WS-17-1355 Permit NO. WS-5-17-1355
sK°RES y,! Miami Shores Village Permit Type:Windows/Shutters
a 10050 N.E.2nd ANE
rte, venue Per
work Cfassifrcatian:Window/Door Replacem
Miami Shores,FL 33138-0000 Perrnit'StatuS:APPROVED
Phone: (305)795-2204
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issue Date:5f19/2017 Expiration: 11/15/2017
Project Address Parcel Number Applicant
660 NE 93 Street 1132060141520
Miami Shores, FL Block: Lot: XIMENA GONZALEZ
Owner Information Address Phone Cell
XIMENA GONZALEZ 660 NE 93 Street (786)488-0828
MIAMI SHORES FL 33138-
660 NE 93 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
HOME OWNER Valuation: $ 10,600.00
_....�.... w.. .Mw__. Total Sq Feet: 0
Type of Work:WINDOWS REPLACEMENT AND DOORS. Available Inspections:
No of Openings: 15 Inspection Type:
Additional Info: Window Door Attachment
Classification:Residential Final
Scanning:4 Review Building
CE`
Cpl
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $6.60 Invoice# WS-5-17-64049
DBPR Fee $3.75
DCA Fee $3.75 05/19/2017 Credit Card $242.10 $50.00
Education Surcharge $2.20 05/18/2017 Credit Card $50.00 $0.00
Notary Fee $5.00
Permit Fee $250.00
Scanning Fee $12.00
Technology Fee $8.80
Total: $292.10
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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 fo ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS A FID IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction d ¢ mw��
he above-named contractor to do the work stated.
May 19, 2017
All)0114ed Signature:Owner / Applicant / Contractor / Agent Date
Buildi g Department Copy
May 19, 2017 1
Miami Shores Village
� • ' ` M Y•X 201
Building Department s 7
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
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97&—
FBC 20 N
BUILDING Master Permit No. 1.3 9--7'
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
} CONTRACTOR DRAWINGS
JOB ADDRESS: 0� ,vimj,— �/,�1 3
City: Miami Shores County: DAVE Miami Dade Zio J�
Folio/Parcel#: 11 - -30 O6 `d''t- 15 7-0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction
Type: Flood Zone: BFE:
cm-
City:
FFE
p O b j
OWNER:N me(Fee Simple Titleholder): Phone#:
Address: (0(w(V hC Q/
� c
City: W ar n(\i State: Zip: 33 las
Tenant/Lessee ame: Phone :
Email: �S -�V lo
CONTRACTOR:Company Name: 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:$ �� . Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: k ) _
.i
Specify color of color thru tile: %M ,
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$ Q
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ U
TOTAL FEE NOW DUE$ f (O
(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 iill at be approved and a reinspection fee will be charged.
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Signatureh)OM-- Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of q—,J a 20 by day of 20 , by
Q '�'1C�1'l Tirr'o'ipersonally known to who is personally known to
me or who has produced Glc)-4las a or who has'a rU h —D produced as
identification and who did take an oath. identification and who did take an oath.
NO LIC: NOTARY PUBLIC:
Sign: Sign:
;P, MAHARAI K.GONZALEZ
Print: ' °= ISSION#GG 044602 Print:
EXPIRES:November 2,2020
Seal: °` Seal:
rFOF Fro?; Bonded Thru Notary Public Underwr tern
****************************** *** ************************************************************************
APPROVED BY ��r7 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)