FW-15-2403 Miami Shores Village ECE VED
Building Department
SEP 2 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY=— —
Tel:(305)795-2204 Fax:(305)756-8972 �1
INSPECTION LINE PHONE NUMBER:(305)762-4949 � ' {i
FBC, `20 I �
BUILDING Master Permit No.T W W 2`703
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL E]PUBLICWORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1050 NE 107 ST
City: Miami Shores County: Miami Dade Zip: -33141
Folio/Parcel#: 11-2232-028-0520 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):GABRIEL KUSKUNOV Phone#:786 488-8315
Address: 1050 NE 107 ST
City: MIAMI SHORE State: FL Zip: 33161
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: GALLOWAY CONTRACTORS BUILDERS Phone#: 305 7962209
Address: 7920 SW 97 TER
City: MIAMI State: FL Zip: 33156
Qualifier Name: DAMIAN FERNANDEZ Phone#:
State Certification or Registration#: CGC1509461 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 11u�JOO 00 0 Square/Linear Footage of Work: �8 L-%7
Type of Work: ❑ Addition ,tom! Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: INSTALL TEMPORARY CHAIN LINK FENCE
Specify color of color thru tile:
Submittal Fee$ v Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
l P
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.
i
"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 noapproved and a reinspection fee will be charged.
ILSignature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrume was acknowledged before me this The foregoing instrument was acknowledged before me this
—2.0 day of —� 20 IS , by -= day of �'� 20 tS by
a
�AfJ21GL �iowA o-JO who is personally known to Iwho is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
• e•.,
� Print: rPrint:
Commission#FF 191910 s
Seal: '%' oily Comm.Expires Jari 21,2019 Seal: ':;;;F :;�!8onded
TNational
,2019
� ry Assn.
��''"`" BondedlhroughNationalNohryAssn. °°°�
nma�•
I
APPROVED BY Plans Examiner Zoning
. Structural Review- Clerk
(Revised02/24/2014)
t
PermitNO. FW-9-15-2403
ars Miami Shores Village Permit Type:Fence/Wall
_ 10050 N.E.2nd Avenue NE Work Classification. Wire Fence
Miami Shores,FL 33138-0000 n t Peimit'Status:APPROVED
ry� ` Phone: (305)795-2204
fLORIDp
Issue Date:9/2212015 Expiration: 03120/2016
Project Address Parcel Number Applicant
1050 NE 107 Street 1122320280520
Miami Shores, FL 33161-7374 Block: Lot: GABRIEL MARTIN KUSKUNOV
Owner Information Address Phone Cell
GABRIEL MARTIN KUSKUNOV 1050 NE 107 Street
MIAMI SHORES FL 33161-7374
1050 NE 107 Street
MIAMI SHORES FL 33161-7374
Contractor(s) Phone Cell Phone Valuation: $ 1,500.00
GALLOWAY CONTRACTORS&BUILE (305)972-8150
_ ..,.�.._ _... �_.... Total Sq Feet: 281
Approved: Available Inspections:
Comments:
LBuilding
Date Approved::
Date Denied:
Type of Construction:Wire Fence Additional Info: INSTALL TEMPORARY CHAIN LINK
Classification:Residential Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
Invoice# FW-9-15-57163
DBPR Fee $4.22
DCA Fee $4.22 09/22/2015 Check#:336 $301.64 $0.00
Education Surcharge $0.40
Permit Fee-Wire&Wood $281.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $301.64
t
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named c n ctor to do the work stated.
September 22, 2015
Authorized Signature:Owner / Applicant / ctor / Agent ate
Building Department Copy Con a
September 22,2015 1
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RCVISlONS DATE NY �j .L a,NR MAP-FR
UPDATE/TOPO SV-15-2215 07-02-45 Alf.ad$ ROBERT L. THOMPSON (PRESIDENT)
UPOATE/TOPO SU-14-2450 08-07-14 AL/NLW PROFESSIONAL SUPVEYCR AND MAPPER No 3665 STATE Or t'tMIDA
DATE OF SURVEY DRAWN BY 4HECKED EY Fifi.0 940K
05/02/14 Dui A >,,,I$ !4—tz� SCALE 1"= 20' M RSU-14-1278