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DS-17-2117Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit NO. DS-8-17-211' 7 Pa Permit Type: Driveways/Sidewalks/Slabs ermiWork Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 8/30/2017 Expiration: 02/26/2018 Parcel Number Applicant 601 GRAND CONCOURSE Miami Shores, FL 1132060172140 Block: Lot: CARLOS FELIPE LEMOS Owner Information Address Phone Cell CARLOS FELIPE LEMOS 601 GRAND Concourse MIAMI SHORES FL 33138- 601 GRAND Concourse MIAMI SHORES FL 33138- Contractor(s) ELECTRICAL SERVICES JC INC Phone (305)244-8628 Cell Phone Valuation: Total Sq Feet: $ 250.00 11.25 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Work: PREFAB SLAB FOR GENEREATOR Bond Return : Scanning: 3 Additional Info: Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $9.00 $0.80 $114.60 Pay Date Invoice # 08/21/2017 08/30/2017 Pay Type DS-8-17-64948 Credit Card Credit Card Amt Paid Amt Due $ 50.00 $ 64.60 $ 64.60 $ 0.00 Available Inspections: Inspection Type: Final Foundation Review Planning Review Building 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. Authorized Signature: Owner / Applicant Building Department Cop ntractor / Agent August 30, 2017 Date August 30, 2017 1 JOB ADDRESS: City: Folio/Parcelt: 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 ❑ MECHANICAL ❑PUBLIC WORKS ► ON hnTCOd/Se Miami Shores County: //',3.2U6o—U/17 —„ /110 Occupancy Type: Load: Construction Type: RSCS1v ° p,\IG 21 15I FBC 20N. Master Permit No. et 1 - l 1- / 9340 Sub Permit No. D �1 \ \ 1 ❑ REVISION ❑ EXTENSION ID RENEWAL ❑ CHANGE OF El CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Miami Dade Zip: i / 5 0 Is the Building Historically Designated: Yes NO X Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titlehol ): 4/tO S '1 r 1 eS Phone#: Address: 0/4 ZW , C�b4GiOti/Z SC - City: Z- Zip:/ City: �A.iNi G.� !�/���' State: /' K�3t7 !r Tenan essee Name: Phone#: Email: CONTRACTOR: Company Name: L% /Lak/CQ / (1w/CES Address: '�"T' Jh) • M2 aye City: Qualifier Name: State Certification or Registration St DESIGNER: Architect/Engineer: Phoned: Address: Gty: State: Zip: Value of Work for this Permit: $ ,25 D Square/linear Footage of Work: , \ • V Phone8:(5) w0 zip,: Phone*: 'O3-) , 24 -36.2s %q 04 i State: �V,eT/GLD / 3DO55la 0 Certificate of Competency 4: Type of Work: ❑ Addition ❑ Alteration Description of Work: �/P. ��d c /e b New ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Educadon Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ Ci —T GO (Revised02/24/2014} Bonding Company's Name (if applicable) Bonding Company's Address City State Tip 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 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. "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 condition to the issuance of o 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 low 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 tosted notke, the inspection will not be approved and a reinspption fee will be charged. Signature) OWNER or AGENT The foregoing instrument was acknowledged before me this day of Oc-tic.) S , 20 , by C'c.ri'.OS--Gi''tc S , who is personally known to me or who has produced Identification and who did take an oath. NOTARY PUBUC: as Sign: Print: Seal: 'w APPROVED BY (Revised02/24/2014) Josefina Jara '�':... Commission 0 GG109716 Expires: May 30, 2021 ; Bonded thnl Aaron N Signature CONTRACTOR The foregoing instrument was acknowledged before me this to day of (O(_,Voc , 20 ) -] , by CH r (o s �f , who is personally known'foe , me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: `GS% t Seal: `,�!(b,,, Josefina Jara ?• i., �"= Commission l GG109716 ;"- Expires: May 30, 2021 Plans Examiner Structural Review Zoning Clerk