RC-13-1073Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
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MAY 16 209
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Permit No.
Master Permit No.0 3
Permit Type: BUILDING ROOFING
JOB ADDRESS: # Aj e 9 15AT-ze l
City: Miami Shores County: Miami Dade Zip:
Folio/ParceW.
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee
CONTRACTOR: Company Name: L-E-L
Address: q 0 's
city: I) ®� _
Qualifier Name: Lt.4J 6- it n
State Certification or Registration #
:b Safi &WP b I n L - Phone#: -19G- yS -1 -ox -1
Contact Phone#: -IJ 16 -4 91 -01 -1 jo —Email Address:
Phone#: 10
irate of Competttenc #:
DESIGNER: Architect/Engineer. Phone#:
Value of Work for this Permit: $ Square/I.inear Footage of Work:
Type of Work: OAddition OAlteration ONew l]Repair/Replace ODemolition
Description of Work:
Color t&u life:
�jJ�� v �
Submittal Fee $ �b �'� Permit Fee $ CCU CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
_ Technology Fee $
TOTAL FEE NOW DUE $ - ���_
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
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 bxochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of mme cement must be posted at the job site
for the first inspectio hick occryrs seven (7) days after the building permit is issu . In tl a absence of such posted notice, the
inspection will not proved a reinspection fee will be charged
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ,20-ft by ,,10.y(iGt—
who is personally known to me or who has produced
As identification and who did take an oath.
The foregoin instrument was ac wledged before me this 3046
day of ,2013
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: l
My Commission Expires: °<"p ^e4 JANICE AIMEE MATOS
* tP MY COMMISSION #FF011193
EXPIRES April 23, 2017
APPROVED BY
Plans Examiner
NOTARY PUBLIC:
Sign..
Print 'rte
My Commission Expires: LOFIVO "vey Notary Public State of Florida
^, Irene M Cuadra
ca My Commission EE115694
0 Expi res 0712612015 a � a e ��aa�aeaa�k
Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06/10/2009)(RvAsed 3/151093
i -
NOTICE OF COMMENCEMENT CFN 2013RD= X401747
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION Or' C `DED F s 1/20 s { 10 �
REGOfiDEQ Cry /'�lr'7r�1a 1�r >46 =s'6
HARVEY RUVINt CLERK OF COURT
nIAi1I -DARE C:OUNTYP FLORIDA
PERMIT NO. TAX FOLIO NO. 11 -5 ,® -oy® ffi (71.1'0 LAST PAGE
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
Ij
3.
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t '---t j..__.... -at_- -9 ...........•.......J ..4.....4 ! -AA-
5. Surety: (Payment bond required by owner from contractor, if any)
Name and Address:
Amount of bond $
6. Lender's name and address:
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes.
Name and Address:
LI~
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor°s Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and Address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified) i pP ao-m.
Signature
Print Owner's Name 5c � 4M VN i
Swom to and subscribed before me this 26. day of
Notary Public.
Print Notary's Name:
My commission expires:
°O� Y t► „�
Robert H, Frame
,,'* "1e' :% =mSS1W#EE8a8788
�Eplpl; Nov. Ol, 2016
h, N. ° °° WWW.AwwNOTAR� C0M
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ADD SMOKE/CARBON MONOXIDE DETECTORS
ANY AND ALL CLOTH AND RUBBER a�
F '
INSULATED CONDUCTORS TO BE REPLACED.
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NO POINT ALONG COUNTER TO BE MORE THAN
2 FEET FROM 6.F.I PROTECTED RECEPTACLE i
PUT D/W RECEPTACLE UNDER SINK.
ALL FIXED APPLIANCES ON DEDICATED CKTS. n H- a z�
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
inspection Number: INSP- 206318 Permit Number: RC -5 -13 -1073
Inspection Date: June 19, 2013 Permit Type: Residential Construction
Inspector: Rodriguez, Jorge Inspection Type: Final
Owner: , Work Classification: Alteration
Job Address: 47 NE 91 Street
Miami Shores, FL Phone Number
Parcel Number 1132060130110
Project: <NONE>
Contractor: LEE CONSTRUCTION GROUP INC Phone: (786)487 -0876
Buildino Denartment Comments
INSTALL CABINET AND APPLIANCE
KITCHEN RENOVATION
Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
For Inspections please call: (305)762 -4949
January 29, 2014 Page 1 of 1