DS-16-3263Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Parcel Number
Expiration: 05/30/2017
Applicant
1561 NE 103 Street
Miami Shores, FL 33138-
1132050310220
Block: Lot:
M2J4 HOLDINGS LLC
Owner Information
Address
Phone
CeII
M2J4 HOLDINGS LLC
1561 NE 103 Street
MIAMI SHORES FL 33138-
(786)290-8051
660 NW 125 Street
NORTH MIAMI FL 33168-
Contractor(s) Phone
C & S PAINT AND WALLPAPER INC (786)290-8051
CeII Phone
Valuation:
Total Sq Feet:
$ 7,600.00
2500
Approved: In Review
Comments:
Date Approved:: In Review
Date Denied:
Type of Work: FRAME AND POUR DRIVEWAY AND SIDE
Bond Retum :
Scanning: 1
Additional Info:
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$4.80
$3.38
$3.38
$1.60
$225.00
$3.00
$6.40
$247.56
Pay Date Pay Type Amt Paid Amt Due
Invoice # DS -12-16-62226
12/01/2016 Check* 14738 $ 247.56 $ 0.00
Available Inspections:
Inspection Type:
Final
Foundation
Review Planning
Review Building
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 A (DAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constru ion a zoning. Fut ermorf' , I auth rize th above-named contractor to d e rk stated.
6 K//l. • December 01, 2016
orized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 01, 2016
1
Miami Shores Village
-g 111 Building Department
BUILDING
PERMIT APPLICATION
UILDING
PLUMBING
JOB ADDRESS:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
DEC 01 116
BY:
FBC 201Y
Master Permit No. VS 1 ( `P '-S 2
Sub Permit No.Rc 1 �O 42-03
❑ ELECTRIC ❑ ROOFING ❑ REVISION
❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
` (21 Ne to3 s -r
❑ EXTENSION El RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: , ` —' 71->05 - b31 o 72 0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): P4 TN Ilv C Phone#:
l T6l sr
Address:
City: M 14-,1( LW AI State: PC. Zip: 731 3k
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: C S P�; .�-� Phone#: /' y3/1 3 h
Address: Cho A/) ° 125 sr
City: /1 /14 I t/i / State: "'r
Qualifier Name: �JA�2 r Iti Crete -46
s
r
•
State Certification or Registration #; •
DESIGNER: Architect/Engineer:
Zips
Phone#: , > • #
Certificate of Competency
Phone#:
State: Zip:
Address: City:
Value of Work for this Permit: $ 7 O
Type of Work: ❑ Addition ❑ Alteration
Description of Work: ° Gi r i t
•
Square/Linear Footage of Work:
New ❑ Repair/Replace
iC ay. -e_wer!
❑ Demolition
e1ie(t
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $A4
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. 1 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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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 sev 7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved j F ifs . ection fee will be charged.
Signature
OWNER or AGENT
Signature
The foregoing instrument was acknowledged before1me this The foregoing inst
' Ul��J�
day of r , 20 lie , by day of
who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY
Sign:
Print:
Seal:
*********
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