BP-05-1190 r
Miami Shores Village
F Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax: (305)756.8972
BUILDING Permit No. "� � 1 `0
PERMIT APPLICATION o �� ster Permit No.
FBC 2001 AUG 2ag5
Permit Type(circle): Building El "n - o In�bin Mechanical Roofing
Owner's Name(Fee Simple Titleholder) `�";/a�As� V 67? Phone#_ A 7srsl —L�0
Owner's Address pp9<6 14.LA) ® S k—
City �� S h 6 e� N State Z_ Zip 3:5,( (
Tenant/Lessee Name Phone#
Job Address(where the work is being done)
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name 0u_, gr Phone#
Contractor's Address
City State - zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
? $Value of Work For this Permit 4 I ® ®6 Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration []New lace Re air/Re
p p ®Demolition
Describe Work:
c; z_ —(-rat-,Q 0-t f 0-eX.
Submittal Fee$ Permit Fee$ �� / CCF$ 1 -2-0 CO/CC
Notary$5• CICU Training/Education Fee$ G7 • 40 Technology Fee$ Z • .:0
Scanning$ 3.cv Radon$ Zoning Bond$
Code Enforcement$ Structural Plan Rleiew.$
Y. `
Total Fee Now Due$ �� A 6 1 9I�
(Continued on opposite side) CHK ,��
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Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip '
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address Y
4
City State Zi
P
y
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 appy ,ed and a reinspection fee will be charged.
Signature r Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 10 The foregoing instrument was acknowledged before me this
day of ,2( by day of 20 by ,
who is persoft4 known to me o 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 PUB NOTARY PUBLIC:
Sign: �P,,, l - 4 Sign:
Print: it :Ju 3,201'-/
Print:
N•
•on e
My Commissi Expires:`' �F °Q' n�>,Tsie nondins 0� 1"c My Commission Expires:
APPLICATION APPROVED BY: �� (/� Plans Examiner
Engineer
Zoning
Che 05/13/03
r _ Miami Shores Village
g
Building Department
• 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tet: (305)795.2204
Fax: (305) 756.8972
Permit No. (95— / AO
Job Name (/41(&Z
BUILDING CRITIQUE SHEET
I-e Cr t C 4/2-011-r w;� � � � L"e-0 r ,4 -2i?-,n t?'
q'ie-criue'a'c 1-0y ai c.
Miami Shores Village Building Permit
10050 NE 2nd Avenue ..►..
Phone: 305-795-2204 Permit Number: BP2005-1190`
Printed:8/29/2005 Page 1 of 1
Applicant: YVROSE VALDES
Owner: VALDES YVROSE
JOB ADDRESS: 86 NW 108 ST
Contractor Contractor's Address:
Local Phone:
Parcel# 1121360110160 Legal Description: DUNNINGS MIAMI SHORES EXT NO 7 PB 52-33 LOT 8 BLK
Fees: Description Amount
FEE2005-11770 Building Fee $100.00 Total Fees:$112.10
FEE2005-11771 CCF $1.20 Total Receipts: $0.00
FEE2005-11772 Notary Fee $5.00 p
FEE2005-11773 Training and Education Fee $0.40
FEE2005-11774 Technology Fee $2.50
FEE2005-11775 Scanning Fee $3.00
Total Fees: $112.10
Permit Status: APPROVED Permit Expiration: 2/6/2006 Construction Value: $1,500.00
Work: REPLACED CABINETS IN KITCHEN
AU
6 2 9 PAID
CHK /633
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:
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