REV-18-656 \� Miami Shores Village
Build' �c����:�►
ing Department MAR 15 2018
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 BY' -— - -
FOC 200 V4
1-7 ' r
'BUILDING Master Permit No. RC-2-17-387
PERMIT APPLICATION Sub Permit No.—VI-C-4 lg - bS (o
❑BUILDING ❑ ELECTRIC ❑ ROOFING ® REVISION ❑EXTENSION ❑RENEWAL
[❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 672 NE 98 St.
City: Miami Shores County Miami Dade
Zip
Folio/Farce(#: 11-3206-017-17$0 Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Carol Invest USA Inc Phone#:
Address: 990 Biscayne Blvd. Suite 801
city: Miami State: Florida
zip:33132 ,
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Aloha A/C Phone#: (954) 772-0079
Address: 4474 Weston Rd. # 170
City: Davie state: FloridaZip: 33331
Qualifier Name: James E. Barry Phone#:_(954) 772-0079
State Certification or Registration#: CAC 025379 Certificate of Competency#:
DESIGNER:Architect/Engineer: Victor Bruce Phone#: (305)310-5030
Address: 370 NE 101 St. city:Miami Shores State: FI. Zip: 33138
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work: As Built Drawings for A/C unit
L
Specify color of colofthru.tile;
tCfJ s1c(t t-a. .rg�• o .ti
Submittal Fee$
R: Permit'Fee'$rs CCF$ CO/CC$
Scanning Fee$ Radon FeeM - i
$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ t co
(Revi5ed02/24/2014)
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 will not be approved and a reinspection fee'will be charged.
Marc Br zzi Carol Invest USA) James E. Barry
Signature Signature _7
OWNJ or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
_day of HQ VC J% 20 1 Y by day of_ f�f i� 20 J y by
Marco Bruzzi who is p Wally kno n to
wh is personally known t
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:
" -;2,
Sig Sign:
Print: -VGA G • SOtSi Print: r �'d"f
Seal: .tom".','.•.; LUCIA G ISASI 4 114NOW
• Seal: „w., ?EI�1t '•
MY COMMISSION#FF1 82628 * #GG i
''�'' EXPIRES December 10,201 P. P E e k&
LA
APPROVED BY /w
tans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)