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MC-18-1083Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. MC-4-18-108 3 Permit Type: Mechanical - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue -.Date: 611312018 Expiration: 12/10/2018 Parcel Number 474 NE 95 Street Miami Shores, FL 33138- 1132060140440 Block: Lot: Applicant ANNE & NESTOR MORALES Owner Information Address Phone Cell ANNE & NESTOR MORALES 474 NE 95 Street MIAMI SHORES FL 33138- (305)283-7233 (305)733-6534 Contractor(s) Phone Cell Phone REGOSA ENGINEERING SERVICES I1 (786)262-2964 (786)344-8720 Valuation: Total Sq Feet: $ 3,500.00 0 Tons: Additional Info: RELOCATE EXISTING AHV Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $2.00 $2.00 $0.80 $122.50 $3.00 $3.20 $135.90 Pay Date Pay Type Invoice # MC-4-18-67286 06/13/2018 Credit Card Amt Paid Amt Due $ 135.90 $ 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 contractor to do the work stated. June 13, 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy June 13, 2018 1 Phone#: 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING ErMECHANICAL El PUBLIC WORKS JOB ADDRESS: 4 l'7 /'' Master Permit No. 144 FBC 20 P �-� [e- 53 5j VJ Sub Permit No.t l C_i & c0 ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: 3S/ 3 ° Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Address: (- ',it- 9 ,$- S Z City: /t'(/9 i-1( /1//1/6 (?/z (///s.r-oiz goegc6 one#: 3/�33 6 S 3 Y State: PrZ Zip: 33 / / g Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: ,/9 S/ t%i6//16-svai � ��� S Phone#: 3� -2/ 8 �3 e6 Address: ,i•S7OO /� f/ City: /1l/1I/ State: FG Zip: Qualifier Name: 6-//x,79 VO .- UgL State Certification or Registration #:c H C. a y9 S� Certificate of Competency #: DESIGNER: Architect/Engineer: / Phone#: Address: City: State: Zip: Value of'Vorkfort is. Permit:$ J� SSA Type of Work: F❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace I I Demolition Desc`ript of Of Work: ±ZO Ch' T Square/Linear Footage of Work: _Ey/57-/'G Specify color,of color thru tile: Submittal Fee $ Permit Fee $ /t CCF $ < • t , `r~TCO/CC $' Scanning Fee $ Radon Fee $ DBPR �`°` ' ` Notary'$: Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) Double Fee $ Bond $ - TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) • P".1 a ! 4:4 J: t Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City �!' . n.l 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 . •chure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of com (j� ment must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In ®•'bsence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature NER or AGENT The foregoing instrument was @cknowledged before me this day of l� , 20 Z A) , by AVH G4 i/ , who is personally known to me or who has produced as identification and who did take axnoath. NOTARY PUBLIC: Sign: Print' Seal: *************** APPROVED BY -. 0220EN. Jodi Ellis Cardenas NOTARY PUBLIC §1•InE*6JE CiR Signature The foregoing instrum �3 day of ACTOR \, t was acknowledged before me this ,20 /8 ,by me or who has produced who ersonall known to identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: as ,``,N,annnap,,,, .•�H G►t��'% _ a� � 2019 Am6.11, all y ;�• No.ODFF2u �; ****************************************************************** Comrn# GG185896 xpires 2/14/202 ans Examiner Zoning Structural Review Clerk (Revised02/24/2014)