EL-17-43 oi jt EL-1-17-43
Miami Shores Village i AMnffTye E101 ",1- t, Rosid ntlal
. s`A 10050 N.E.2nd Avenue NW rm" (/ O*C1�TS�l� tt��-Additlon/Alteratlort
Miami Shores,FL 33138-0000
Phone: (305)795-2204
�007 s Latus:APPROVED
FCOR1Dp'
jssus Data:2/2$12017 Expiration: 08/27/2017
Project Address Parcel Number Applicant
29 NW 94 Street 1131010340140
Miami Shores, FL 33150- Block: Lot: STEPHEN HARPER ODALYS AC
Owner Information Address Phone Cell
STEPHEN HARPER ODALYS ACOSTA 29 NW 94 Street f
MIAMI SHORES FL 33150-2237
Contractor(s) Phone Cell Phone
Valuation: $ 900.00
CJ POWER, LLC
(561)201-0735 (561)201-0735
Total Sq Feet: 121
Type of Work:KITCHEN REMODELING Available Inspections:
Additional Info:KITCHEN REMODELING Inspection Type:
Classification:Residential Final
Scanning:1 Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
Underground
W.W.
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee InVOICe# EL-1-17-62550
$2.25 01/06/2017 Cash $50.00 $109.10
DCA Fee $2.25
Education Surcharge $0.20 02/28/2017 Check#:166 $ 109.10 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
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 zoning. Futhermore,I authorize the above-named contractor to do the work stated.
February 28, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 28,2017 1
Miami Shores Village
Building Department
JAN 0 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. d1l C
PERMIT APPLICATION Sub Permit No. —�
❑BUILDING W ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [:] SHOP
p, CONTRACTOR DRAWINGS
JOB ADDRESS: Vey
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: .5 F14 Load: Construction Type: C/3 Sl Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): ��/y�f -�,���� Phone#: 5to-5
Address: 9 ,9MI" gy Jr`
City: HII' -il -5�"121'5 State: �(� Zip: 3:5I so
Tenant/Lessee Name: Phone#:
Email: a /'
CONTRACTOR:Company Name: 1 PQ s.A) p LLL Phone#:
Address: •�Q 1 L V 1�1 5 o %)� %-zQ
City: Stater Zip:
Qualifier Name: q41 t\1 'O1V O I. Vr. Phone#: 6t) 101 �
State Certification or Registration#: t ()0 !1 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ty®e� Square/Linear Footage of Work: X•2/
Type of Work: ❑ Addition ❑ Alteration ❑ New P5 Repair/Replace ❑ Demolition
Description of Work:,
i,.
Specify color of color thru tile:
Submittal Fee 6 ){/2PEP► D Permit Fee$ �✓�®'°�'� CCF$ ® CO/CC$
Scanning Fee$ `7 Radon Fee$ 2• Z DBPR$ 2• 25 Notary$ —�
Technology Fee$ Training/Education Fee$ Zo Double Fee$
Structural Reviews$ Bond$
I�
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 reinspection fee will be charged.
Signature Signature
OWNER or AG NT CONTRACTOR
7for, oing instruReent was ac�nowledged before a this The foregoing instrument was acknowledged befor me this
( �'//°I day of ^T` 20 f' by �day of� � ,20 by
� ' .who its personally known to dOL2~111 �� L d� who is personally known to
me or who has produced_ y
V (Y 7l[ '�"/'�� as me or who has produced > as
identification and who did take an oath. identification and who did take a o+th. ®��
FEIPI®
NOTARY PUBLIC: NOTARY PUBLIC: Notary Public,State of Florida
Comm,sslon#FF 970M
MY comm.expires Apr 25,2020
Sign: Sign:
il
Print. Y� ��- Print.
Commission#FF 037338
Seal: Expires October 5,2017 Seal:
00
��,RP h;.• Loreled TIw Troy Fahr Innroama 800385.70
�k,gk/#��k
APPROVED BYW*4 �'� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)