO OWNER: ` YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IIVIPROVEMENU, TO YOUR PROPERTY. IF YOIT ' hftND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to AppHcant: As a condition to the issuance of a building permit with an estimated value exceeding$2300,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 cen&d copy of die recorded notice of cotnmencemant must be posted at the job site
for the first inspection which occurs seven(7) 15 a 8 permit is issued In the absence of such posted notice, the
inspection 'll not be approved reinspwectiote:fee w'l� e c
Signature
Owner or Agent Contractor
The foregoing in ivimm was aekmwledged More ice tbis°�7 The forgoing inamnift was aclmowledged before A>e
day of gkk,"-20 0,by 1 LD"l t-L W iU�a� � Hof A"L61 .2013 by
wbo is pasonally ktewn to ne or who-has prodiri:ed who is pasonally known to me or who
As identification and who did take an oaft as identification no (14,01W 94 ofth.
NOTARY PUBLIC: NO`I4OVv
Sign:
Prim :Q O Punt: '� e°3e `� �e�r ±++�, •- 4. ,...-�:�—
My Commission Facpires: =Q` 04''�� My :orion ;�
�.�� C°qtr.•'� �.� �7`'r+fn�lti����
a+k*+taeweatMsees+Mtt«sst�eljess+ s*+a+«as*ss *se ss *ss+as+ssseas
APPROVLDBY -Zo*g
Structural Review Clark
Wxvind 3Jn21012)Wxdsed 07nW7XRvvhd oGq&MXRevl=d SnMM
e� Q� Miami
Shores
es villa e -
Builder De EIVED
7Q050 N.E.2nd A g Department AUG 2 � 2013
���MiNd SMM Florida 33138 t
Td-'(305)795MU Fax:(305)756.8972
INSPECTION'S HONE NUMB L-(W 762.4949 ��•
BUILDING F'BC 20 �O
PERMIT APPLICATION &- No.
M
CANCELLED P emdt Tw. BUDING
ROOFING
JOB ADDRESS:
Chy: Colmty'
is the 8 Mftrj.�Daub&.yes .. NO-
OW aX Name(Fee Simple Titleholder):_ �e 1 � �{ C t !t A k�
I
gadt,ese: Z
Teusnt Nam.. ._.._.__
CONTRACTOR:Company Name:
Address:
Yi A If-A P
Qae1i>ur Name• CA r
StateCert ca4ioA or Registration#: Cwmco*of Cqqetwy 6;
WYNYI. v a • �a v .
_mW Addmi
D Att tectlgA�emr: �F V &I e 3 w' r`a per• � 'l
Vake d Work for thle Pet=it: _ �i•••, •'.,.a:,1?00* a of World
Tyke at Woft t)A&N= Oghenda
DNew �air/Replace �
Den*Ww at Wor1t; A
Q
bbbn*W Fee •d`�
S
Permit Fee a
� CO/CC
...Ra&n Fa S __..._°�_Brs
Not"S a natln Fe $ ' Fe
BW s
Dable
--'_
Fee s Strad Revim$
TOTAL FEE NOW DUE S
Bonding Company's Name('2 f applicable)
Bonding company's Amass
City state ZIP
Mortgage Lender's Name(if applicable)
Mortgage Lender`s Address
�► state rip
Applic Dion is heAby made to obtain a punk to do the work and ons as indicatod. I certify that no work or lm aWon has
commenced prior to the issuance of a permit tom,wog be perf r ed to meet the standards of all laws regulating
construction m this jurisdiction. I under :t t. tmrt'tp be secwW for ET.BCTRICAL WORE,PLUMBING,SIGNS_,
WaU,ILLS,KWAM,BOA. RS.IiISA , AN$S and AIIt CONDIITONERS,ETC..».
Owmts AFmAvrn I ofy that all the foreioing information is aomm and that all work will be done in c omplianoe with all
applicable laws regulating construction and zoning.
,-WARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYERG TW-CE FOR
DDROVEMENTS TO YOUR PROPERTY. IF YOlU bdiND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COM 1ENCEMENT."
Notice to Ticant. As a conditlon to the is in an esthwed value exceeding$2500.the applicant must
N App
good faith that a co the notice e� ement and lien law brochure will.be delivered to the person
promise m 8 f copy�
whose property is subject to attacknent. Also, a cert>jied copy of the recorded notice of camntenement must be posted at the job site
for the first inspection which occurs seven (7)days *er the.building permit is issued. In the absence of such posed'notice, the
inspection 'U not be approved and inspection fee will be charged
Signatxin Av. Sigaatore ,
Owner or Agent Cawactar
The forgoing insuvaunt was acknowledged before me this forgoing inownent was acknowledged befQra ax ibis
day of 20 jL by 'Ls���4-\ LIJ►v. day of 20 by 9'a
' -, vft is known to me,or �-
who is personally bows to me or who has��. P3'
4 As Maditcadon and who did tape an oaft as identification and who 40.v"*0 h.
NOTARY P*')DU : ����`�al►I ulurii��i�,�i NO�'ART PiIAM.
Sign.
Sign: '.
Prbm LL
My commission :;,mod' ..:��, MyCoton r
«esu�esese+eeea,►r�*e�s*sa*ats�*t**sass*�esesswe�ews�sst*+a+s* fuesa011lx `aIM
ill,1 1 1 1 1 1 N�
APPRONTb BY l Zoning
structaral Pxdcw -® ' Clark
t��9n?/�t2�lievisoa o7nauo�t�a dvtttllAO9)(ltev�ed 3/lst� '