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MC-18-1782Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. MC-8-18-1782 Permit Type: Mechanical - Residential Worts Classification: Addition/Alteration Pemlit'Status: APPROVED Issue Date: 6/28/2018 Expiration: 12/25/2018 Parcel Number Applicant 1263 NE 101 Street Miami Shores, FL 1132050250040 Block: Lot: CLAUDIO RODRIGUEZ Owner Information Address Phone Cell CLAUDIO RODRIGUEZ 1263 101 Street MIAMI SHORES FL 33138- 1263 101 Street MIAMI SHORES FL 33138- Contractor(s) UNIVERSAL PLUMBING CORP Phone CeII Phone (305)887-3131 Valuation: Total Sq Feet: $ 14,000.00 0 Tons: 3 AND 4 TONS Additional Info: Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: Fees Due DBPR Fee DCA Fee Permit Fee Total: Amount $0.o0 $0.00 $490.00 $490.00 Pay Date Pay Type Amt Paid Amt Due Invoice # MC-6-18-68087 06/28/2018 Check #: 1519 $ 490.00 $ 0.00 Available Inspections: Inspection Type: Final Rough Duct Review Mechanical Underground 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: 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. Futhermore, I authorize the above -named co tor to do the work stated. Authorized Signature: Owner / Applicant / `Contractsr / Agent June 28, 2018 Date Building Department Copy June 28, 2018 1 Address: ( 2 fv 3, i\J l ' _L. 5 l_ State: l city: . BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC PLUMBING MECHANICAL JOB ADDRESS: I 2, City: Miami Shores Folio/Parcel#: Occupancy Type: ROOFING ❑ REVISION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FFBC�2`00 (b Master Permit No..1�,%��-" 0ENEWAL Sub Permit No. EXTENSION ❑ PUBLIC WORKS TfCHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS County: Miami Dade Zip: 3' 3) ( q Is the Building Historically Designated: Yes NO Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C Z c-9 O ���C�il �� _Q�`2 Phone#: 2 /42 Z 4.. Tenant/Lessee Name: Phone#: Email: Zip: • CONTRACTOR: Company Name: cinitoe-asM, P(c%f jiil,7 Goi2 Address: lc/ C e $� 4 CGS{ State: Qualifier Name: �vG�le e444v 4 State Certification or Registration #. DESIGNER: Architect/Engineer: Address: \ i0 1 I¢ •1 J 1 1 2-t+ t Value of Work for this Permit: $ r• 006 • Type of Work: ❑ Addition ❑ Alteration New 0 Description of Work: . Phone#;.4 ,. ?O 4'@;- / Zip: 370ff Phone#:fi'',2JO c/ClG/J(/ Certificate of Competency #: ;]� Phone#: ?y C _.s '� —� S S S City: `✓,4. r2 S 'S State: 4— ( Zip: Square/Linear Footage of Work: u Repair/Replace ❑ Demolition vi_ Specify color of color thru tile: • Submittal Fee $ Permit Fee $ CCF $ Scanning Fee $ Radon Fee $ DBPR $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ / IId ° (Revised02/24/2014) ,F 6 Bonding'Compans Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address i ``City _ • 1 t. i >t• State Zip ( I'1 — 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 yf 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. "WARNINGS 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." 1 w , 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 th'e 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 Signature ,OW aorAGENT The foregoing instrument was acknowledged before me this 2 day of V f , 20 o,fn me or who has produced ` identification and who did take an oath. • NOTARY PUBLIC: Seal: v>Le`'' MAHA ., MY COMMISSION # GG 044602 "' !we EXPIRES: November Bonded Thru Notary Public Underwriters by known to as ******************************* APPROVED BY CONTRACTOR The foregoing instrument was acknowledged before me this � ( day of c/ e , 20 / ?l , by / ' 1 dui f�? G i - - . , who is personally known to me or who has produced • identification and who did take an oath. NOTARY PUBLIC; Sign: Print: Seal: as $ f,4r, •,.J _ Notary Pu' rc stare of ! U1 ja Lourdes Marin Rivera My Commission (3G 124638 Expires 07/18/2021 ******_**************************************************************** Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk