WS-17-1573 PBrmitW WS-6-X17-'l. r7 .
Miami Shores Village ;. P817) f 7-Aw:Windo1NS/'.ts"�tCS
10050 N.E.2nd Avenue NW
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Miami Shores,FL 33138-0000
FP S Phone: (305)795 2204 Status:Ap`IPA-0VED
tonio� `�
611412017 Expiration: 121112017
Project Address Parcel Number Applicant
67 NW 97 Street 1131010330270
LUCIANO ANDRES GATTI 1
Miami Shores, FL Block: Lot:
Owner Information Address Phone Celt
LUCIANO ANDRES GATTI 67 NW 97 ST (305)796-8477
MIAMI SHORES FL 33150-1732
Contractor(s) Phone Cell Phone Valuation: $ 5,000.00
HOME OWNER
Total Sq Feet: 0
Type of Work:REPLACE 1 DOOR AND 5 WINDOWS Available Inspections:
No of Openings:6 Inspection Type:
Additional Info:
Window Door Attachment
Classification:Residential Final
Scanning:1 Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $3.00 Invoice# WS-6-17-64309
DBPR Fee $2.40
DCA Fee $2.40 06/14/2017 Credit Card $ 175.80 $0.00
Education Surcharge $1.00
Permit Fee $160.00
Scanning Fee $3.00
Technology Fee $4.00
Total: $175.80
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I rti all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin . Fu a authorize the above-named contractor to do the work stated.
l June 14, 2017
Autk6rIzed ature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 14,2017 1
Miami Shores Village RECEIVED
Building Department JUN 14 201
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 H S�
BUILDING Master Permit No. IN I - 13
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
n/f/� , /�,� CONTRACTOR DRAWINGS
JOB ADDRESS: 6 � ' " ' V �� /I�(7�'
City: Miami Shores County: Miami Dade Zip: ( w
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder.): U6 r�'V ` ' Phone#:
Address: G 7 /V
City: f SftUa(3 State:-- Zip: 33/ SL)
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: V Gl, Phone#:
Address:
City State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#•
Address: City: State: Zip:
Value of Work for this Permit:$ U Square/Linear Footage of Work:
Type of Work: ❑ AdditionEl Alteration 1:1New ❑ Repair/Replace F-1Demolition
y
Description of Work: 1 7'�)olyz' -j'— S W I rq-k-->1z,i-xi —S —'C-c)
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$ j C�
TOTAL FEE NOW DUE$ 1� J
(Rev1sed02/24/2014)
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 ao a reinspection fee will be charged.
Signature 0/1Signature
WNER or AGENT CONTRACTOR
The foregoing ins rument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of c CAN—Ik_ 20 C1 by day of 20 by
�`' 3oFiois►p�ersonown to who is personally known to
me or who has produced Ct - \JrG--1`4��—C 2, as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOT"PUBLIC: NOTARY PUBLIC:
SignSign•
Print: Print:
Seal: =M ®` ate:wb Seal:
Ptl 0 iR1191
APPROVED BY -Plans Examiner Zoning
Structural Review Clerk
(RevisedO2/24/2014)