PL-05-39 Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
BUILDING REC,EWED � Permit No.
PERMIT APPLICATI NIA-A 2 M5 Master Permit No. �Q
FBC 2001
Permit Type(circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) $ G►�V Phone# 3�� 21ej a
Owner's Address 3 11 l). F=. 10 1(NST-
city
�%V%VYt �t Sino Yr S State Zip 3 1,32
Tenant/Lessee Name Phone#
Job Address(where the work is being done) 3 34 N . ca J 0
City Miami Shores Village County Miami-Dade Zip 3 g
Is Building Historically Designated YES NO
1
Contractor's Company Name U � � _SPhone# 3 S 'W,? 460
'
Contractor's Address of
City lM.l&nN l State Zip 3 3
Qualifier (1 &161/xz C.
Loe
State Certificate or Registration No. C.9 C-OLI q Q Certificate of Competency Nov
Architect/Engineer's Name(if applicable) V ,c1`o 6 ✓Kl c1.►-.O Phone# 3a S- 9 7 S 3_21.aC
$Value of Work For this Permits Square Footage Of Work:
Type of Work: ❑Addition p ❑Alteration (✓flew ❑ Repair/Replace ❑Demolition
Describe Work: ` e r% Y 'e't-ed" (:P0-C) C Q tIti�
Submittal Fee$ Permit Fee$ CCF$ V, 0 0 CO/CC
Notary$ Training/Education Fee$ Technology Fee$_
Scanning$ 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
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.
Sign01 Signature
Owne or Agent Contractor �}
The fpregoing instrument was acknow dged before me this 6; The foreg i instrument was acknowledged be this CQK
day o ,; ? LLI�y; Q ;b , day of >2tIJS ,by i
wh' 'rsonally known to me or;who has produced who is rsonally known to me or w o has produced
As-identification and who did take an oath. s i entification and who did take an oath.
NOTARY PUBLIC. ' NOTARY PUBLIC-
Sign:.... :"' � ,s Cnxuny x. GcT1
A' scion#DDarm
Pn�nt ,,
M 26008 K
a .- -
tf� iiia¢ BondedyThni �= ,
My Commission E ires: � Atlantic Bonding�M Commission Explresn , oQ\E ices:Ju; 13,2007
ovFlo�. londed Thru
***rAPPLICATION APPROVED BY: �®"'Plans Examiner
Engineer
Zoning
Chc 05/13/03
*' eri"zs
Miami Shores Village Plumbing Permit
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: PL2005-39 R
Printed:2/11/2005 Page 1 of 1
Applicant: DALLAS BROWN
Owner: BROWN DALLAS
JOB ADDRESS: 334 NE 101 ST
Contractor SUNSET POOL AND SPA Contractor's Address: 5355 SW 133 CT
Local Phone:
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
FEE2005-1852 Building Fee $160.00 Total Fees:$114.80
FEE2005-1853 CCF $0.60 Total Receipts: $0.00
FEE2005-1854 Training and Education Fee $0.20
FEE2005-1855 Technology Fee $4.00
FEE2005-1856 Submittal Fee ($50.00)
Total Fees: $114.80
Permit Status: APPROVED Permit Expiration: 7/27/2005 Construction Value: $600.00
Work: PERIMETER POOL PIPING
0162005
Signed: (INSPECTOR)
with all ordinances and regulations pertaining thereto and in strict
In consideration of the issuance to me of this permit,1 agree to perform the work covered hereunder in compliance w 9 p 9
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: