BP-2005-1382 Miami Shores Village n ,
Building Department SEP 2h 7%1-5
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
BUILDING Permit No..V=—
PERMIT APPLICATION Waster Permit No.
FBC 2001
Permit Type(circle): Buildin Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) J,4Vj[� 5,6Z Phone#
Owner's Address &/7 A� -• /�
CitA 44 5 , ss5 State Zip 331-�F
Tenant/Lessee Name Phone#
Job Address(where the work is being done) Alic lw;i4,�4. sl s
City Miami Shores Village County Miami-Dade Zip 3r 3
Is Building Historically Designated YES NO V'
Contractor's Company Name K ' CMC- i 6A Cc- r--,r<-Phone# 9.S`f - C) 1)-2-
Contractor's
Contractor's Address 5 S 0 i 1 ? t4,11-wc.
City (:-Ocnoee- c�f7j State jr f —zip--a3 3Z?
Qualifier 'g�tin,
State Certificate or Registration No. C&C 05.7 It f Certificate of Competency No.
Architect/Engineer's Name(if applicable) ILI
Phone#
$Value of Work For this Permit G Oo o Square Footage Of Work: 4�Z•0
Type of Work: ❑Addition Iteration ❑New
❑ Repair/Replace Demolition
Describe Work: ThyL It A f c of A ...&, ,( 1,
20 1.J -
• •M • • • •
Submittal Fee$—)a— Permit Fee$ {�n:_;�: :•: @CF$ .3. CO/CC
,Notary$ Training/Education Fee$-) .2_C? Technology Fee$ +^��'--].
Scanning$ Radon$ •Z3n4'd'� •• ,• Bond$ ,
. .
Code Enforcement$ StructV**l Tiles Aeriew.%•
Total Fee Now Due$ ` ' �'� i ••. 000 •
(Continued on opposite side) :
.•• 0 • . 000 . .
Bonding Company's Name applicable)
t
Bonding Company's Address
± a'
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 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.
Signature M Signature
e�—
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Z04—
day of ,)Sk ,20 C by _ day ofiQs 2005,by ,
who is personally known to me or who has produced " , , , e ly known to me or who has produced
J
As identification and who did take an oath. as identification and who did take an oath.
NOTARY P :°g,, NOTARY PUBLI .p
9 US CUESTA oB�n 1
ION DD 17 S CUESTq
Sign: Sign;
Print: oa"lip 80Rd9d Thm eudpt Notary Services Print: a •°p N'1RES:A 74 6
.2007
My Commission Expires: My Commission Expires:
.. ... ..•
APPLICATION APPROVED BY: ' ' •• • Plans Examiner
... . . . . .. .
.. . . . .. .... ..
Engineer
. .. .00 .00 . .
• : : 0 Zoning
chc 05/13/03 • • • • • • • •
NOTICE OF COMMENCEMENT 1111111111111111111111!111111111111111141 ILII
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
C F=1+1 'tea 135RI 0995,', 2
OR Bk 2380 i Ps 11991; t1Pe)
P,Fi3MIT NO. TAX FOLIO NO. !1" �((�/�A��►-d0 MRECORDED 09/22/2005 1337:31
HARVEY RUWIHP CLERK. OF COURT
STATE OF FLORIDA: MIAMI-DADE COUHTYP FLORIDA
COUNTY OF MIAMI-DADE: LAST PAGE
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
is provided in this Notice of Commencement.
1. Legal description of property and streeVaddress: 1Z /A457 /��, ,/i(;,¢ _ �5 � 41f
X-
2.
2. Description of improvement:Z,sdkd 41-_- i, .-i—
3. Owner(s) name and address:
ze/ 3313Y
Interest in property: n4
Name and address of fee simple titleholder:
4. Contractor's name and address: C0AjqkLAe N-a T�
S _ OF FLORIDA,COUNTY OF DADE
5. Surety: (Payment bond required by owner from contractor, if any) original h1eq in this office on day of
Name and address: . AD ion
Amount of bond $ MTNEss my hand and Waal S08L
wavp HWIy.Ct Kao► oa�Canp
6. Lender's name and address: ey' � � �= D.C.
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida 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
in Section 713.13(1)(b), Florida Statutes.
Name and address: ,►! A kl—Ads z4l.?_1 33osz
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
differeQt date is specified)
Signature of Owner ' I
Print Owner's Name ��✓�C �t/1 �v Prepared by756 -a&
Sworn to and subscribed before me this Zy day of , 20ac C j�
a.ptARY Address:
Notary Public wJESUJEST7Cpi'oZC V(JL./ Z r3
�A�y
q
Print Notary's N e E i�' X4376
My commission expires: 11WPtNt,;rser„rces
123.01-52 PAGE 4 10/04