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REV-16-3094BUILDING PERMIT APPLICATION ❑ BUILDING Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 RECJr E NOV 14 2016 FBC20 T Master Permit No. ` 71 Sub Permit No. fV b -3094 ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑ PLUMBING IN MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR JOB ADDRESS: 2;G RE 9� DRAWINGS City: Folio/Parcel#: Occupancy Type: Miami Shores Load: County: Miami Dade Zip: Is the Building Historically Designated: Yes NO "\ Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): ©�� 't--) . `Phone#: 3c` 30o 143 Address: 2- ?),e cC c? �T City: Lk, S �?s° - State: Zip: 31)1 Tenant/Lessee Name: Phone#: Email: one(:e�SJ\Cf CONTRACTOR: Company Name: Wk. Address: /3cif City: M) , o 11,1 Qualifier Name: i rhii U State Certification or Registration #:C SLA r°s/ State: Al 1-? y.<pSC14,/SIV 0 Phone#: Zip: 3 1 ;7 ( s'/ l ?/ 7Y Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: Value of Work for this Permit: $ Square/Linear Footage of Work: State: Zip: Type of Work: ►l Addition ❑ Alteration Description of Work: 0 Com.` ❑ New ❑ Repair/Replace G Cr 0 Ste' ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Structural Reviews $ �5 (Revised02/24/2014) CCF $ CO/CC $ DBPR $ Notary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 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 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 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 OWNER or AGENT The ^^foregoing instrument was acknowledged1�beforemethis 'ht day of MifMV7e.. , 20 VO , by ( irg e. cDon2a('€Z^-1 , who is personally known to me or who has produced Dri 1'e r Lioenqt identification and who did take . • .ath. NOTARY PUBLIC: Sign: Print: Seal: as YANADY PRIETO *1 MY COMMISSION €s FF 214031 .4 EXPIRES: March 2S, 2019 Bondeu Thru Notary PubG. Un ivrv;ritere ************* APPROVED BY (Revised02/24/2014) CONTRACTOR The foregoing instrument was acknowledged beforeme this S day of C�C-�-� �+ VV -1/, 20 l(:..J/, by `�`1 & r!1 `A rsonally known to me or who ha p • rY!h d,� i-` � as identification a NOTA '+r7; : LI Sign: Print: Seal: did take an oath. 4c:N ADRIANA QUTIERREZ * MY COMMISSION # FF 207740 EXPIRES: May 24, 2019 �',sOBoc•�Op Bonded Thru Budget Notary Services ************************************************************* 'r( Plans Examiner Zoning Structural Review Clerk STATE OF FLORIDA go, -30 ot Lit DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 2601 BLAIR STONE ROAD TALLAHASSEE FL 32399-0783 COSCHIGNANO, ANTHONY JESUS BELOW ZERO AIR CONDITIONING INC 4444 CRYSTAL LAKE DR DEERFIELD BCH FL 33064 Congratulations! With this license you become one of the nearly ane million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Departments initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR (850) 487-1395 RC5- 12.33( STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSI ®; GULATION CMC1249471 -z4v1 08/23/2016 CERTIFIED MTOR COSCHIGNANO,, BELOW ZERO IS CERTIFIED tender the provisions of Ch.488 FS. Expiration date : AUG 31, 2018 L1608230003081 DETACH HERE KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The MECHANICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 COSCHIGNANO, ANTHONY I BELOW ZERO AIR CON 4444 CRYSTAL LAKE DEERFIELD BEAM ISSUED: 08/23/2016 ss�> DISPLAY AS REQUIRED BY LAW SEQ # L1608230003081 002818 Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 4703121 BUSINESS NAME/LOCATION BELOW ZERO AIR CONDITIONING INC 8600 NW 64 ST 8 MIAMI FL 33166 RECEIPT NO. RENEWAL 4911617 EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED BELOW ZERO AIR CONDITIONING INC 196 GENERAL MECHANICAL CONTRACTOR BY TAX COLLECTOR CMC1249471 $75.00 09/26/2016 CREDITCARD-16-057589 Worker(s) 1 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory Taws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles — Miami—Dade Code Sec Ila -276. For more information, visit www.miamidade.gov/taxcollector