DEMO-09-1870 y 1
WOMIM
_ Miami Shores Village
10050 N.E. 2nd Avenue I�R
Miami Shores, FL 33138 -0000 r Y
KAI� Ell,
Phone: (305)795 -2204
Expiration: 06/16/2010
Project Address Parcel Number Applicant
601 GRAND CONCOURSE 1132060172140 PAUL & MILDRED MAJOROS
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
PAUL & MILDRED MAJOROS 601 GRAND CONCOURSE
MIAMI SHORES FL 33138 -2473
Contractor(s) Phone Cell Phone Valuation: $ 1,000.00
H OME O WNER
_ Total Sq Feet: 638
Type of Demo: Building For Inspections please call:
Additional Info: ASPHALT DRIVEWAY (305)762 -4949
Classification: Residential Available Inspections:
Inspection Type:
Final
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $0.60 DEMO -11 -09 -36400 $ 109.60 $ 50.00 ducation Surcharge $0.20 AMC �.
Notary Fee $ 5.00 DEMO -11 -09 -36400 $ 109.60 $109.60 $ 0.00
Permit Fee $100.00 Check #: 729
Scanning Fee $3.00
Submittal Fee $50.00
Submittal Reversal Fee ($50.00)
Technology Fee $0.80
Total: $109.60
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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
November 18, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
November 18, 2009 1
M ami Shores 'Villdge TVU 797ML
Q
Budding Department
1 coos
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 B Y: -- --------------- -
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No.
PERMIT APPLICATION Master P N o.
FBC 20
Permit Type BUILDING ROOFING
Owner's Name (Fee Simple Titleholder) j le�YC.d o 0
M l Oro 3 Phone # 3 S S ! . fo 4 5
Owner's Address -- 6 fl 1 6 -a „d C er► � usr�Jt-
City i,j t �ko rt State FT_ Zip 33 1:5f
Tenant/Lessee Name i„ 7 oa. Phone #
Email
Job Address (where the work is being done) E 0 v ►'Ft_
City Miami Shores Vitlaee County Miami -Dade Zip 3
FOLIO / PARCEL # f -' ?212(9— 01 31_219'
Is Building Historically Designated YES NO ✓ Flood Zone X
Contractor's Company Name 7 Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No: Certificate of Competency No.
Contact Phone E-mail
Arehiteet/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 46 00 .— Square/ Linear Footage Of Work: st' TF
Type of Work: E]Addition []Alteration EINew El Repair/Replace [Demolition
Describe Work: 1V%0 ro 6 3g-. s . op ki r `n
aridl rc�( w i f� 5b ( a `s
64 ac_ ( td
� *1 non
* OV
4 12
Submittal Fee $”" - W Permit Fee $ Aad e9 � CCF $ • } -$
Notary $., Training/Edueation Fee $ (M Technology Fee $ •
Scanning $ Radon $ DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $
See Reverse side
i
Bonding Company's Name (if applicable) pv
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,TURNACES, BOILERS, HEATERS, TANKS and AIR WND TIONERS, 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. LENDR 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 a roved and a relnspection fee will be charged..
Signature Signature
Owner or Agent Contractor
The foreg ing instrument as ac kn ged b fore a this The foregoing instrument was acknowledged before me this
day of 1 20 b day of 20 _, by ,
a ..
who is perso known to met ps who has produce who is personally known to me or who has produced
An
i 1ation and who did take an oath. as identification and who did take an oath
NOTAR UBLIC: � NOTARY PU13LIC:
1
,��,�
Sign: - - �.. �,0. Sign
Print:. 4 l Print:
My Commission Expires:'. My Commission Expires:
APPROVED BY - - - -� s� �l ' / e e !' Plans Examiner l! Zoning
Engineer Clerk checked
(Revised 07 /10 /07)(Revised 06/10/2009)