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PL-11-918 Miami Shores Village All Building Department 10050 N.E.2nd Avenue Miami Shores Florida 33138 Tel:(305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING Permit NoQ PERMIT APPLICATION Master Permit No.gc 0 C' FBC 20 Permit Type: PLUMBING Owner's Name(Fee Simple Titleholder) (' C V-e 1NlQ e)Aer Phone# Owner's Address 100�O 1 N S (O Z S CityNjaMj S 60YCS State zip 3 3(fo$• Tenant/Ussee Name Phone# Email Job Address �s where the work' 4 �0 N I i 02. ( being done) ' � S City 'ami Shores Villaee County ami-Dade Zip 3 313 FOLIO/PARCEL# \S2 C>S 02 40140 Is Building Historically Designated YES NO Flood Zone Contractor's Company Name J�%C tACW M1a rnj SUOYeS QIum l 305?512q 4Q , Contractors Address of O©- -1�;1i,�� city State F 1 zip 33 I(o $ Qualifier Name a �• U 1 n. Phone# 3cob 7�J124q' 6• State Certificate or Registration No. OF C 01a2.0'5 . Certificate of Competency No. Contact Phone E-mail M 5 ow J i Y1 a Architect/Engineer's Name(if applicable) Phone# Value of Work For this e'er � , mit$ s5 ,, r Footage Of Work Type of Work: []Addition [Alteration [] Tew- Repair/Replace ❑Demolition rr , Describe Work: lI( O Q►S Q►V1 • _:_ Submittal Fee$ Permit Fee$_ /5-0 CCF$ CO/CC$ Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ DPBR$ Bond$ Double Fee$ Violation date: Structural Review.$ Total Fee Now Due$ See Reverse side II i w 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 F URE TO RECORD A NOTICE OF COIVIN.ENCEMENT MAY RESUL YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR P Y. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE MMENCEMENT." Notice to Applicant: As a condition to the issuance of a:buxlding permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of Commencement and construction lien'law brochure will be delivered to the person whose property is subject to attachment. Alsv_,vo ee?Wfied copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (�days after the'building permit is issued. In the absence of such posted notice, the, inspection will not be approved and a reinspection fee will be charged. Signature Signa Owner or Agent Contractor The foregoing instrument was acknowledged before me this ing instrument was acknowledged before me this— day his '-_ day of 20�,by iR J of 2011,by %his LA"k (r who is personally known to me or,who has produced who is personally known to me or who has produced 43 As identification and who did take an oath. as idgntificatio who did take an oath. NOTARY PUBLIC: N Y PUBLIC: EKPIRES:.h*30.2D14 Bonded'[IagPubb Undwwkws Sign: t S Print• lS Print My Commission Expires: My Commissiol MY COMMISSION#DD753WS v� 301 v201Y MI . EXPIRES March 16,2012 FbrI9Plo'erySarvtrecom 3esYintnYir4e3n1r9c4rir4rtF4eaYe48i�ir4tveir+rledeQ4ntirar4r 1Fsk9rirdrs�r$e&dr9rlydrdlcdrd9rdrdnYs�ntrvY4iirst 4rdr9c4n9r4r4r4r#ardrar4esYsY&vY9e4aSr4r4r4rdr9rdr4adrdrdrt+kde9r4r4r9r4r.9ide9idF4rac9rdr4eitdedrQr APPROVED BY � Plans Examiner Zoning Engineer Clerk checked (Revised 07/10/07XRevised 06/10/2009) pp- MAY 10 2011 BY:_ 24 HOURS MIAMI SHORES PLUMBING TELEPHONE: 900 N.W. 144th Street 305)751-2446 Miami,Ft 33168 FAX: CC# CFC019205 (305)754.5402 incensed and!named Miami Shores Village Building Department. 10050 Northeast 2nd Avenue. Miami Shores,Florida 33138 To whom it may concern, This letter is to request cancellation on the following permit#PL-5-11-918. We had requested this permit in order to do the job but MSP is not going to do the work for 1461 102 Street. Please cancel and close this permit. Thank you, Dennis McLaughlin