CC-11-619 Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 JUL 2016
Tel:(305)795-2204 Fax:(305)756-8972 \
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2
BUILDING Master Permit No. C-Clik Gig
PERMIT APPLICATION Sub Permit No.
(BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF 231CANCELLATION ❑ SHOP
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CODNTRACTOR DRAWINGS
JOB ADDRESS: L+-S- vkg *,-
City: Miami Shores un : Miami Dade zip: T>'9"
Folio/Parcel#: ' Z �X 0 1 k3 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): ��� L4. Phone#:
Address: y'-'3
City: aw k State: �� Zip:
Tenant/Lessee Name: Phone#:
Email: ED
s'
CONTRACTOR:Company Name: k�7 Phone#:�_j-�25 S g CP
Address: 3
City: la \'\� State: Zi
p: � �.
Qualifier Name: E—n— Phone#:
State Certification or Registration#: �. t S 1 t2- 2 Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$_ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ =I> 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)
t
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 must be posted at the job site
for the first inspection which occu seven (7) days after the building permit is issued. in the absence of such posted notice, the
inspection will not be approved nd a Xreinspection fee c
3#40 - -
I
Signature Signature
�—VA-R GENT CONT CTOR
The foregoing instrum nt was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 .by day of 20 / .by
f✓� I L 1 who is personally known to AJt L&Ri iJ9 -f4Gfl� wh is personally known to
me or who has produced as me or who has produced L L as
identification and who did take an oath. identification and who did take an oath.
NOTARY PURL NOTARY PU Q
Sin Sign:
Prt .••`` lQTH A Print:
°+ . Notary Public- at of Florida
S l ' ."My Comm.Expires Mar 27.201 F Seal:
N +�
.F °,� Commission#FF 097586 RUTH A.BYDASH
P"unu4
Bonded Through National N(sar y AF F, �J<►ar Pbg4
:et. "16Notary Public-State of Florida
Commission#FF 097586
Banded Through Natlanal Notary Assn.
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
t9'N` NATEC0N Tradition
CORP.
Licensed:
CGC1517242 - COC1329000
y N
July 27,2016 JUL,
To:Building Official
Miami Shores Village,Building Department
10050 NE 2'd Ave,Miami Shores,FL 33138
Dear Building Official:
Please cancel the permit application No: CC11-619 applied on April 08, 2011 by Advanced
Construction Tech & Roofing, Inc regarding 8945 Biscayne Blvd, Miami Shores, FL 33138.
Permit hasn't been issued to us, and no work has been performed at the property by our
company. Should you need any further info,please let us know.Thank you
Note:Advanced Construction Tech&Roofing,Inc is the former name of"NATECON,Corp".
Best regards
Wilbert Edward
Manager-Senior H ir e' '