WS-17-513 Permit NO. WS-2-17-513
`SNORES yMiami Shores Village Permit Type.WindowstShuitters
10050 N.E.2nd Avenue NE
er I York Glassifrcatiarr:Window/Door Repiacem
- Miami Shores,FL 33138-0000 Permit Status:APPROVED
Phone: (305)795-2204
FLORIDA
Issue Date:2/28/2017 Expiration: 08/27/2017
Project Address Parcel Number Applicant
311 NE 103 Street 1121360130240
Miami Shores, FL 33138- Block: Lot: RENEE KOCH
Owner Information Address Phone Cell
RENEE KOCH 311 NE 103 Street
MIAMI SHORES FL 33138-2432
Contractor(s) Phone Cell Phone
Valuation: $ 29,850.00
HOME OWNER
Total Sci Feet: 0
Type of Work:25 new impact windows Available Inspections:
No of Openings:25 Inspection Type:
Additional Info: Window Door Attachment
Classification:Residential Final
Scanning:6 Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $18.00
Invoice# WS-2-17-63093
DBPR Fee $5.25 02/28/2017 Credit Card $381.50 $50.00
DCA Fee $5.25
Education Surcharge $6.00 02/28/2017 Credit Card $50.00 $0.00
Notary Fee $5.00
Permit Fee $350.00
Scanning Fee $18.00
Technology Fee $24.00
Total: $431.50
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 AFFID 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 mg. Futhermore, I authorize the above-named contractor to do the work stated.
February 28, 2017
Authori Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 28, 2017 1
Miami Shores Village cPTVFT)
Building Department FEB 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 20
BUILDING Master Permit No. W_S 13
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I J �S I o3 51
City: Miami Shores County: Miami Dade Zip: ;3132
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFEFFE:
OWNER:Name(Fee Simple Titleholder): 5Z-nC, 5( & LH Phone#: 1:yp /6h 115V
Address: i 103 IJ' `�
City:a\ \ (I�0 1 G E� Stater O `J� Zip: 3313
Tenant/Lessee Name: Phone#:
Email: 5LOE'Q"S" l ULA C`Trj ' O
CONTRACTOR:Company Name: ADVN-f O w N-1--t Y Phone#: 7? 6 7 S6
Address: -J T 7
City: 0 State: rL Zip: 3 133
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: Statue: Zip:
Value of Work for this Permit:$ 2 7®Z-� d Square/Linear Footage of Work: �C
Type of Work: ❑ Addition ❑ Alteration n ❑ New ] Repair/Replace ❑ Demolition
Description of Work: � (' C VV`+ 7 LJ
Ct - ZO
Specify color of color thru tile:
Submittal Fee$ pal"
Permit Fee$ s 350 CCF$ ICS CO/CC$
Scanning Fee$ Radon Fee$ 5 - ZS DBPR$ 5 . 2!9— Notary$ S
Technology Fee$ 29 Training/Education Fee$ fo Double Fee$
Structural Reviews$ Bond$ 2 Q C,
TOTAL FEE NOW DUE$ 3 S I ✓�
(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 approve I nd a reinspection fee will be charged.
Signature Sign ure
WN AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing' strument was acknowledged before me this
day of -I C b C V 20 by day of 20 , by
TrA o S I 0 4 who is personally known to who is personally known to
me or who has produced rlY�f r Li C�erS�l as me or who has produced as
identification and who did an oath. identification and who did take an th.
NOTARY P NOTARY PUBLIC:
Sign: `O Sign:
Print: Print:
Seal: NADYPRIETO Seal:
MY COMMISSION#FF 214031
a'• EXPIRES:March 25,2018
Bonded Thru Notary Public Unde ,i rs
APPROVED BY / Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)