16-1630 Miami Shores Village
Building Department u 3 0
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 7 _ _ I
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20tA
BUILDING Q Master Permit No. t (.�y
N��
PERMIT APPLICATION � Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
QCONTRACTOR DRAWINGS
JOB ADDRESS: ` I � d-... S�
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:
LAI
OWNER:Name(Fee Simple TitleholderK BQY e,0A34 + 6A + QeVE1061h07 'Phone#: 11Z57- 61
Address: /W /e 1491 It
City: /j1/V"I !A® _' State: fL< Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Phone#:
Address:
City: State Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: V J 1 A- Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ �� Square/Unear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: CAAA-CL— "bL'I-*— t*,
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)
r
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
A
Application is hereby made to obtain a permit to do the work and insta ations as indicated. 1 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 approv and a inspection fee will be charged.
Signaturx Signature
ER or AGENT CONTRACTOR
The foregoing in ument was acknowledged before me this The foregoing instrument was acknowledged before me this
day f 20 by day of .20 .by
l,dlallK yJ6 .who s personally kn n 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• Print
Seal: "` NWM Public State d F Seal:
Michael Robert Jaer
ii My Commission EE 831947
N EmArm 09/032018
************************************************************************************************************
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#16-1630—Cancellation;
1391 NE 102nd Street
Miami Shores,FL 33138
Dear Building Official,
Please be aware of formal request for cancelation of permit number 16-1630. The reason 1 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,
r
Oscar
Authorized Agent to Owner
Miami Shores Village
C�r-
Building Department 1u 0 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 BY: /
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC201y 'L
BUILDING Master Permit No. ®lb` I&M
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I -- <O-L Ai
City: Miami Shores County: Miami Dade Zip:2�%,Atel!
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): ca`4-Xku, one#: -)
e
Address: S '565
City: wt I 44t.-d State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: C*�i vs Phone#:
Address 5`5
-- Z�
City: � State: C1Z-- Zip:
Qualifier Name: t-A !O iI A a e- Phone#:
State Certification or Registration#: �--� ) �V I Certificate of Competency#:
DESIGNER:Architect/Engineer: PC Phone#:
Address: City: State: Zip:
o+o
Value of Work for this Permit:$ 4� s Square/linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace M4-14emolition
Description of Work: Q—V(N'b AL j;.X(5'� L-466D (�4 jrA k, , ZR[,%eA A--\
Specify color of color thru tile:
Submittal Fee$ eO ! M Permit Fee$ I C)3 C3 CCF$ U GO CO/CC$
Scanning Fee$ q ' G3 Radon Fee$ a -co DBPR$ r Notary$
Technology Fee$ O ' Training/Education Fee$ (3 "20 Double Fee$
Structural Reviews$ P Bond$ i
TOTAL FEE NOW DUE$ f-j
(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 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 m yst be posted at the job site
for the first inspection which occurs seven (7) days after the buildi rmit is issued. 4 in the absence of sbch posted notice, the
inspection will not be approved and a reinspection fee will be char '
Signature Signature
ER or AGENT CONTRACTOR
The foregoing i rument was acknowledged before me this The foregoing in m nt was acknowledged before me this
day of - ,20 110 ,by day of 20 ,by
r
4(bLAt,V V> 1 ois person Ily known 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:
i
Sign:
Print: M 1 L-14M Print:
11 1ARCOS 1.
Seal: pet,
Seal: t"• �' MY COMMISSION*R1d72W2
,�+ t�rotery FubWheel R ' EXPIRNS ftelou try 07,201'7My commisExpkes o9AAPPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Re%ised02/24/2014)