MC-16-3190 (2) 3r3n nn Miami Shores Village g RECEIVED
Building Department MAR 23 2017
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 $
FBC 2011
BUILDING Master Permit No.CC-6-16-1530
PERMIT APPLICATION Sub Permit No.MC-11-16-3190
BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION RENEWAL
PLUMBING r■ MECHANICAL PUBLIC WORKS CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9501 NE 2nd Avenue
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1132060133920 Is the Building Historically Designated:Yes NO No
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER:Name(Fee Simple Titleholder):DVS, LLC Phone#: (305) 751-2220
Address:201 E 95th Street
City. Miami Shores state: Florida Zip: 33138
Tenant/Lessee Name: Miami Independent Learners, LLC Phone#:(305) 853-8600 117
Email: anaolaya@ikumon.,com
CONTRACTOR:Company Name: Million Air Conditioning Corp Phone#: 954-775-4980
Address: 13762 State Road 84, #245
Cit,: Davie State: FL Zip: 33325
Qualifier Name: Manuel A. Morales Phone#: 305-684-9324
State Certification or Registration#: CAC1814827 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: q p City: State: Zip:
Va#ue,of Work forAhis.Permit:.$ 'y C C#,A Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Des�ior�f•work:--T . �t c Ac focctfjoro uo f ZE o
c Ct 1 (n,
Specify color of co r u tile:
Submittal Fee$ Permit Fee$ L99— CCF$ 0' GO CO/CC$ XJ
Scanning Fee$ / Radon Fee$ �" q DBPR$ 2 � Notary$
Technology Fee$ Q 90 Training/Education Fee$ ZO Double Fee$ ,0
Structural Reviews$ Bond$ 0!
TOTAL FEE NOW DUE$ l �� • ��
(Revised02/24/2014)
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.
--=�
4 Z
Sig ure Signature
NERCrAG�E CONTRACTOR
The oregoing instrumeent was acknowledged before me this The foregoing instrument was acknowledged before me this
a 3�day offy 14ar J,— 20 1 -7 by 0 day of �C11 20 by
/ {'t�►�trg� (.ttcE�ppr» �who is personally known to QflUe.\ M ofa\,eS ,who is personally known to
me or who has produced as me or who has produced*l- OL 'M 641-`��il• 61-0411-O as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
r
Sig Sign: C
Print: J G-�l rr`a Print: C
JESSICA A. SANTOS
Seal: ;�"'tiy ELIZABETH ELORRIAGA Seal: Notary P,blic-State of Florida
MY COMMISSION#FF953536 '� MY Comm. Expires Jul 1,2018
Commission # FF 138162
EXPIRES January 25.2020
aoii�ise-o•s:+ c
APPROVED BY "
ans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)