CC-11-782$rlenit Silvera
To:
Subject:
Norman Bruhn
Close Permit# CC11 -782
Norm can we cancel permit # CC11 -782. There is no activity since July 2011. We also received a letter from the electrical
contractor to cancel the sub permit #ELC11 -957.
Arlenis Silvera
Permit Clerk ( Building Department
Miami Shores Village
305- 795 -2204 Inspection Line 305- 762 -4949
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• I �� Miami Shores Village
'511SII2- 0�'�
Building Department
90050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit NoC..%C./ t I �1
Master Permit No.
BUILDING
PERMIT APPLICATION
FBC 20
1118 .e.........o...a
Permit Type: BUILDING BA /r4 ROOFING
OWNER: Name (Fee Simple Titleholder): BA/�y UN Vef S/ Phone#:
Address: /1 3OO Z'°"� AO—
City: V
/ j t1( Ao (QS State: T 3-21‘
Tenant/Lessee Name: Phone#: 3oSz '? 399S
Email:
JOB ADDRESS:
Allow koce€ (SN dm/y-1 Goui )
City: Miami Shores County: Miami Dade
Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: / 4t/ 114/✓6. 1-4244 74/e Phone#:
Address: � / //¢ %O 3D tf ir4o *944 6f4tAr
City: JA A'i 682
Qualifier Name: tom/ i f t./j O/ (/✓
State Certification orRegistratilon r' #: UGC . Y 1.5b 98 y8 Certificate of Competency #:
Contact Phone#: 3o rR 7 - -7C /- T 4i Email Address: Ne&s// ✓,/V 6'Cyf/ %i'I Ciq, 've) 614NX . et/
DESIGNER: Architect/Engineer: t7/ekteer ik/fR S Phone#: 5 / — 197-1724
tate:
,3os- 767 'f''r
re. Zip: 33004'
Phone#: 3 761 VrY c%
Value of Work for this Permit: $ /( GO° • 00 Square/Linear Footage of Work:
Type of Work: DAddition Alteration ONew ORepair/Replace
Description of Work:
AMOde (TA/6 Jot/ Srptcsigsvi C4 ce, ,
UDemolition
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DIJE $
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 AH IDAVIT: 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 budding permit is issued. In the absence of such posted notice, the
inspection will not be approve, nd a reinspection fee will be charged\
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 2nd
day of MAY ,2011 ,by GRJJ Gei gb W
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Signatur --
Contractor
The foregoing instrument was acknowledged before me this q "�
day of/ l/ y ,20!/,byD1'h/ 0 1 yp 274/V
w h o is p e r s o n a l l y k n o w n t o e or who has produced Ft- A
PkI77ry
ve U CePdentification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
My Commission
Eta
NO
Kelly E. Gale
.
Commission #DD931513
Expires: NOV. 21, 2013
BONDED THRII ATLANTIC BONDING CO„ MC,
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APPROVED BY Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk