BPP-15-1259 Miami Shores Village F �- �
3 I� R
b Building Department MAS n15
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 ( 6
BUILDING �
Master Permit No-��P?y 17-`a51
PE MIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL E:]PUBLIC WORKS E] CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /&V A')
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Namp jFee
Simple Titleholder):
Or/ S fs Phone#:
Address: � V 3 q`v�
City:
� State: Zip:c33/.�
Tenant/Lessee Name: Phone#:
Email: Q.I'1�f�1�'�ft� • C L*\Qj
CONTRACTOR:Company Name: q1zFf �� ' cZ Phone#:
Address: / Z A-) `G Aja
City: � 1 `/ C ( Q State: Zip: 31
1--
`
Qualifier Name: uy� i A c1C�-(� A , a,9 %�� Phone#:
State Certification or Registration#: Certificate of Competency#: l Z�20067 Zj L3
DESIGNER:Architect/Engineer: Phone#:
Address: rr City: State: Zip:
Z
Value of Work for this Permit:$ to 0 0(� Square/Linear Footage of Work: _1.5 O
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 5 o v a Ca N, � LC
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
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 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 b d and a reinspectiop fee will be charged.
Signature Signature—,.41
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged befg� this The foregoing instrument was acknowledged before me this
day of 20 = y �� day of 1�l L 20 by
S �� w;o is perso ally know mt _ "+� \—ko who is personally known to
me or who has produced � V trS `` me or who has produced W, I V
identification and who did take an oath. entification and who did take an oath.
NOTARY PU C: NOTARY PUBLIC:
.► a c S10N FF PAS
Sign: A Sign: ;. �5..Yahl11, 1kaA
Print: P FF 126M
f7,2016l (�,
Print:
Seal: Seal:
APPROVED BY Plans Examiner d") S^ Zoning
I
Structural Review Clerk
i
(Revised02/24/2014)
a
NOV p 9 2015
11/3/15 $'Y.
To Whom it may concern:
RE: Permit Bpp-15-1259
1460 NE 103 ST
Miami Shores FI 33138
1 ,Christopher Savits owner of 1460 NE 103 ST, Miami Shores Florida 33138 am requesting you
please cancel /close the above referenced permit number due to no work being performed by
the company that pulled the permit.
If you have any questions please feel free to contact me.
Thank you for your attention to this matter.
Best Reg
Christopher Savits C�
786-877-3564 �S ��
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