FW-14-2155FEB 2 4 2015
February 231d, 2015
Miami Shores Village
Building Department
10050 NE 2"d Avenue
Miami Shores, FL 33138
FV A/
RE: 11225 NW 5th Avenue, Miami Shores, FL 33169
To Whom This May Concern:
This letter is to inform you the property owner no longer intends to re -do and/or
re -place the existing fence. Should you have any questions or concerns, please
feel free to contact Hubert Dube @ 305-206-5564.
Sin
rely,
Dq
Herby Dorval
JH Investment GrVuN
&µ►r rSOWAL.KOSTER
* * W CW4$10N 6 FF 120-15
* EXPIHIS: �2.018
OWF g dlliruBudgetl p'+
Cavy, ,
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑BUILDING ❑ ELECTRIC ❑ ROOFING
OCT 0 1 2014
FBC 2W17
Master Permit No.Ea2 IL- 21s.
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF CANCELLATION ❑ SHOP
s�� /� CONTRACTOR DRAWINGS
JOB ADDRESS:%ate a%V 0� U
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 6-2zoo h t -Le -Phone#: gUj %S l
Address: "2261 ?U" � 9eA2:!(& .r'
Of
City: 9)4-z A State, Zip: s ��
t� F
Tenant/Lessee Name: Phone#: ®J7 z"J>%/
,s
Email: ' ...,
CONTI
Address: f bJ 4b / --> t4J f (� �
o O
City: �% 7 Arz C State:
Qualifier Name:
State Certification or Redi
�y
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ -7J 0 ' �f Square/Linear Footage of Work: /1 r j
Type of Work: ❑ Addition ❑ Alteration ❑ New KI Repair/Replace ❑ Demolition
Description of Work:
;/r,./
Specify color of color thru tile:
Submittal Fee $ —�-30 Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Technology Fee $,
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $
Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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 wA an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement an uction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of c notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after th ermit is issued. I he absence of such posted notice, the
inspection will not be approved and a reinspection fee will�k
Signature 1 & ignatuie
OWNERrACONTRACTOR T �y�°fib
r
The foregoing instrument was acknowledge re me i��s' p � Arhe foregoing instrume t was acknowledged before n . e r
day of 020 z�, day of ,3 , 20 /JA� u fl
o ,-- ' d CMS Z & p
r
/ vulio is personally kno aim ho is personally kr n
Elf -
me or who as produced c ig J Jne or who has produced ^'
V
identification and who did take an oath. iP ^ CD �'ldentif(cation and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
l P
Sign:160264 ,- Sign /_CS✓ vrla�%c� �.
Print: %%zinc �. Cly Print: I%-14� 11,
Seal: Seal:
APPROVED BY Plans Examiner Zoning
Structural Review
(Revised02/24/2014)
Clerk