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MC-06-2169 �; 0 ,,,Miami Shores Village AUG s 2006 B p,j��`o� uilding Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax: (305)756.8972 BUILDING Permit No.mco&_Z1 rop� PERMIT APPLICATION Master Permit No. �� L Z37 FDC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name Fee Simple Titleholder) (f ' Phone# Owner's Address z Cityh 1 State Zip Tenant/Lessee Name Phone# Job Address(where the work is being done) A d�'��t�` unty Mianu-Dade Zip City Ai"iami Shores Village / 1 Is Building Historically Designated YES (/' NO Contractor's Company.Name Phone# � Contractor's Address I � City S e Zip 1� Qualifier VCS State Certificate or Registration No.Q2Z- G434 Certificate of Competency No. Architect/Engineer's Name(if applicable) �, 1�^(:-5- Phone# $Value of Work For this Permit 000 Square Footage Of Work: Type of Work: ❑Addition DAlteration ❑New ❑, Repair/Replace [I Demolition Describe Work: Submittal Fee$ Permit Fee$ CCF$ MCC Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review. $ Total Fee Now Due$ (Continued on opposite side) I Bonding Company's Name(if applicable) 1� 1 Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) L.-J 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 Jo ofencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit the absence of such posted notice, the inspection will not be approved.and a reinspe 'on fee will be charged. Si e Si tune 0gn� t� Owner or Agent Contractor The foregoing instrument was acknowledged before me thi�� The foregwas acknowledged before me this day V 2 ,by I day DW' 20 by who is personally known to me or who has produced who is personally known to me or who has produced As id cation and who did take an oath. as identificati d who did take an oath. TARY C - NOTARY P L Si Sidu gn Prim: +� JULIET I E COLLADOq Priv : �F M1'CQ�y E COuADO 11 COMMISMON W.DO 24,M70 UF IV' s My Commission �9`® EXPIRES:January 1,2ooe My Co '+Res:Jen'nu '1,zoo eoo uorr�av FL NOWY nftaxa AM=Co. "� ,n �����,�,�����,��,���,x��������,����,����,�x�����,�,�,x:•,rte APPLICATION APPROVED BY: Plans Examiner Engineer Zoning Chc 05/13/03 N PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address Tax Folio Legal Description j I I')y.0�6 I MGoway a I�istorically Designated: Yes No Owner/Leswe/Tenant Master Permit# Owner's Address Phone �65- �!66 Contracting Co. Address C Qpm � �1 �. �I C IC__In, SS# Phone 3b5'oV5—53lV State# Municipal# Competency# Ins. Co. Architect/Engineer • Address �� Bonding Company t3 019 Address Mortgagor Of-) Address Permit Type(circle one): BUILDING ELECTRIC )'LUMBING CHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR EWPROVEMENTS TO YOUR PROPERTY(IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above,and on the attached addendum(if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING,SIGNS,POOLS,ROOFING and MECHANICAL WORK. OWNERS 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. Furthermore,I authorize the above-named contractor to do th ork stated. b4bk �\k.-r�A Si f owner and/ Colo President Date Signa tractor or Owner-Builder Date 0 otary as to er and/or Condo Pres N tary as to Qr Date Co o M Co �. 41- M CO JUUETTE COLLADO , �miq oq► O y W COMMISSM# DO 278278 q genu X27 EXPIRES:.January 1,2008 �'or�,��Y 1,��e 1400 40TAW P nxnaw 0WOum Meoc"Co. "tet Co FEES: PERMIT RADON C.C.F. NOTARY BOND APPROVED: TOTAL DUE Zoning Building h Electrical Mechanical Plumbing Strvctutal Engineer YJ Miami Shores Village o��v / Building Department 1(1 OL 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 mcml OJ z� ,� l '? 3 BUILDING �L UIL ING C� 0 Permit No. CI u PERMIT APPLICATION 2 2006 aster Permit No.�` � � FBC 2004 BY-_ Permit Type(circle): Building Elect •c Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) WA ,C�[ e.) hone# Owner's Address ;9. e-r i V City-66U-C�,5- — State 41- 0n O,A Zip 33 Tenant/Lessee Name VIA Phone# Job Address(where the work is being done) aZ C, z City Miami Shores Village County Miami-Dade Zip FOLIO/PARCEL# Is Building Historically Designated YES NO Contractor's Company Name GAS kw_, Phone# Contractor's Address sv syc,e� Ci // ,�Q� State Zip 33 Qualifier Name I.e, '—\° f - Phone# State Certificate or Registration No. ``<,irotificate of Competency No. Architect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$ Square/Linear Footage Of Work.• Type of Work: ❑Addition ❑Alteration �INew ❑ Repair/Replace El Demolition Describe Work: / z v ` b Submittal Fee$ Permit Fee$ '4? CCF$ CO/CC Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$ See Reverse side Bonding Company's Name(if applicable) Bonding Company's Address t 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 Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20___,by day,of .20— by , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC; Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 02/08!06)