FW-18-302Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Parcel Number
Permit NO. FW-2-1 8-302
Permit Type: FencelWall.
Work Classification: Wood Fence
Permit Status: APPROVED
Expiration: 08/05/2018
Applicant
1050 NE 107 Street
Miami Shores, FL 33161-7374
1122320280520
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
FORTIS CONSTRUCTION GROUP LLC (786)252-3770 (786)226-4264
Valuation:
$ 4,500.00
Total Sq Feet: 400
Approved:
Comments:
Date Approved: :
Date Denied:
Type of Construction: Wood Fence
Classification: Residential
Additional Info: NEW PERIMETRAL WOOD FENCE F
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Wire & Wood
Scanning Fee
Technology Fee
Total:
Amount
$3.00
$6.00
$4.00
$1.00
$400.00
$9.00
$4.00
$427.00
Pay Date Pay Type
Invoice # FW-2-18-66359
02/06/2018 Credit Card
02/06/2018 Credit Card
Amt Paid Amt Due
$ 377.00 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Foundation
Review Building
Review Planning
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 AFFIDAVI,': -.'i mat all the .regoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zo ng� ut .• •i - a t l:rize the above -named contractor to do the work stated.
February 06, 2018
—"Authorize • Si"' re: Owner pplicant / Contractor / Agent
Building Department Copy
Date
February 06, 2018 1
BUILDING
PERMIT APPLICATION
®B LD1NG ELECTRIC
Miami Shores Village.
Building.: Department.
10050 N.E.2nd Avenue„Miami Shores Florida 33138
Tel: (305)-795-2204 Fax: (3051756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
RECEIVED
F 0_,62018
(oh
fBC 24 t'"`
Master Permit No. RC-7-17-1901
Sub Permit No. RAJ \ @ _3 D Z
❑ ROOFING REVISION ❑ EXTENSION []RENEWAL
❑PLUMBING [] MECHANICAL DPUBtf`C WORKS
ioB ADDRES-s: 1050 NE 107 ST
CHANGE Of E CANCEEC?t:1 FE1* E SNOP
CONTRACTOR
DRAWINGS,
-City: Miami Shares
Folio/Parcel#:11=2232-028-0520
Occupancy Type: RES Load:
County:,
Is the Building Historically Designated: Yes
Miami Dade, Zip:. 3 I & /
NO X
Construction Type: REMODEL Flood Zone: BFE: FFE:
`OWNER: Name (Fee Simple Titleholder): G'ABRIEL' MARTIN KUSKUNOV
Address: 1050 NE 107'ST
Pho ne#.: 786-488-8315
:City.: M1AMI'SHORES State: FL
Tenant/Lessee Name: N/A
Email:. GABRIEL@NATURALISTONE.COM
zip: 33161
Phone#:
CONTRACTOR:: Company Name: FORTIS CONSTR,UCTION:GR:OUP'
Address.: 8725 NW18TH TER, STE 308
Phone#: 786-252-3770
City: M IAM I State: FL Zyp 33172
Qualifier Name: AGUSTIN MORALES Phone#: 786-226-4264
-'State Certification -or Registration*: CGC 1.523422 Certificate .of Competency'#:
DESIGNER: Architect/Engineer: JUAN FERNANDEZ'BARQUI'N P.E Phone* .786-336-0881
Address:2520 NIl1/;:9.7TH';AVE
value of'Work for this Permit: ..$ 4,500
Type of Work: ❑ Addition ❑ Alteration
Description of Work:
NEW PERIMETRAL WOOD
ONE DOOR ACCESS & CAR GATE
City: DORAL state: FL
,Square/Linear-Footageofwork 400 LF
0 New
Zip: 33172
❑ Repair/Replace ❑ Demolition
FENCE & FRONT FACADE ALUMINUM FENCE WITH
Specify color of color dimtile: .izi-ucAl1 wood pr 02 sti LI �rn`f S/Ay 41vIr l 11 vim,
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
:Scanning`Fee'$ Radq ee'$ DBPRR:$ Notary'$
Technology Fee':$ ' Training/Education fee:$ Double Fee':$
StructuraI.Reuiews $
Bond ;$
TOTAL FEE NOW DUE'$
(Revised02/24/2014)
Bonding Company's Name (if applicable)
BondingCompany's Address
,
'City t — 'State _ Zip
'i:Mortgage Lender's Naine'(if:applicable)
•
Mortgage bender'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• standardsof all' I"aws, regulating;
construction in this jurisdiction. I understand thata; separate' permit must be secured for ELECTRIC, PLUMBING; SIGN% POOLS,
FURNACE% BOILERS% HEATERS, TANKS, AIR,CONDITIONER:S/ ETC
•e
OWNER'S, AFFIDAVIT: I certify that all the foregoinginformation is;;accuraterand 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_IAI YOUR PAYING TWICE' FOR JMPROVEMENTS TO IYOUR-PROPERTY. IF•YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUWLENDER:ORAN',ATTORNEY I EFORE 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. 1a the absence of such posted --notice the
;inspection wilt not be approved` and' c reinsp y fee will be charged: I rt
Signature Sigwat ew
OW R or AGEN .. CONTRACTOR
The foregoing.instrument.was .acknowledged before me this The foregoing instrument wasacknowledged before me this
/0 daypof __ OCT , 20 / 7 , by
C,tee/Et, ..%%S $G✓a/olJ .,who is personally known to , /¢40c n a. fie e it1- , who is personally known to
/0 day of d e-
,20 %? ,by
me-orwho has produced ,as .me,or_who has produced -
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
�a
Print.
Seal:'
*************
JULIAN A CARDONA •
{T)yY FVP i�ii
Notary Public - State of Florida
c • ; �� ; _- • Commission #. FF 191910
My Comm. Expires Jan 21, 2019
*,44:41-N0s* elect ;IwVatle ?i ad ry s
•
'''APPROVE-6
identification and who did take an oath.
NOTARY PUBLIC:
Sign: -
Print:�
Seat:'
***********
Plans Examiner
`Structural Review
Y.
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as
,,``n� t JULIAN A CARDONA
�.`c's_ Notary
yyrrPublic - StateaFFof Florida
^^
AS MyExpires J., 1,
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iftevised02/2 /20y4i
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