EL-05-42 Miami Shores Village
Building Department
10050 N.E.2nue,Miami Shores,Florida 33138
Tel:(3 5 � .8972
BUILDING JAN"28 Permit No.PERMIT APPLICATION aster Permit No. 155 - } ,
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) PDX Aj Phone# -905- _Sc d-ol
Owner's Address 33q /1/ 6, a
City ,^Vt m . sews State .__ FZj Zip �J 3 1,3
Tenant/Lessee Name Phone#
Job Address(where the work is being done) 33
City Miami Shores Village County Miami-Dade Zip -3 3/
Is Building Historically Designated YES NO
Contractor's Company Name 2f>_c) /G =N C_ Phone# 2oS- aO 7 076 d'
Contractor's Address 1035' j /�69 C---f
City /$ State— Zip .33
QualifierC7 fe.Z
State Certificate or Registration No: O'®O 3 S-17 3 Certificate of Competency No. 0 e9ac7,0 1/9
Architect/Engineer's Name(if applicable) Phone#
Value of Work For this Permit �Oy Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ANew ❑ Repair/Replace ❑Demolition
Describe Work:
r, r -_
Submittal Fee$ �Q ,0V Permit Fee$_ �5 CCF$ V CO/CC
Notary$ ( Training/Education Fee$ LA Technology Fee$ JI
"
Scanning$ Radon$ Zoning Bond$
Code Enforcement$ Structural Plan Review. $
Total Fee Now Due$
(Continued on opposite side)
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
pP Y p fY
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Sign Signature
Owne or Agent Contrctor
The foregoing instrument was ackno edged before me this } The foregoing instrument was acknowledged before me thisV
day of 20�-. %C /�� �l day of J A 20Q�,by
who is sonally known to me or ho has produced who ispersonally known to me or who has produced
tis eYitifiication and who did take an oath. as identification and who did take an oath.
NOTARY UB IC: _ NOTARY PUBLIC:
Sign:--- _.ot Y? -; Ginny H. GNw l
omnussion#DD 3�$�q
punt.. t t. :Q_ :May
1)
punt.. g r-
OF FL Bonded 77tiu' MARITZA CONSTANZO
My Commission Expires: / / ""'" Atlantic Bondi CbVIcCommiss s'
/U g _ MY COMMISSION#DD 286462
84Ytd�d Tliru Notary Public Underwriters
APPLICATION APPROVED BY. ' -P,5 Plans Examiner
Engineer
Zoning
Chc 05/13/03
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305) 756.8972
-- -- _ - -- 5 ► �3-
---Permit-Na: v-- -- _ .
Job Name
BUILDING CRITIQUE SHEET
Miami Shores Village Electrical Permit ,
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: EL2005-42y`
OR
Printed:2/11/2005 Page 1 of 1
Applicant: DALLAS BROWN
Owner: BROWN DALLAS
JOB ADDRESS: 334 NE 101 ST
Contractor IRO ELECTRIC INC Contractor's Address: 525 NW 27 AVE 101
Local Phone: 305/207-0766
Parcel # 1132060135300 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOT 8 &W1/2 OF LOT 7 BLK 39 LOT SIZE
Fees: Description Amount
FEE2005-1847 Building Fee $225.00 Total Fees:$181.43
FEE2005-1848 CCF $0.60 Total Receipts: $0.00
FEE2005-1849 Training and Education Fee $0.20
FEE2005-1850 Technology Fee $5.63
FEE2005-1851 Submittal Fee ($50.00)
Total Fees: $181.43
Permit Status: APPROVED Permit Expiration: 7/27/2005 Construction Value: $700.00
Work: POOL PUMP LIGHTS-MASTER PERMIT BP05-138 FEB:16 296
Signed: (INSPECTOR)
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 responisibility for all work
done by either myself,my agent,servants or employes.
Signed: (Contractor or Builder) BY:
Zol A4
MIAMI SHORES VILLAGE Q
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date
Type Insp'n E t G'
Permit No.
Name 8 td �n
Address �3 t
Company /sY (til l l )
Phone#
Inspection Date 11 5
Approved
Correction
Re-Insp'n Fee