RC-14-1624 (6) Miami Shores Village
SAL V--, Building Department o 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 -P4
INSPECTION LINE PHONE NUMBER:(305)762-4949 �T
,FBC 20 (�{
BUILDING Master Permit No. lZL 19
PERMIT APPLICATION sub Permit No. PL04 - 1 C�S
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [CHANGE OF ❑ CANCELLATION ❑ SHOP
2 CONTRACTOR DRAWINGS
JOB ADDRESS: / ® >� �� �� 577 Ai L.T
City: Miami Shores County: Miami Dade Zip: 33 ;
Folio/Parcel#: 11320-5-0160320 Is the Building Historically Designated:Yes NO_X
Occupancy Type:Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 10 3 N G.%!tm IL. Phone#AQ 7)`f/(o"J l06
Address:
AJ E, 4?`a S T REi % i
City: 1yL .. 4 A4: S ®62��� State:�— L Zip: 3
Tenant/Lesse Name. Phone#:
Email:
CONTRACTOR:Company Name: /°�dJ �'� �A Phone#:
Address: / AJ � 1
City: I`6 �c P ► State: t--• Zip:
Qualifier Mame: (AJ i I I( +6-!n4 Phone#: �" b -695 0194
State Certification or Registration#: /R Foo o Y—Certificate of Competency#: ?1 CM l " -12)(
DESIGNER:/Architect/Engineer: J®d A '5t'�:?-01.AN 1/ =-,- ?,ab-3pp /1 Phone#: (pl 3(,Z- 7�b ..
Address: Co D 6!A5 1 tt� 5 I City:86CP, State:f(—Zip: 3 3 q
Value of Work for this Permit:$ -` —2, Do z� Square/Linear Footage of Work: Sa
Type of Work: ElE_Addition Alteration ❑ New ❑_/Repair/Replace ❑ Demolition
Descript n of Work: A-/,-EL,) A-44-c°`-
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$ —I b • 60
(Revised02/24/2014)
Bonding Company's Name(if applicable)
R
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
YOB 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.
62
SignatureC Signature
OWNER or AGENT CONTRACTOR
Xhi%f egoing instrument was acknowledged before me this The foregoing instrument `was acknowledged befo ,
day of C`�C�,b.- ,20 11K .by 2,451"" day of t�.�blasx-c" 20
.- who is personally known to who is personall r n
ho has produced as me or who has produced
= tcation and who did take an oath. identification and who did take an oath.
` „tQTARY PUBLIC: NOTARY PUBLIC:011 tN'
Si Sign:
print: Print:
Seal: J Seal:
**w *�s�***s�����a*a��***�sa����**x��►*ixw*Www*wx���rw�x**aw�w�����xa�x�*w�x��wx��xx��x***��w�ss�a�**�x�x�s
APPROVED BY ****w ..24-15 Plans Examiner Zoning
ot
ew Clerk
(Revised02/24/2014)
Cox)c L L o C v-4is�f
• v t k
Butler Plumbing Inc. C C 1427470
• •• 2440 DeerCreek Country Club Blvd
Unit # 209
U��. ,
erfield BeachFL 33442
•
..... ...:
Z-561 ) 613-7338
•••••• ••' fico@butler-plumbing.com
July 9th, 2015
Attn: Arlene silveraaaa,miamishorevilla eg com
Re: 1032 NE 98th Street Miami Shores, FL 33138
Permit # PL-7-14-1625
Pursuant to our phone conversation of today July 9th, 2015,
We are hereby notifying you that Butler Plumbing Inc. will
not and has notepreformed any work at 1032 NE 98th Street
Miami Shores, FL'33138. At this time wewould like to
cancel permit # PL-7-14-1625 for any plujmbing work at
the referenced location. The only Qualifier for this job
pertaining to the plumbing is Jon Sabaroff and he is signing
off as the Plumbing Contractor for this project.
If yo ave any questions please give us a call.
81 ,te lorida Broward County
Qualifier/O
9 ' Printed Nam ;f Qualifier/Owner
Printed �(�, WOVS Signed
Notary Public State of Florida'
Personally Known to me
mar - m eta._
moa r 21703
tom° Aors.�v