RC-05-1104 yn) jU IQ 31610 Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fag: 305 756.8972
RECEIVED
BUILDING FEB. Y005 Permit No LC-��— 4-
PERMIT APPLICATIONaster Permit Nogcdr&— 1 1 d 4
FBC 2001
Permit Type (circle): Buildin Electrica Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) J l M m Lj 'tt6,P 5 Phone# tax-) -7&o-v (o �a-
Owner's Address q q l LL.E 4 1si-
Cityi&4t arN1 j �IQY�Q State ';F( Zip 's l 3
Tenant/Lessee Name Phone#
Job Address(where the work is being done) q�1 .�
City NHami Shores Village County Miami-Dade Zip
32 ,39
Is Building Historically Designated YES NO
Contractor's Company Name O k2lbN l N C Phone# (4 9 s d q a
Contractor's Address NO 40 9. W
City �J&4h M a"1 1 State_JEJ. Zip
Qualifier
Architect/Engineer's Name(if applicable) O Q M�2bQ J Phone# Q -3 93do
$Value bf Work For this Permit ` '39" 700&() Square Footage Of Work:A5
Type of Work: ddit''ion ❑Alteration []New ❑ Repair/Replace ❑Demolition
Describe Work: AA t<V� �'� - 1Y1 QS r(�rarYl bc&r ck�n Ja f )j nperi
(jhhp ►jkt4-" +y e(Its . yen. r -rr L oLtrGb1 t
Fees*s*****�c***a�****�******reaa**�
Submittal Fee$ -0 O Permit Fee S-3? g 1 °� CCF$ -7 9-8C�) CO/CC i 50. 00
Notary$ Training/Education Fee$ '-7(4P - G0 Technology Fee$ 99 -
Scanning$ 130'CXR Radon$4.10 +, 41-10 Zoning Bond$ 300- 00
Code Enforcement$ Structural Plan Review.$ 4a (DO*.6"O' a -AS0, Od �f,�Q, 00
Total Fee Now Due$ 4 ? �' `�� COt YT12 A e ¢ s
114,91
(Continued on opposite side)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) x
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 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.
Signature Signature � _ f
Owner Agent _ Contractor
The foregoing instrument was acknowledged before me this S The foregoing instrument was acknowledged before me this S^
day of 20 Of-,by / HMS/ &4!E_6 day of j� �zt ,20!L-�by
who is personally known to me or who has produced who is personally known to me or whg r >tl�S
As ' ntification and who did take an oath. as i oath.
NOTAR LIC: 0'O IJ01" Nancy Iglesias NOTARY PUBLIC: 9 Th C•,m�.
a . #DD1170PA •,rF ��. tiBc 9oadtas
t�� Commission y
Sign: ` •° ires May A Was
— SiNAM Ibm
gn:
.
Print: Prin��o
My Commission Expires: Mymmission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY: AX4 411-911010 ry Plans Examiner
Engineer
Zoning
Chc 12/15/03
�,°rs Inspection Worksheet
Miami Shores Village
) 10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-849 Permit Number: RC-12-05-1104
Inspection Date: 09/27/2006 Permit Type: Residential Construction
Inspector: Grande, Claudio
Inspection Type: Spot Survey
Owner: BAES, JAMES AND JACQUELINE Work Classification: Addition
Job Address: 941 91 Terrace NE
Miami Shores Village, FL 33138- Phone Number (305)762-6122
Parcel Number 1132060030050
Project: <NONE>
Block: Lot:
Contractor: ORONI INC Phone: (305)685-0412
Building Department Comments
�j Inspector Comments
Passed
Failed E]_
Correction
Needed
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid.
Tuesday, September 26, 2006 Page 1 of 2
CANCELLED
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