MC-16-3492 y Permit IVB?.
Miami Shores Villagea ypE ie�anical-Reside>r tial
a 10050 N.E.2nd Avenue NE WorkOtaufflbatron:AIC Replacilm' ent
It
`•• "'"'" Miami Shores,FL 33138-0000
Phone: (305)795 2204 `it SO A""ED,
<ORi9� �
a .. Issue Date:'11I6I2017 Expiration: 07/05/2017
Project Address Parcel Number Applicant
1192 NE 91 Terrace 1132050010480
Miami Shores, FL Block: Lot: NICHOLAS PATON
Owner Informatfon Address Phone Cell
NICHOLAS PATON 1192 NE 91 Terrace (786)301-9433
MIAMI SHORES FL 33138-
1192 NE 91 Terrace
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 200.00
MASTER MECHANICAL HVAC CORP (305)394-6218_ _. ___.....__...._. .... Total Sq Feet: 0
Tons: Available Inspections:
Additional Info:installation of A/C wall unit Inspection Type:
Classification:Residential
Final
Approved:In Review Review Mechanical
Comments: Date Approved::In Review
Date Denied: Type of Work:installation of A/C wall unit
Scanning:1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# MC-12-16-62499
$2.00 01/06/2017 Credit Card $58.60 $50.00
DCA Fee $2.00
Education Surcharge $0.20 12/29/2016 Credit Card $50.00 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $108.60
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 assu a responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRI AL,P MBINI MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVI I cert all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoni Fut r I authorize the above-named contractor to do the work stated.
i January 06, 2017
Authorized Si to .Owner / Applicant / Contractor / Agent ate
Building De artment Copy
January 06,2017 1
Miami Shores Village I DEC 29 2016
Building Department31 -
� �
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 I_
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 �-�-�
FBC 201
BUILDING Master Permit NO.A C 1016 - -2-7P4
PERMIT APPLICATION Sub Permit No. W\ C [( --319 2
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING XIMECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Z At C -2I Afrr
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1/- 32Ar-aOl- fWP Is the Building Historically Designated:Yes N0/4
Occupancy Type:-4-3 Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): A11l1101 H 5 -D GAAP" Phone#:
Address: 1'-ee,d-
City: �� � ,l�iGof�. State: �G Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:
Company Name: i9JTf/� I�CgI�AY!/GGA �J� /fl//� Phone#:� - 3� - og�Z/�
Address: I
City:�j, ze" , State: �C Zip:
Qualifier Name: /4212'/f� 40- it/U62 Phone#: �S>4 17,731-3
State Certification or Registration#: -APr A /� V 3? 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
Descritptibn 1of Work¢ZOD= //17fL7/�A�`i0>�I �� �A/�A!/?ll _
. pedfy color of color thru tile:
Submittal Fee$ b' '•'•`Kermit Fee's F$ ! (0 C. ._CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ 61 Training/Education Fee$ Double Fee$ �—
Structural Reviews$ Bond$ �.
TOTAL FEE NOW DUE$ • v
(Revised02/24/2014) VL�
Bonding Company's Name(if applicable) /y//g
Bonding Company's Address /'/w
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 Signature
0 NER or AGENT C/A TRACTO,
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
0-:) day of l0:-Q -. 20 /G by °Z day of 4?�C 120 by
'e 14 coIot who is personally known to We /ca /Vde who is personally
me or who has p oduced as me or who has produced too laos
identification and who did take an oath. identification and who did take an oath.
NOTARY NOTAR LIj
of
Sign: Sign:
Print- i C �ia le!a Print- Gam'Av Aa
Seal 'sq ;y OILQERTOC Seal: 4%.-N(�j, t,"•�i='F�iTOCABALI6RG T
•; MYCgyMISS ALLlRO
EXPI ION#FF95T145 ;• F.r.���Fa:I►ga�ch "i�"
Bonded 7 N No M —J�, � Wdao i :+lotary Pitbl�U�err.rl.c.5
arch 28,2x20
mryPu6LsUrde
APPROVED BY v JPIns Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)