WS-15-586- -
%s° y,4 Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
" Phone: (305)795-2204
rroiect Aaaress Parcel Number Applicant
41 NW 102 Street 1131010180110 HERBERT PARLATO
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
HERBERT PARLATO 41 NW 102 Street (305)321-0278
MIAMI SHORES FL 33150-
41 NW 102 Street
MIAMI SHORES FL 33150 -
Contractors) Phone Cell Phone
J8,G CARPENTRY INC (561)333-5042
le of Work: CHANGE OUT 1 DOOR
of Openings: 1
iitional Info:
ssification: Residential
inning: 3
Fees Due
Amount
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$110.00
Scanning Fee
$9.00
Technology Fee
$2.40
Total:
$127.80
Valuation: $ 2,604.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # WS -3-15-54827
03/17/2015 Check* 18647 $ 50.00 $ 77.80
03/30/2015 Check #: 18750 $ 77.80 $ 0.00
Available Inspections:
Inspection Type:
Window Door Attachment
Final
Review Building
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: Ice that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction- e�.�k�nore, I authorize the above-named contractor to do the work stated.
March 30, 2015
_�utNi9Fi;9Mgnature: Owner / Applicant / Contractor / Agent
3uilding Department Copy
March 30, 2015
1
;�Iqsem_ AQP' /
r�G06
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
$_(7R
MAR 17 2015
FBC 20/®
BUILDING Master Permit No.W s 1 S-~S�
PE MIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING REVISION [:] EXTENSION ❑RENEWAL
(]PLUMBING [:]MECHANICAL FJPUBLICWORKS CHANGE OF [] CANCELLATION `] SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 'j I jj &o l a 9 3 f
Ci • Miami Shores County: Miami Dade ZiD:. acv,
Folio/Parcel#:i Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: - BFE: FFE:
OWNER: Name (Fee Simple Titleholder): °i-�'� C` 'PCL r Ica L-) Phone#� 3 -al- d0 e
Address: Ll 1 A I IC) 0-\
City: � i Wo f- es;, State: 1� Zip: - `S ��
Itnant/Lessee Name:
Email:
CONTRACTOR: Company Name: � w� l.r
Address: Y—
City: � l' � ca t _-�,Stattee::
Qualifier Name: -'s
State Certification or Registration M
Certificate of Competency M
!Ip:
_-7A
I _�t
Ct'
DESIGNER: Architect/Engineer: Phone#:
Address: City: State Zip:
i Value of Work for this Permit: $ (0()q, S - f! Square/Unear Footage of Work'
Type of Work: ❑ Addition ❑ Alteration / El New E2 Kepair/Replace El Demolition
Description of Work• I ' iA � � ^ /9a r . %��( �� riP�r� 9('v �CeC\ ® (°. A X01
I.J
Specify color of color thru tile:
Submittal Fee So I
-W Permit Fee $ 1 1 a
$
Scanning Fee $ Radon Fee $
Technology Fee $
Training/Education Fee $
CCF $ CO/CC $,
DBPR $
Notary $
Double Fee $
Structural Reviews $ 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
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 accurat d that all work will be done in compliance with all
applicable laws regulating construction and zoning.
�a
e �®
"WARNING TO OWNER: YOUR FAILURD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IM EMENTS 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, tke
inspection will not be approved and a reinspection fee will be Fharged.
Signature
U
OWNER'or AGENT
The foregoing instrument was acknowledged before me this
day of tA 20 ) j .by
0-004c' CuAle . who is personally known to
me or who has produced '^
identification and who did take an oath.
Signature "_
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of m Q froh , 20.15,_, by
-Lb V , who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
r�)Z
401
Sign: Sign:
Print: -
P -040 -Seal.
*****
APPROVED BY
(Revised02/24/2014)
DOLORES LEAW
MYGOMMS M 6 EE 14922&
Balled heli Match 24, 20ur 1
Print:
Seal: I my
if Plans Examiner
Structural Review
it EE188835
EXPIRES April 12, 2016
as
Zoning
Clerk
M
J & G carpentry hw.
13461 79di Ct. N.
West,Palm Beach, FI 33412
561-855-4052
561-9554054 fax
May 5. 2015
Miami Shores
Building Department
Re: Permit #WS -3-15-586
To Whom It May Concem
Please be advised that we would like to cancel/close permit #WS-3-15-584for customer
Herbert Partato located at 41 NW 102 St.. Customer has cancelled and J& G Carpentry
has done no work. at this site.
Should you have any questions please do not hesitate to contact our office.
Sincerely,
L"James D. Davis
STATE OF FLORIDA *COUNTY OF PALM BEACH
The foregoing instrwnent was acknowledged before me
this day of '20 1 5
Who is personally known to me and who did not take an oath.