WS-17-59 Permit NO. WS-1-1 7-59
`5t!..�5��! Miami Shores Village Permit Type:Windows/Shutters
10050 N.E.2nd Avenue NW Work Classification:Garage Door
T Miami Shores,FL 33138-0000 Per i
Permit Status:APPROVED
Phone: (305)795-2204
F'<ORLDp'
Issue Date: 1/12/2017 Expiration: 07/11/2017
Project Address Parcel Number Applicant
64 NW 99 Street 1131010330060
Miami Shores, FL Block: Lot: THOMAS TELESCO JR.
Owner Information Address Phone Cell
THOMAS TELESCO JR. 64 NW 99 Street (305)216-6161
MIAMI SHORES FL 33150-
64 NW 99 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone Valuation: $ 1,700.00
ALL AMERICAN DOORS, INC/ALL All 305-885-8088 (954)646-6133 Total Sq Feet: 0
Type of Work:REPLACE EXISTING GARAGE DOOR Available Inspections:
No of Openings: 1 Inspection Type:
Additional Info: Final
Classification:Residential
Review Building
Scanning:3
Fees Due ]AnPay Date Pay Type Amt Paid Amt Due
CCF
Invoice# WS-1-17-62568
DBPR Fee DCA Fee 01/12/2017 CreditCard $ 126.20 $0.00
Education Surcharge Permit Fee Scanning Fee Technology Fee Total:
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 zo ermore, I authorize th ve-named contractor to do the work stated.
January 12, 2017
Authorize ign ure:Owner / Applicant / Contractor / Agent Date
Building Department Copy
January 12, 2017 1
Miami Shores Village 1RF1CFIVED
Building Department
{ JAN 10 2017
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: ak
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 k q-�h
BUILDING Master Permit No. As I-' 1 I —5
PERMIT APPLICATION Sub Permit No.
(BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL [—]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
j 11 ` y CONTRACTOR DRAWINGS
JOB ADDRESS: b`7 N % IsI�''�c I
City: Miami Shores i,County: Miami Dade Zip:
Folio/Parcel#: 11_3 10 1 -Ora3-OW0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: p Flood Zone: BFE: / FFE:
OWNER:Name(Fee Simple Titlehholder):�/ �a� ����S�CJ Phone#:211(D-6Gb/
Address: but N w 9q"' ab � _
City: ��a�V 1 (-'j'yy'i%S State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: ) � ��('A j'1 � ISS �, Phone#:
Address: Sy- /n'I w r� Q
City: [ State: Zip: wo
Qualifier Name: p Phone#:
State Certification or Registration#: d O dO CO ZZQ Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: `lx i-c�Aci q e2ra.2pe Doo r
Z1-
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(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.
Signature�(ah Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 01 20�� by of^-IiWX )U�20 by
Dm who is personally known to ,DrrM,c, 6o iS who is-personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: I M S
FARIAS Print: ,►•' •
s•*— do
+� mission V FF 897808
Seal: !tip .My Commission Expires Seal: •� .,My Commission Expires
fi MdrCh 12, 2018 Maich 12, 2018
+ �p�
************************************ ** ** *****************************************************************
APPROVED BY �Y Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)