16-1628 Miami Shores Village . X,RD
Building Department FBY:
U s o
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 4 15 tk
FBC 201
BUILDINGFIMaster Permit No. l u t62-3
PERMIT APPLICATIONwm
CANC Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF 'CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: , "' {� '55
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
ILC
OWNER:Name(Fee Simple Titleholder}��� CdnS-h-Ae,�,j4 &Wj AtA1 E Phone#: � ]
Address: J Z/ &E /®/,$-f' I
City: /'y LglY 1 s io r S' State: �L Zip: 33/39
Tenant/Lessee Name: Phone#:
Email:
'r
CONTRACTOR:Company Name: AJ Phone#;
Address:
City: State Zip:
Qualifier Name: Phone#:
State Certification or Registration M Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
�
Value of Work for this Permit:$ 5 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: C,44'�IZA_ 1)6C.4C_ 7_jAro
Q
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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 V 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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,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 approveand einspection fee will be charged.
Signaturc�(- Signature
O ER or AGENT CONTRACTOR
The foregoing ins ment was acknowledged before me this The foregoing instrument was acknowledged before me this
d day of �u°1 ,20 ( ,by day of 20 .by
!8L*—kALVe5 ,who is ersonally wn to who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: ►'i'►t kF Print:
Seal: ►+""4NotMy ary Public State of FWW8 Seal:
. Michael Rout Jaar
d�c EExPaee 09 X016 831947
orM
************************************************************************************************************
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
To: Miami Shores Village Building Department
10050 NE 2"d Avenue
Miami Shores,FL 33138
Re: Permit#16-1628—Cancellation
1421 NE 102nd Street
Miami Shores,FL 33138
Dear Building Official,
Please be aware of formal request for cancelation of permit number 16-1628. The reason I have
decided to cancel the permit is because i no longer want to remove the decking since a decking
replacement permit is NOT required by DERM.
Sincerely,
fizedAgent
OscaAuthto Owner
Miami Shores Village :
,09-23 Building Department Ju 10 els
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 �Y-
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 (�
BUILDING Master Permit No.-D&A 0 1 G' f GZ&
PERMIT APPLICATION Sub Permit No.
BUILDING ELECTRIC RO ION EXTENSION ORENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [] SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1442J
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): C-OkbSVA-�"dij -T DX4(-J--• Phone#:'_Ml?,6r � -�✓�
Address: SA 3 6 V5Q!NK - Mx.AD
City: W 10#4-0- State: iL Zip: 331 51
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Phone#: 955 06 4
Address: /55) Lu au 17 t '�� CAP-(if
City: ®lnm aP,_0ke P//uE%S —State: Zip: 33076
Qualifier Name: 'f' orzAC0 �_%.tV R_ Phone#:
State Certification or Registration#: C- G /:6 125 4 Certificate of Competency#:
DESIGNER:Architect/Engineer: Mk Phone#:
It
Address: City: State: Zip:
Value of Work for this Permit:$ 2-60 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Demolition
Description of Work: 9n,,9ANWK- �"_"'moi L%4� C?
Specify color of color thru tile:
Submittal Fee$,C50 „ Permit Fee$ SUV CCF$ 0. 00 CO/CC$ 0
Scanning Fee$ C: l 'Q Radon Fee$ DBPR$ 0100 Notary$ �
Technology Fee$ 0` Training/Education Fee$ Double Fee$ X'�9
Structural Reviews$ Bond$ P
TOTAL FEE NOW DUE$ `.4 . ro b
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City ate Zip
Application is hereby made to obtain a permit to do the ;J� i 1 ' dicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that �r b or ed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of co mencement the osted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the ab su posted notice, the
inspection will not be appro and a ection fee will be charged. '
Signature Sig ure !
ER or AGENT CONTRkT611
The foregoing instr ment was acknowledged before me this The fore m nt was acknowledged before me this
day o -J � ,20- by day of 20 �k' ,by
c7� 4A�C�Mt.Ji�rs
____,who i ersonally kn n toot,who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
MARCOS LINARES
Print: Print: :�: •:-
Notary POW$tate of Fi°rde EXPIRES February 07,2017
Seal: ;P� Michael Robert Jaar Seal: haTi�°3eso1s3
6 d, My COZI. idt EE 831947
WE Expires 09AM018
04 A ANA
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)