MC-18-123Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. MC -1-18-123
Permit Type: Mechanical - Commercial
Worts Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 1117/2018
Expiration: 07/16/2018
Parcel Number
Applicant
9190 BISCAYNE Boulevard
Miami Shores, FL
1132060100030
Block: Lot:
BRITE STONE INVESTMENT LL(
Owner Information
Address
Phone
AMMIIIIIIIMMINISIONSUMEIRMSNOV
Cell
BRITE STONE INVESTMENT LLC
1160 KANE Concourse
BAY HARBOR ISLANDS FL 33154-
(786)340-7513
1160 KANE Concourse
BAY HARBOR ISLANDS FL 33154-
Contractor(s)
SIMMTEGRITY AIR, INC
Phone Cell Phone
(305)424-8586
Valuation:
Total Sq Feet:
$ 900.00
0
Tons:
Additional Info: SUPPLY GRILL, EXHAUST FAN
Classification: Residential
Approved: In Review
Comments:
Date Denied:
Scanning: 1
Date Approved: : In Review
Type of Work: SUPPLY GRILL, EXHAUST FAN
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.25
$2.00
$0.20
$150.00
$3.00
$0.80
$158.85
Pay Date Pay Type
Invoice # MC -1-18-66142
01/17/2018 Credit Card
01/16/2018 Credit Card
Amt Paid Amt Due
$ 108.85 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
fts
Inspection Type:
Ventilation
Final
Rough
Rough Duct
Duct Detector Test
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 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
con • n and zoning. Futhermore, I authorize the above-named contractor to do the work stated.
January 17, 2018
Authorized Signa . e - = • cant / Contractor / Agent
Building Department Copy
Date
January 17, 2018
1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION
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
Master Permit No.
❑PLUMBING 0 MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 9190 BISCAYNE BLVD.
City:
Sub Permit No.
RECE, VEO
J' 1162018
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Fec Zoic
Cc -8-17- aloe?
14c, 8 - 123
❑ EXTENSION ❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Shores
County: Miami Dade
Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type:
Load:
Construction Type: Flood Zone:
BFE: FFE:
OWNER:Name (Fee Simple Titleholder):Tcl-tt-Eaq Phone#: S`�O•
Address: \ L
City: �� tSc,
Tenant/Lessee Name:
C) ,.J �cafZSi
State:
Email:
Zip: •3"�LS�
Phone#:..
CONTRACTOR: Company Name: SIMMTEGRITY AIR, INC.
Address: 12030 SW 114 PLACE
Phone#: 305424-8586
City: MIAMI
Qualifier Name: STEVE SIMM
State: FL
State Certification or Registration #: CAC045881
Phone#:
Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $ 900.00
Zip: 33176
305-424-8586
Phone#:
City: State: Zip:
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑■ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: SUPPLY GRILL, EXHAUST FAN
Specify color of color thru tile: r�
15o C " v CCF $ CO/CC $
2 • DBPR $ 2. 2—S Notary $
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $ Double Fee $
Bond $
TOTAL FEE NOW DUE $ 108 • 85
Structural Reviews $
(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 a reinspection fee will be charged.
Signature
OWNER or AGENT
The foyegoing instrument was acknowledged before me this
day o� 9�r , 20 / 2 , by
I40Gi /Ye9e7—
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
dgii
Sign.'VG_%' "--
Print. CO
rt)atGuir/
pS1YPL'• Boris Borukhov
Seal: =ate'"'e. Commission# FF164392
=��, `.%�.; o Expires: SEP 30, 2018
'`*;,•• Off.' BONDED THRU
OF ' 1ST FLORIDA NOTARY, LLC
*************************************** ******* * * **********
1 , T.
PI s Exa finer
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
I day of "Dec.emb r , 20 / 7 , by
g-feoe 5, nisi , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: ft Jtj'1 GL Vi4c-60
Print: /d 6
r
ie d f eine-
Seal:
APPROVED BY
(Revised02/24/2014)
Structural Review
MMM
***************************************
Zoning
Clerk