EL-17-558 p - -'17,,61 3
�s�'O1Es1 Miami Shores Village �G'!?J?it 7j�p8 E(et~trt ai* Rel �l�lt tial
10050 N.E.2nd Avenue NW
1rVoC` ienlAitaration
Miami Shores,FL 33138-0000 �
v� :APPROVED
Phone: (305)795-2204
fGORI L
Expiration: 09I25/2017
Project Address Parcel Number Applicant
133 NW 94 Street 1131010330710
KATERi GARCIA ANDREW R JO
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
KATERI GARCIA ANDREW R JOHNSON 133 NW 94th St 505 264-2794
Miami Shores FL 33150
Contractor(s) Phone Cell Phone $ 1,200.00
Valuation:
KLEAN POWER ELECTRIC INC Total Sq Feet 0
Type of Work:KITCHEN AND BATH REMODEL Available Inspections:
Additional Info:KITCHEN AND BATH REMODEL Inspection Type:
Classification:Residential Final
Scanning:3 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 $1.20 Invoice# EL-3-17-63158
DBPR Fee $2.25
DCA Fee $2.25 03/03/2017 Check#:1065 $50.00 $116.70
Education Surcharge $0.40 03/29/2017 Check#: 1107 $ 116.70 $0.00
Permit Fee-Additions/Alterations $150.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $166.70
In consideration of the issuance to me of this perm;t, I agree to perform the work covered hereunder in compli ince with all ordinances and regulations
pertaining thereto and in strict conformity with the plars,drawings,statements or specifications submitted to the prol ar 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 com�liance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated.
Man;h 29, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent ate
Building Department Copy
March 29,2017 1
4'k�7 'M r
Miami Shores Village
C
g
Building Department
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.
PERMIT APPLICATION Sub Permit No.
BUILDING [KLECTRIC ❑ ROOFING ❑ REVISION ❑D(TENSION [:]RENEWAL
[:]PLUMBING ❑MECHANICAL ❑PUBUC WORKS ❑CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 133 N VI !3'�1 T4" S�M'e++
Miami Shom,4 County: Miami Dade ZIR:3260
Folio/Parcel8: I I -Z1I Q1 O Bb- 0110 Is the Building HistoriraBy Dated:Yes NO
Occupancy Type: Psig�ad: Construction Type: Flood Zane: BFE: FFE:
1Loii}ert 4
OWNER:Name(Fee Simple Titleholder):AindyVnl IL Sc: 'irlscin Phone#:
Address 133 NW gy4b SAlree�
City:Mi&W "horn State: T:L- zip: 33ISO
Tenant/Lessee Name: Phone#:
Email: lC.dl 'Xi(7PQlrCi0. !bk ItYlelc..e.�M
CONTRACTOR:Company Name: !�/.e�/� ?() Q-C- G ��Phone#:
Address: 5 10 kV® r6a/.9—
City:S�,a. 1W� �f�VIC 1�LP-1 State: X� Zip:
Qualifier Name: lh+ Phone#-. (8(42,9 7•b 2-1-7
State Certification or Registration o: ®Q�7-0\D Certificate of Competency M
DESIGNER:Architect/Engineer. Phone#:
Address City: State Zip.
Value of Work for this Permit:So Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Descclption of Work:Y 1 kn 1n W
dada �-eca tv, QLFCr 611'1+'i�hA 1 t,+st,
�� exp shV,Y 00LI 6'ih e(+()'e
Specify color of color thru tile:
Submittal Fee$ 5o ew tN Permit Fee$ �5~O�Gr3 CCF$ , CO/CC$ —
Scanning Fee$ !q yy��yy Radon Fee$ `�- DSPR$ �-• �� Notary r-'
Tedmology Fee$ -�C Tralning/Education Fee$ ° LA® Double Fee$
StruMral Reviews$ Bond$ -
TOTAL FEE NOW DUE$ v
(Rewaedo2/24/2014)
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: 1 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 on estimated value exceeding$750D, 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 o reinspection fee will be charged.
Signatura�2t=�gnature
OWNER or AGENT 10 CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
dayof ��b� a Z�I � "by day of Llr" 020 17 b
V-61 1-C v (0QiCA0 CAA y
QA IJ Iy.l L_J c)k v1 S( who is personally known to ��1 ,who is personally known to
U0 r m me or who has produced. J Y ►V e� (C Q i� ` as me or who has produced as
0 y �v- 2
0 - 0 0 0
U U identification and who did take an cath. identification and who did take an oath.
40
0 0-9 NOTARY PUBLIC: NOTARY UBUC:
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moEc
tYUUWDJ
Sign' Sig
Print: Print:
Seal: C onsul Seal: _�� IRENE IZQUIERQO
U.S. 'ffibaBBy B080d Carnnlssion#FF912843
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APPROVED BY YfL_ X0/1/AA/Vpians Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)