BP-04-375 Miami Shores Village
z Building Department
10050 2n Avenue,N E
. d Miami Shores,Florida 33138
MM w � ?004 Tel:(305)795.2204 Fax: (305)756.8972
BUI- m m o Permit No. o
CANC
PERMIT APPLICATION Master Permit No.
FBC 2001
Permit Type(circle): Building Electrical Plumbing Mechanical Roofmg
Owner's Name(Fee Simple Titleholder)160"_ 1E,U< (, l���TD Phone#
Owner's Address _ 95W /lJE 1114 a� S
City State lz � zip /3c?
Tenant/Lessee Name Phone#
Job Address(where the work is being done) 1,4
City hfiami Shores Village County Miami-Dade zip
Is Building Historically Designated YES NO_A!,2
Contractor's Company Name �� r I u s S v- !A)i r A a LJs Phone# .,30S- S.;I lv -a/a
Contractor's Address WO tJ N -St, */0-7
City //Id d le e_ State Zip 3.30/`f
Qualifier u I 6 ry e r r,&r0
Architect(Engineer's Name(if applicable) StrudV f l Cri3 i ne eri n j Phone# 7X Ya/7a0
$Value of Work For this Permit 70DD• OD Square Footage Of Work: 96 s .. �.
Type of Work: []Addition ❑Alteration [:]NewNew R,ep/ Meplac ElDemolition
Describe Work: /a 110rizonral ,eoller W1 nAA ws v- SinG�e /jungs 19/I2-m
Submittal Fee S , Q Q Permit Fee$ CCF$ CO/CC
Notary$ Training/Education Fee$ Technology Fee$ .
Scanning$ Radon$ �— Zoning Bond$
Code Enforcement$ f7Structural Plan Review.$
Total Fee Now Due$ ,
(Continued on opposite side)
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 ELECTRICAL WORK,PLUMBING, SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certifted copy of the recorded notice of commencement must be posled at the job site
for the first inspection which occurs seven (7) days after the building permit is-issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature d �! � Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 0� The foregoing instrument was acknowledged before me this 4A,
dayof 44,rck 2001(,by ItIlAe�i oto0—&ry0,1�0 day of 14 carCk 2004 by Fo-u� bug,rrp�C�
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath as identification and who did take an oath
NOT PUB/ NOTARY P I . ,
� �pU�ii� Rosa I. Palados �.•��'"��•, Rosa I. Palados
Si- Expires Der—29,2005
a L$C=MisdCM#DDD=1 Si
Print. 0`DUL- �, P610-ios % �2 Bonded Thm ®o 'm c: Baps- Dec.28 2005
•" Print: 54� Po�Ic eioS
11TAWS un Atlantic Bonding Co.,Inc.
My Commission Expires: My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. —Certificate of Competency No.
APPLICATION APPROVED BY: MAR 19 2004 Plans Examiner
Engineer
Zoning
Chc 12/15/03 !
Miami Shores a Villa9Building
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: BP2004-375
Printed:3/23/2004 Page 1 of 1
Applicant: ANNELI DE CARVALHO
Owner: CARVALHO ANNELI DE
JOB ADDRESS: 356 NE 102 ST
Contractor YAMILL GLASS &WINDOW INC Contractor's Address: 480 W. 84 St. #107
Local Phone: (305) 826-2121
Parcel # 1'132060135120 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 3&4 BLK 38 LOT SIZE 100.000
Fees,:. : Description Amount
FEE2004-3019 Building Fee $155.00 Total Fees: $185 4
FEE2004-3020 CCF $4.20s P
FEE2004-3021 Training and Education Fee $1.40 Total Receipts: $U.0
FEE2004-3022 Technology Fee $3,88
FEE2004-3023 Scanning Fee $21.00 ) �
Total Fees: $185.48
Permit Status: APPROVED Permit Expiration: 9/14/2004 Construction Value: $7,000.00
Work: 12 HORIZONTAL ROLLER WINDOWS AND 4 SINGLE HUNG WINDOWS ALL IMPACT
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:
������d`�� ��� COMMENCEMENT �111111111111111111111111111111111111
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* ARECORDED COPY MUST QEPOSTED ONTHE JOB SITE ATTIME OFFIRST INSPECTION
C F-t4 2 0(14 FZ 0 1-7_7 3 f?9
OR Bk 22123 Ps 3314� (lny)
PERMIT NO. FOL0NO RECORDED 03/z6/2004 13:45:03
R OF COURT
STATE OFFLORIDA:
COUNTY OFM|AM|-DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property;and in accordance with Chapter 713,Florida Statutes,the following information
ioprovided inthis Notice ofCommencement.
1. Legal description of pgperty and street/address: 35, �
Q
2. Description of improvement: Fu r n)s of- T_rls�c,I I 0i
Interest in property:
Name and address offee simple titleholder: 4)/k
4. Contractor's name and address: I I 0,W , /1 Glass ,+- Wividows qSQ (0 &q -�)I . 107 .
5. Surety: (Payment bond required by owner from contractor, if an&
STATE OF FL IDA,COUNTY OF DADE
Name and address:
6. Lender's name and address:
7. Persons within the state of Florida designated by 0 te��Cpdijfnents m _rved as
provided by Statutes,
Name and address: +^
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided
inSection 713.13(1)(b) Florida
Name and address: ~
S. Expiration date ofthis Notice ofCommencement: (the expiration date in1 year from the date ofrecording unless a
differ ate is pecifipd) A;
amaa
Signature of Owner
Print Owner's Name,*2�EZ/ N_ Prepared by 417i,7el,Cle(3 r V,�
Sworn to and subscribed before me this day of 20 .