WS-17-2717 I
Perm&NOVS41-17-2717'
Re Miami Shores Villa a Permit Type:Windo'WStSbutters
�` ..� 10050 N.E.2nd Avenue NE Classification:Window/Door.Repl'acem
ll9 Miami Shores,FL 33138-0000 � ��
Pennit Status:APPRt?VED
Phone: (305)795-2204 i
e'NtEB N 9
FLORLDp`
Issue Date:1116/2018 Expiration: 07/15/2018
Project Address Parcel Number Applicant
440 NE 91 Street 1132060190050
JEFFREY COOPER
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
STEPHANIE LOPEZ GOMEZ 440 NE 91 Street
MIAMI SHORES FL 33138-
440 NE 91 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 4,031.58
VEPCCO CONSTRUCTION&MANAGE (954)980-5786
_. ,. Total Sq Feet: 0
Type of Work: INSTALLATION OF NEW FRONT DOOR BACK Available Inspections:
No of Openings:8 Inspection Type:
Additional Info: Window Door Attachment
Classification: Residential Final
Scanning: 1 Review Building
r
r
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $3.00 'Invoice# WS-11-17-65662
DBPR Fee $2.70
11/15/2017 Check#:2653 $50.00 $ 145.70
DCA Fee $2.00
Education Surcharge $1.00 01/16/2018 Credit Card $ 145.70 $0.00
Permit Fee $180.00
Scanning Fee $3.00
Technology Fee $4.00
Total: $195.70
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: ertify t at a I th foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zo " . F the o�au orize the above-named contractor to do the work stated.
January 16, 2018
Aut ized Signa re:Owner / Applicant / Contractor / Agent Date
Build' g Department Copy
January 16, 2018 1
Z2 4 Fc)
Miami Shores Village
Building Department N V 1 2017
10050 N.E.2nd Avenue,Miami Shores, Florida 33138
Tel: (305)795-2204 Fax:(305)756-8972 B
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 iq
BUILDING Master Permit No.J[.a-%��' Z3
PERMIT APPLICATION Sub Permit Nlov�l -I — 2-1�
E!fBBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 4AQ 1JEi7 �\
City: Miami Shores County: Miami Dade zip:
Folio/Parcel#: r. Q Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): -� ''�, - r Gc, � Phone#:(
Address: 44q ut nC\ 5 'fi
City:_ 1 A l&LM S State: VL Zip: �1
Tenant/Lessee Name: Phone#:
Email: iL,G:Qt-A
CONTRACTOR:Company Name: yt3PgLQ CG7�. IT- !lam SQJ : 14- Phone#:
Address: \113 k
City: State: Vi- Zip:
Qualifier Name: • 1_F-Q \aj2 Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: t(� City: State: Zip:
Value of Work for this Permit:$ 41� ` . ;)O Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ /Re lace
Re air
p p ❑ Demolition
Description of Work: k1 tKiJ Qn-- we%c-
,41j-'.3b Co
Specify color of color thhi,tile:
Submittal Fee$ Permit`Fee$,_ CCF
Scanning Fee$ Radon Fee$ :2. DBPR$ a Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 145'--O
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address '
City t 3 i 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 C Signature l�!
OWNER or AGENTC RACTOR
The foregoing instrument was acknowledged before me this The foregoi/ginstrumentw�as acknowledged before me this
1\ day of 20 1- by 1\ day of 171yeMPcL 20 " by
Gcx' 3,L ,who is personally known to IDZMVFG yr�px who is personally known to
me or who has produced as me or who has produced 1—Nc_e " as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: `== -z`_ Sign: —'
Print: 'S ZOP40 1��QM00_X— Print: 1ZkCkT7D0 IDgL-t9GcV-
,����y�P��•,,, Ricardo oming z— ���r}�pf ,, Ricardo Dominguez
Seal: ;� pec Seal: •��'%
Commission # FF958686 �? `�- Commission # FF958686
"= Expires:February 8,2020 _-0�
%V •
Bond thru Aaron Notary " Expires:February 8,2020
�.,'; 4� �'� Bon Bonded thru Aaron Notary
APPROVED BY 47 I Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)