MC-18-619 ' Permit No.,MC-3-18-619
�%s O1�s y� Miami Shores Village Permit Types Mechanical-Residentialtr 10050 N.E.2nd Avenue NE a r
Work Classification. Kitchen Hood
- Miami Shores,FL 33138-0000 Permit Status:APPROVED
Phone: (305)795-2204
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Issue Date:3113/2018 Expiration: 09/09/2018
Project Address Parcel Number Applicant I
265 NE 92 Street 1132060133561
Miami Shores, FL Block: Lot: MIAMI SHORES 265 NE 92 ST CC'
Owner Information Address Phone Cell
MIAMI SHORES 265 NE 92 ST CORP 265 NE 92 Street
MIAMI SHORES FL 33138-
265 NE 92 Street
MIAMI'SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 500.00.
C R MECHANICAL CONTRACTORS IN (954)540-7585
. ,. •..� .._ ��_ �.w....� r ,... ._.._ Total Sq Feet: 0
Tons: Available Inspections:
Additional Info:KITCHEN HOOD Inspection Type:
Classification:Residential
�
Approved: In Review Final
Rough i
Comments: Date Approved: : In Review Review Mechanical
Date Denied: Type of Work:KITCHEN HOOD
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Scanning: 1
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Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# MC-3-18-66737
$2.25 03/13/2018 Check#: 1504 $ 108.85 $50.00
DCA Fee $2.00
Education Surcharge $0.20 03/09/2018 Credit Card $ 50.00 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $158.85
I
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.
OWNER AFFIDAVIT: I c ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructs and zonin Fu r ore, I a thorize the above-named contractor to do the work stated.
r March 13, 2018
Authorized Sig tura:Owner / Applicant / Contractor / Agent Date I
Building Department Copy
1
March 13, 2018 1
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I
Miami Shores Village RECFJVEID
MAR 0 9 ?01R
Building Department p'
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�
BUILDING Master Permit
PERMIT APPLICATION Sub Permit No. M,c
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION t ❑RENEWAL
❑PLUMBING 19MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 2 t� r 0, I
x
Cit : Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: i
OWNER: Name(Fee Simple Titleholder): I1 F 6 ! 4 7D095-t0g,K.) Phone#-1 7e&
Addressn P 6, 5 N �6
City: H/✓q-r ( 7"A State: tG- Zip:
Tenant/Lessee Name: Phone#:
Email:
a CootK)k(40 P
CONTRACTOR:Company Name: ��E ��� •;'' E 1� K_E_G�►3 ►y�L�L Phone#: :6 6 - S53 =03 c�3
Address: +/ 9/ 3 3 AV a�-�-
p
City: H( State: F Zip: -2
Qualifier Name: , C 94-b-#5`r— A Jill L0 !Wo Dou F t- Phone#: 1��C, S53 -09 33
State Certification or Registration#: C14 C I I Q Certificate of Competency#:
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DESIGNER:Architect/Engineer: A W A- Phone#:
Address: City: KLA" State: fG Zip:
Value of Work for this Permit:$ SO OH Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alterationu New ElRepair/Replace ❑ Demolition
Description,of Work: K!-rG�([--K) FG9
i
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ �ov 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)
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t
f
t.,
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
7
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.....
l
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 goodfa h that a copy of the,notice of commencement and construction lien laWbrochure will be delivered to the person
whose property is s ject to ottachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspecti which occurs seven (7) days after the building permit is issued.- In the absence of such posted notice, the
inspection will not proved and a reinspection fee will be charged.
{
Signature Signature
0 NER or AGENT C NTRACTOR
r.
The forgoing instrument was acknowledged before me this The foregoing instrume t was acknowledged before me this
day of mQ CC 1 20 _, by �day of ---------,20 , t)�-by
i A�(C?tP l n ,who is personally known to ` `� � ho 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:
Print:' Q(�J'l(JID� Print: 95'X 4 LW
Seal: .►x�►ey� ": :+ MY COMMISSION FF 206514
FLORENCIA RODRIGUEY Seal: • EXPIRES:March 5,2019
MY COMMISSION#GG 090164 aBf,h Bonded nm,rainy Public UndmnifoR
EXPIRES:April 4,2021
*�#d d Thrs*s**L s**
ezz Mctary Services
4
APPROVED BY vp&s Examiner Zoning
Structural Review Clerk
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(Revisedo2/24/2014)
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