BP-05-1524Miami Shares Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 7952204 Fag: (305) 756.8972
BUILDING
PERMIT APPLICATIO
FBC 2001
Permit Type (circle): B din
Owner's Name (Fee Simple Titleholder) LA
Owner's Address
N
Permit No. k�->RD5—
Master Permit No.
Mechanical
1 Phone #
City 1/M_ S .- a e,!j -State P—(— Zip _3 3 /S o
Tenant/Lessee Name
Job Address (where the work is being done) SU-jx Q
Phone #
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO.
Contractor's Company Name Q w 11 f- & Phone #
Contractor's Address
Roofing
City State Zip
Qualifier
State Certificate or Registration No.ificate of Competency No.
/0t
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit Square Footage Of Work:
�Ch&L-
Type of Work: ❑Additionltera dn'Wj' 1 []New
❑ ^R�wepair/Repplace ❑Demolition
Describe Work:[ i 1ti3 it t� �t�i°P� ('i1 y��'»l',
Submittal Fee $ Permit Fee $ [ t/ ®% . CCF $ CO/CC.
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address _
City
State
Zip
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: Asa condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature
I Owner or Agent
The foregoing instrument was acknowledged before me this
day of � , 20 Eby L.-n�eA COOL -4E5y
who is personally'known to me or who has produced
As identification and who did take an oath.
NOTAR PIJBI,lr:
Sign:
Print:1�-Jandez
YOT�
My Commission Expires: Commisslon # DD476455
Expires: SII? 27, 20119
+Y9e 4e+SnY�Tc9c*irfdr drkt4 flr�trftr4drirsa�te,tr,t�$��e.�,x�11.Ei lanti� Ar]�ul.i�._� _.._i._. _...... .
APPLICATION APPROVED BY:
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of . 20 __, by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
4iraFde4r dr4r4ratr itie 4r4r�cir4e4rieir9F4rdcdc4eicvkt+kBc�e4aYvk 4r 4cdcdr4Ar
a4 ��Lb r:� Plans Examiner
Engineer
chc 05/13/03 Zoning
• Miami Shores Village
APR 1 -2013
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY— ......
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
a t,��-r'�l C 20
BUILDING Permit No. .Y
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 7 /� >� % �'� ;/tet wt t' �'! ` 1��,
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): Phone#:
City:
State: Zip:
Tenant/Lessee Name: Phone#:
Email:
Address: 7 9 10 , if* 411h % t-- V s
L r°rt 14e—
56/. X16, 3a W
City:. fiJ� ,%� C State: ~ �U Zip:
Qualifier Name: ` " Ve er l Phone#: '5�6 �` i ��' 3 Ole
State Certification or Registration #: C6 C- /Q0 v ')2'?rCertificate of
Contact Phone# —C�P►^° A/�'� Email Address: /-.Z
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: OAddition
Description of Work:
Submittal Fee $
Scanning Fee $
OAlteration ONew ORepair eplace jemoliti
Mire
Color thru tile:
Permit Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $.
Technology Fee $
TOTAL FEE NOW DUE $
k7Iqb I I J — �avP„nst
BUILDING
Miami 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
4:�, uA_,rW,-�7
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: 1? �L--j / o r .5r
C 20 13
Permit No. z .
Master Permit No.
ROOFING
City: Miami Shores County: Miami Dade Zip: 331St/
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): r a C 4V1, Lt—C Phone#: 305- 3 SY -
Address: 17 O 7 O Ca l 4w+2. 7, 6 Z
city:5�� yt e Pte, Lj State: F L. Zip: 3 11-60
Tenantlessee Name: Al /A 4e"o Phone#: A1 / 4
Email:
CONTRACTOR: Company N e: WCs'!
Address:
,)910
l�`
Com S! A,1 /',
City: °�'+��"/� �- State: F Z_ Zip:
Qualifier Name: PO Vie r_VrC1_ Phone#:.<6 �`, �� r Ole
State Certification or Registration #: C6 G Certificate of Compe ency #:
Contact Phone#:-�t-° Ajrel Email Address: 14 Dae -
DESIGNER: Architect/Engineer. Pho a#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑Additiioon� ❑Alt„e�ration ❑ENew�t ❑Repair eplace demolition
Description of Work: '"7" ��� �' I t° �''� ' (/'®�'� � r y m�> J
Submittal Fee
Scanning Fee $
Notary
Color thru tile:
Permit Fee $
Radon Fee $
Training/Education Fee $
Double Fee $ Structural. Review $
CCF $ CO/CC $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $ I&LU
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 ' n the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature's YV `-� -11N,
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this
day of _, 20 L;:S by e7r= A �
Jej-
The foregoing instrument was acknowledged before me this
day of rTd , 20 l3 , by
who is personally known to me or who has producedwho is personally known tome or who has produced 4`
1 rl yey &6&9, As identification and who did take an oath. 095 d 9^ f(L as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
N�
® ca
Sign: �— Sign: p
Prmt: $ � we Print: Q N`
My Commission txpires: SIBILA MENECIER My Commission pn'es:
�o MY COMMISSION #EE013884 w` OLIVER LIMA
EXPIRES: AUG 02, 2014 ` Notary Public, State of Florida
Bonded through lot State Insurance Commission# EE 181596
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 5/2/2012)(Revi9ei13/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR / ARCHITECT _
2�
Permit N. 'AA 004 Wit, ? 7
Owner's Name (Fee Simple retie Holder) r, 06 A t r Z G Phone #: 36 5— 3 s -1-I,K6 q
Owner's Address: 1 U 611 w S 4 y e I S v i) c- Z 6 7—
City: 9U VJu d l 9'ea ein State : rL Zip Code:
Job, Address (Of where work is being done): 7-7 A)") 10%
City: Miami Shores State:_Flodda Zip Code: 3 3/<
Contractor's Company Name: s�� dh�odu Phone #:
Address: 7 �61 .
City:a- AAA44 ,g,%,��tat
Qualifier's Nam i%,o
Architect/ Engineer of Record Name:
Address:
City: _
Describe Work:
Zip Code:
Lic. Number: Cf✓L
Phone #:
State: / Zip Code:
I hereby certify that the work has been abandoned and/or the contractorlarchitect is
unable or unwilling to complete the contract. I hold the Building Official and the
Miami Shores harmless for all legal involvement.
Signature Signature
owner orAgent Contractor orArchkect
The foregoing instrument was aknowledged before me The foregoing instrument wps aknowledged before me
this PLy of ,20t3,by%at�� this _ day of 2V IF 0%,2fiy
Who is personally known to me or who has produced who is perso ally known to me or who has produced
F-6 tiJo b t vIefr Lk!*m s e- as indentification. L ��� i as lndentification.
Sign:
Seal:
SHIA MENECII
t
MY COMMISSIONEE013884
EXPIRES: AUG 02, 21
Bonded t =9111st State Inaetance
Notary Pgblic-
Slgm�"
Seal: , putl, state ova VW
V
� leo. 24•ti49.1�i�10
S y
guallfied in Kites IO i
)mission Expires IlM>