RC-12-1500Mimai 02/14/2013
Att: Miami Shores Village
To: Whom it may Concern
FEB 272013
I want to take the opportunity to inform that we would like to
cancel project of renovation and addition on 54 NW 107th street
, Miami Shores, FL 33168 submitted to the city due to the
longtime of process that this has taken. I would like to keep the
drawings
Thank you
Pedro De Mello
54 NW 107th Street
Miami Shores, FL 33168
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
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PERMIT APPLICATION
FBC 20
Permit No. etc, 19-_
Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 6 N • Ui•/ 0 7 7 S7-
City: Miami Shores County: Miami Dade Zip: -33 lP g
Folio/Parcel#: 11 ° 21 31p - 001- ODD
Is the Building Historically Designated: Yes NO ! Flood Zone:
OWNER: Name (Fee Simple Titleholder): Pact 120 ° 1'1E1 k, Phone#:
Address: 5µ 14.14• } 0 rl ST
City: NIIAM,t SNORES State: PC., Zip: dog
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company N a m e : CAP iTP t 44 t 2 A I CD/0712-#04 CT&I2 Phone#: 3t 'cg 2-0 "42/
Address: 1-Vg b U) . g Sr Su ■I 1V Co
City: 41 A I1 h State: Zip: 336 fl
Qualifier Name: CA 12.J 4 • 65 i la Phone*. 305-8 2..1- p 21 /
State Certification or Registration #: d G (' . 1 SO11-0 g2 - Certificate of Competency #:
Contact Phone#: 305 - SZ/%- 4PZI I Email Address: C9 CAPi77�1I9eN �AlL19rf 1 AC1D/LS. col
DESIGNER: Architect/Engineer: 514 ! H i I( Cot ° Phone#: 3D5 — Z-i 106/
Value of Work for this Per + • $ '`` co . bL7 SquareJLinear Footage of Work:
Type of Work: lettcldi fir" °Alteration ONew ORepair/Replace
Description of W +g; Ica' •• ROOK f 61 F°li Iy 2O0h A irl oni
Color thru tile:
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 DUE $
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•
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 ET.RCTRICAL 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 properly 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 n the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ZiA l , 2012 -- , by P.8 rzv N • $E t. L 10
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: `
Print �/ D
L
Signature
44,7
Contractor
The foregoing instrument was acknowledged before me this_20/
day of 37/1)( , 2012, by CAR -Ins A . 13fT 91) ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
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tear PVeq OLGA L. CRUZ
Nota Public - State of Florida
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My Commission Expires:
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Sign:
Print:
OLGA L. CRUZ
ti `t °e Florida
_.1 P My Comm. Expires Sep 23, 2013 1
Comm ss on ' 4805
My Commission Expire;: °;,F, .P /boded Through National Notary Assn.
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APPROVED BY Plans Examiner
Structural Review
(Revised 3 /1212012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk