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EL-03-114 Miami Shores Village 1� Building Department 10050 N.E.2nd Avenue,hfiami Shores.Florida 33138 Tel:(305)795.2204.F= (305)756.8972 a� 1 BUILDING Permit No.Marm PERMIT APPLICATION Master Permit No. Z40 FBC 2001. Permit Type(circle): Building <�Electr4i, Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) X0as-' Phone#-7o"' G'i "`.S S.Ra Owner's Address ZZ11 JW city /Ll��a r-t stagy jIm—4 zip .33 I S S TenaoMessee Name Phone# Job Address(where the work is being done) city Mami Shores Village County Miami--Dade Zip U Building Historically Designated YES NO_,&X _ Contractor's Company Name &UC GJ CC- Phone# .r30! W-TO ` 1 Contractor's Address b d YI-ArQ NL&& . City y State T Zip 3 Architect/Engineer's Name(if applicable) �J ��� Phone# 9' $Value oWork For:trPermit� Square Footage Of Work Type of Work: ❑Addition ❑Alteration ew ❑ Repair/Replaco ❑Demolition Describe Work: L� ~`u ` �,��rc�t,ta.CA,-� Submittal Fee$ Permit Fee$ y— CCF$ CO/CC Notary$ Training/Education Fee$ Technology Fee$ Scanning,$ Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ 75- .(Continued on opposite side) 4 Bonding Company's Name(if applicable) Bonding Company's Address City State Zips Mortgage Lender's Name(if applicable) Mortgage Lender's Addr6s 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 m 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,LTC..... 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 o, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which-occur sev (7J days after the building permit'is issued In the absence of such posted notice, the inspection will not be approved an re- sp c#on fee will be charged Signature Signature er or Agent - Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 D ,by _ forte- 1.a .2 day ofGty .2001by C41 los rnort�7�Z who is Oersopally known to me or who has produced who is y known,to me or who has produced L— As identification and w did take anbath. L as identification and who did take an oath. NOTARY PUBLIC• NOTARY PUBLIC: Sign: Sign: 49V Print: Ate'% L.Bet8IIMurt Print: kb 0im Q: DOW May 22,2006 On#DD12033F My Commission E � ceded Ibm My Comma May 22, 2005 a4a4a4dedeaYaYd&f/iinYa4inYaka4dea@tin4&e7i9i8rsnt>tis�. 1css�i $ G�raaw*�i�rtr�i�e�rtr�r�rtr,ear�r�iatrtrtc�r�r ateSr�r�r�itr�iat�r ,xsr�r�e�esr (Certificate of Competency Holder) Bott c°"L`' State Certificate or Registration No. Ceitificft of Competency No. *+�>b�e�e>k�eex�e���eax�x��e�e>k�e>��e*�e��xe��e�e�*�e*�e*ex+�xe�e**�eae�ee�exaee�*exx,xex�e�ex�e*ex*�e�e�e*�exee�eex�e�ee��e�e�e�eaeer*wexeex�e+�*�e�e*we�+�xreae**�****ex>tea>aexe APPLICATION APPROVED BY: Plans Examiner Engineer Zoning Chc 12/15/03 PERMIT APPLICATION FOR MIAMI SHORES VILL GE 10050 N.E.2ud nnue•Miami Shores,Florida 33138•Phone:305-795-2204• F :301 ff�- 2 Date Job Addres i� �f �u � Tax Folio Legal Description Historically Designated: Yes No Li ' edfLessee/Tenet Master Rermit# 0- IN 7 twners AddressEle� ��q !,t p1d Co.�1a l L Address �DT7� 14) W [-t- --#40 t a4rb L -e SS# Phone 2^5evic'f State#0000 524 Municipal# Competency#OPM it 2771 Ins.Co.lvs"renc-c Myeket m IF THERE IS NO PERIVIIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,' THERE WILL BE NO INSPECTION.RE-INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING PLUMBING MECHANICAL ROOFING WORKDESCREMON: Vew 61'elcqleEICE-�all rov- Vy'(') kdwwPh Square Ft. ted cost(value) 1�, V UQ•OY-) WARNING TO OWNER:YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY(IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR ANY 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 all disciplines. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all wo will be done in con fiance 'th all applicable laws regulating construction and zoning.Furthermore,I authorize the above named contractor to do work s 0.130„-03 Signature of o d/or o dent Z Date Si of Contractor or Owner Builder Date ■ r Notary as t er andlor Condo Preside t Date Notary as to CUtractor or Owner Builder # Date My Commission ExFv0*=LWTARYSM My Commission Expua,( NOMBER � l^"r nGpJ81 N-WW MYt 167 E8 & CCy78148 NOv.192 W �iF off. W �py�19z00� FEES:PERMIT RADON C.C. NOTAR OND APPROVED: TOTAL DUE Zoning Building Mechanical Plumbing Structural Engineer Miami Shores Village Electrical Permit 10050 NE 2nd Avenue Phone: 305-795-2204 Permit Number: 1 Printed:11/16/2005 Page 1 of 1 Applicant: LATIN AMERICAN INVESTMENTS Owner: INVESTMENTS LATIN AMERICAN JOB ADDRESS: 9495 BISCAYNE Blvd. Contractor CARLY ELECTRICAL SERVICE Contractor's Address: 680 FLAGAMI BLVD. Local Phone: 305-970-6345 Parcel# 1132050070010 Legal Description: Fees: Description Amount FEE2003-2735] Building Fee $375.00 Total Fees:$750.00 FEE2005-14604 Renewal/Extension Fee $375.00 Total Receipts:$750.00 Total Fees: $750.00 Permit Status: APPROVED Permit Expiration: 12/31/2006 Construction Value: $225.00 Work: NEW ELECTRICAL FOR NEW HOUSE V 16 PAID 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: