MC-18-29 Permit NO. MCA-18-29
`y�aort£s Miami Shores Village Permit Type.Mechanical-Residential
10050 N.E.2nd Avenue NE ' Work Classification:Addition/Alteration
Miami Shores,FL 33138-0000 P t Permit Status:APPROVED
Phone: (305)795-2204
Issue Date:111212018 Expiration: 07/11/2018
Project Address Parcel Number Applicant
113 NE 105 Street 1121360050100
Miami Shores, FL 33138-2032 Block: Lot: ANNIKAASHTON ERIC HERNAN
Owner Information Address Phone Cell
ANNIKA ASHTON ERIC HERNANDEZ 113 NE 105 Street (954)554-0418
MIAMI SHORES FL 33138-2032
Contractor(s) Phone Cell Phone Valuation: $ 1,100.00
ALVAREZ APPLIANCE INSTALLATIOP (954)680-5658 Total Sq Feet: p
Tons: Available Inspections:
Additional Info:EXTENSION OF DUCTWORK
Classification:Residential Inspection Type:
Final
Approved: In Review Rough Duct
Comments: Date Approved: :In Review Review Mechanical
Date Denied: Type of Work:EXTENSION OF DUCTWORK Underground
Scanning: 1
I
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
Invoice# MC-1-18-66048
DBPR Fee $2.25
DCA Fee $2.00 01/12/2018 Check#: 1097 $ 110.45 $50.00
Education Surcharge $0.40 01/04/2018 Credit Card $50.00 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $1.60
Tota I: $160.45
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 AFF ID VT
: I ertify t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction d in uther / ,I authorize the above-named contractor to do the work stated.
January 12, 2018
Auth ed Sgnature: wlicant / Contractor / Agent Date
A
Building Department Copy
January 12, 2018 1
} z«� Miami Shores Village
� RECEIVED
Building Department JAN o 108
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305)795-2204 Fax:(305)756-8972
_ INSPECTION LINE PHONE NUMBER: (305)762-4949 1 1
FBC 201-
BUILDING Master Permit No. V_C_� - Z4U
PERMIT APPLICATION Sub Permit N -'m c isV 2 0-1
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING EN MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores2 County: Miami Dade Zip:
Folio/Parcel#: o Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type:
Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): /I/1 �' !�f?i�� '� � Phone#:
Address: &6^00 � 1T �r7 SS
City: State: Zip: �1/
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: X jyq A L✓t, 649011A,42- Phone#: 9SY 4� 5`6 S-r
Address: /S7 o 6 FL j 6—r; sT -
City: SCA I ✓PANcy,--X State: �� Zip: 3�3J�1
Qualifier Name: ��14 S 4 r` Phone#:
State Certification or Registration#: LSA C Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ //00 Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 0j
r
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ v t9 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ 2- 1 cl�Q DBPR$ ZS Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ ' Q
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Cam%'pany'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 abse osted_notices,.the
inspection will not be approved and a reinspection fee will be charged.
�a DENIC�,�iUZ
ary Public � a
Not -
State of Florida
yjf or emission#FF 204543
�j�� ' ,ryo, o;• mm.Expires Apr 7 2tfp
Signature �` Signature �—� """ �ndtlthrou "�j
- NotayAsn:
OWNER or AGENT CONTRACTOR M -
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day ofe� 120 , by k day of DeC ,20��, by
i5 f C 14411 OAAF'Z ,who is personally known to NzA R! who is personally known to
me or who has produced as me or who has produced Ar//G- as
identification and who did take an oath. identification and who did take, �y. rt
NOTARY PUBLIC: NOTARY PUBLIC: + °'`'+No i=i`bENA CRUZ
,.,� „ DEN'a - " ,*� , tart'Public:<.
Notary Public-S. eZot �'`t t State of FIc
a`c_ Commission#
.o.� Y,FF 20454
;..'
Jii! F Commission#FF 2045 '%O;;;,°a•� r MY Coriim,Expires' k
Sig o'mm.Expire! ."' Sign: , Bondedthrou APr 7 s20
—01111
Print:-Ip"- 7., Print:
#•^0. *`� Notary Public:'cJ state eZof Florida ,
Seal: Seal:
Catnmission# FF 204543
Omen.Expires Apr 7,2t'Ic c
- o lthrouof .tional Nc!*A`
APPROVED BY V VlExaminer Zoning
Structural Review Clerk
(Revised02/24/2014) N.