RC-12-1154 Miami Shores Village
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Building Department NOV 14 2012
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 IIs:
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762A949
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$ ING Permit No.
PERMIT APPLICATION master Permit No.Sco- I lsLi
Permit Type: BUELDING ROOFING
JOB ADDRESS: 806 NE 97th Street
City: Miami Shores County: Miami Dade gip; 33138
Folio/Parcel#: 11-3206-014-2760
Is the Building Historically Designated:Yes NO X Flood Zone: Y
OWNER:Name(Fee Simple Titleholder):Edward L. Harkrader Jr. Phone#: 786-246-2500
Address: 806 NE 97th Street
City: Miami Shores State: FL Zip; 33138
Tenant/I.essee Name: NIA Phone#: N/A
Email; mustangsgd@aol.com
CONTRACTOR:Company Name: Owner Phone#: 786-246-2500
Address: 806 NE 97th Street
City: Miami Shores State. FL gip; 33138
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:ArchitecttEngineer: Mierela/Adriana A-1 Engineerincphonem 786-930-357
Value of Work for this Permit:$ 21,000.00 +/- SquardLinear,Footage of Work: 130 sq ft+/-
Type of Work: ❑Addition ❑Alteration ❑New 96pair/Replace ❑Demolition
Description of Work: Remove&replace drywall, remove and replace kitchen cabinets
Remove existing kitchen 30"door&replace w/36"door per attached engineer/architect drawing(s)
Block in existing kitchen comer jalousie window per attached engineer/architect drawing(s)
Color thru tile:
OZZ's
Submittal Fee$ Permit Fee$_ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$ 09% oft
TOTAL FEE NOW DUE$ JW
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Bon0ing 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
Signature
Owner or Agent Contractor
Jy
The foregoing instrument was acknowledged before me this The forere4��
was acknowledged before me this
,
day of ND✓ 2012 byUKAAZO l-1Q� �day of . 0 by ,
who is personally known to me or who has produced '':::� '''o 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: ����+++++++++mei/, NOTARY PUBLIC:
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Sign: a= �O; Sign:
Pant. Pant.
My Commission Expires: 9 o : �144 My Commission Expires:
.....
APPROVED BY f�j IJ 7-t�Plans Examiner Zoning
* V Structural Review Clerk
(Revised 3/1212012)(Revised 07MV07)(Revised 0611(V2009)(Revised 3/15109)