RF-14-1932BUILDING
Miami Shores Village
Building p De artment IRIEC�
SEP 5201144
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 e-
FBC 20
Permit No. e I L4 _ l �-
PERMIT APPLICATION
Permit Type:
JOB ADDRESS:
BUILDING
1C
Master Permit
ROOFING
City: Miami Shores r p County: Miami Dade Zip: 1!0.01 ')TS
Folio/Parcel#: �_ ' o�� V 1 LA 00 � 0
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): �/� ,fel i7 C, r Paco ges Phone#:,,,�5'o�g"�q`'1 q
AA-... 1('11 / t)a n K11� s P1 a
City: State: Zip: 3-6 161
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: D__)
City:
Qualifier Name:
State Certification or Registration #:
Contact Phone#:
Address:
of Competency #:
DESIGNER: Architect/Engineer: Phone#:
pg�-Daau
Value of Work for this Permit: $30,550-00 Square/Linear Footage of Work:gt-700 SE
Type of Work: DAddition DAlteration ONew epair/Replace ODemolition
Description of Work• :"( I'P. , P/1 Ijct 4- rp,rt�
Color thru tile:
Submittal Fee $ V ° (Z Permit Fee $ 3S 00 CCF $ Q) CO/CC $----��.��� ° W
Scanning Fee $ 2-i "U Radon Fee $' - '-75 DBPR $ S • 2-5 Bond
Notary $ a Training/Education Fee $ 0 Technology Fee $ 9�4
Double Fee $ (%i Structural Review $
"TAL1;NOW DUE $ f'6 t
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 issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Owner or Agent
The foregoing instrumen
taacknowledged before me this
day of 20 0 XI's ,
who is personall known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: C----
Print:
✓Print: ��II
My Commission Expires:
APPROVED BY
Contractor
The foregoing instrumen wled ed befgre me
day o r 20 , by
who is personally known to me or who has produced
as identification and who did take an oath.
Expires: Nov 13, 2017
www.AAxoNNOURT. om
G� Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
Sign: ell
Print:
My Commission Expires:
trxpires: Nov 13, 2027
www.AM0XN0r aey=X .
Zoning
Clerk
ocT 2 2 2014
REQUEST FOR CANCELLATION OF PERMIT
October 20, 2014
City of Miami Shores
Building and Neighborhood Compliance Dept
10050 N.E. 2nd Ave
Miami Shores, FI 33138-0000
Re: Permit # RF -9-14-1932
10690 NE 5 Ave
Miami Shores, FI
Dear Building Official,
We are hereby requesting that the above reference permit number be cancelled. No work has been performed on the
property. The owner has chosen not to pursue the project any longer. Please do not hesitate to contact us should there
be any further questions.
'o F ada
sident
Roofing Contractor CCC1327381
pw.4-0
�,.�?, V 'Ix Jacqueline Espinosa
"ammism-#FF070372
' #
K XFspim: Nov 13,2017
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WWW.AARONNoTAMA m
t L� CITY ROOFING
22700 SW 172 CT MIAMI, FL 33170
0: 305.246.2994 F: 305-248-2677
INFOO-CITYROOFING.CC