MC-16-1831Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
1551 NE 103 Street
Miami Shores, FL 33138 -
Owner Information
Permit
Permit NO. MC -6-16-1831
Permit Type: Mechanical - Residential
Work Classification: Pool Heater
Permit Status: APPROVED
Issue Date: 11129/2016
Expiration: 05/27/2017
Parcel Number
Applicant
Address
1216 NE 93 ST
MIAMI SHORES FL 33138-2941
Phone
Cell
Contractor(s)
AQUATIC ENVIRONMENTS
Phone
(786)390-9029
Cell Phone
Valuation:
Total Sq Feet:
$ 3,100.00
0
Tons:
Additional Info: GAS HEATER POOL (GAS BY OTHERS)
Classification: Residential
Approved: In Review
Comments:
Date Denied:
Scanning: 1
Date Approved: : In Review
Type of Work:
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$2.40
$2.00
$2.00
$0.80
$108.50
$3.00
$3.20
$121.90
Pay Date Pay Type
Invoice # MC -6-16-60411
11/28/2016 Check #: 3227
06/30/2016 Check #: 2969
Amt Paid Amt Due
$71.90 $50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Mechanical
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 e. her myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOW , D®.f,-S, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing infor ai• �� - d that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above -n: . on or to do the work stated.
November 28, 2016
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
November 28, 2016 1
BUILDING
PERMIT APPLICATION
Miami Shores Village
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 20 (`�
Master Permit No. BP P1 - 1 S
Sub Permit No. Iv C/c,- 1st -3i
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑-MEG-HANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1551 N.E. 103rd. Street
City:
Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: SFR Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Kurt Gustinger
Address:1551 N.E. 103rd. Street
Phone#:
City: Miami ShoresState: FL Zip: 33138
Tenant/Lessee Name: NA Phone#:
Email:
CONTRACTOR: Company Name: �c�C� G (NU'i-D f‘ % Phone#: 3 C)9
Address: 1-"(D-4 (\
City: ( ne c.._Ae_kt State: FL Zip:
Qualifier Name:
Phone#: -1-c61-& 'Cl 1021
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: TC Engineering Phone#: 305-261-0321
Address:7805 SW 24 Street City: Miami State: FL Zip: 33155
Value of Work for this Permit: $ 1 OA" Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alter tion► (661❑ New / ❑ Repair/Replace ❑ Demolition
VDescription of Work: t HU A A ool.y o-Ple eS
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ \V? 1) CCF $ Z 1io_ CO/CC $ -�}
Scanning Fee $ Z Radon Fee $ 2 - DBPR $
Z . Notary $
Technology Fee $ 3. 0 _ Training/Education Fee $ ' So Double Fee $ .96-*
Structural Reviews $ "'8"' Bond $ -Er_
TOTAL FEE NOW DUE $ ' 1 ' [ 0
(Revisedo2/24/2014)
40.
Bonding Company's Name (if applicable) NA
Bonding Company's Address
City
State Zip
Mortgage Lender's Name (if applicable) NA
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 subjec t� attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection hich occurs seven (7) days after the building permit is issued. In absen •f such posted notice, the
inspection will not be a 4 proved and a reinspection fee will be charged.
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
--2-31C day of U` , 20 1 , by
1 day of
Kurt Gustinger
C -NC Sok} , 20 i by
, who is personally known to - M
me or who has produced as me or who has produced as
ho is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: la
Commission FF 924095
y Comm. Expires Dec 13, 2019
Bonded through National Notary Assn.
Seal:
***ii*i*****iii*iii****ii****
APPROVED BY
(Revised02/24/2014)
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
`- • ‘ 41110
_ 1
FFiStismatatitid
�;��'. r taommssr on#r "jtSl924095
Floritl„
g''
•.,+ - Y ,, My Comm. Expires Dec 13, 2019
orir Bondsdtlrough National Notary Assn.
****i****** *i****************************iii****s**s********************** IL
Plans Examiner
Zoning
Structural Review Clerk