PW-17-829Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
[94 NW 94 Street
Miami Shores, FL
Owner Information
Issue Date:1118/2018
Permit NO.' I ! '= = 74829
Peet Type: Public Works
Work Classification: • Public Works
Pet'rntt'`tatus:APPROVED_
s t
Expiration: 04/18/2018
Parcel Number
Applicant
1131010340230
Block: Lot:
SANTIAGO JIMENEZ ANTONELJ
Address
Phone
Cell
SANTIAGO JIMENEZ ANTONELA
INTIZIKVVIOWIERV
94 NE 94 Street
MIAMI SHORES FL 33150-
(561)596-7146
94 NE 94 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone
MAJESTY ELECTRIC SERVICES CORI (786)402-9150
CeII Phone
Valuation:
Total Sq Feet:
$ 1,500.00
0
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$o.00
$0.00
$0.00
$0.20
$100.00
$3.00
$0.80
$104.00
Pay Date Pay Type Amt Paid Amt Due
Invoice # PW-3-17-63458
01/18/2018 Credit Card $ 104.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Excavation
Review Electrical
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 whh the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assu ne re0bnsibl9ry for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECT (CAL, PLUMBthiG, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNER
construct
i
rtify,'th t all a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
/Futher re I horize the above -named contractor to do the work stated.
thorized Signature: Owner / Applicant / Contractor / Agent
January 18, 2018
Date
Building Department Copy
January 18, 2018 1
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
Scanning Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
6
FBC 20(0
BUILDING Master Permit No. (2._C- 1�C3
PERMIT APPLICATION Sub Permit No. PW (9--s241
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
II] PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION
CONTRACTOR
JOB ADDRESS:
Gig N W °1411n
❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade Zip: 2)21(GO
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone: BFE:
OWNER: Name (Fee Simple Titleholder): In 1A A1& 1t C na")
Address: C N W CAA --
NO
FFE:
Phone#: S(01- S2 3-32S6
City: [Xka t SVI�JI,ULS) State: .(.L Zip: 331SO
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: }"1GiyS
Address: (1 B SO -EA Gt(.pc -
city: L-1i G1 \ALoi v (--)Ga
2a [ Ciu 0
eAret nr[C. SeNV t C2 C 0`C Phone#: --q13)
cyfok
State:
Zip: 3J O lq)
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #: 7i 00 l 1 '4
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ A) (5Q0 . 00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: a L V IA- Cldbf ctic v- (%Y1/ 1 GQ (i?ccz..- A-t,
_..mow...,,....... ,.
Specify colo
126' r 9 .77 r nrkia i[n6ina
3.m�(m�r,3 • V �,"
ry: t1'1C Anna
Submittal Fee $ Permit Fee $ 715142
�00.00
CCF $ CO/CC $
Radon Fee $ DBPR $ Notary $
Double Fee $
Bond $ TOTAL FEE NOW DUE $ /V //jtt00
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.
Signature Signature
OWNER or AGENT / CONTRACTOR
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to
The foregoing instrument was acJ,inowledged before me this
day of %//C2/lt�" , 20 l / + by
)f k e./
Q Gv, mac., , who is personally known to
me or,who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
identification and who did take an oath.
•
NOTARY PUBLIC:
Sign: Sign:
Print: Prin
Seal: Seal. • ' t ► Commission• GG ' 1455
My CORM►.. Wien Sep 25, 2
( Bonded NNW
************************************************************************************************************
APPROVED BY / r t Ians Examiner
Zoning
• Structural Review
(Revised02/24/2014)
Clerk