DEMO-18-721Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pe
mit
Parcel Number
Permit NO. DEMO-3-1 8-721
Permit Type: Demolition'
Work Classification: Mechanical
Permit Status: APPROVED
Issue Date. 4/13/2018
Expiration: 1'0/10/2018
Applicant
1421 NE 103 Street
Miami Shores, FL 33138-2625
1132050310150
Block: Lot:
VILMA QUINTANA
Owner Information
Address
Phone
Cell
VILMA QUINTANA
1421 NE 103 Street
MIAMI SHORES FL 33138-
(305)527-3904
1421 NE 103 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
TEST AND BALANCE AIR CONDITION (305)218-1798
Valuation:
Total Sq Feet:
$ 500.00
0
Type of Demo: Mechanical
Additional Info: INTERIOR DEMO, REMOVE KITCHEN
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Amount
$0.60
$2.00
$2.00
$0.20
$100.00
$3.00
$0.80
Total: $108.60
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO-3-18-66857
03/21/2018 Check #: 7919 $ 50.00 $ 58.60
04/13/2018 Check #: 1144 $ 58.60 $ 0.00
Available Inspections:
Inspection Type:
Final
i
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.
April 13, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
April 13, 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
FBC 20 f
BUILDING master Permit No.-AD'D 6) j1
PERMIT APPLICATION Sub Permit No7 M(5 I
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PLUMBING
MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I L\Z \ i ti e
City: Miami Shores County:
Miami Dade Zip: \�J C�
Folio/Parcel#: \\ — -2j2..05 — v\ — C:›V'3 O Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): ,) A'(N( _..- QUA r\�(-\a Phone#: ��` to-- Oy
Address: ,--\Z l \�_ c (-)�(e SN •
City: M \ A M \ U Y\O c (' S State: -V i-- Zip: -3�
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: � �� Y�`��P Phone#:
Address: Z X ,v J 7 \* Ave
City: J N\ G1< m \ State: 1 L_ Zip: 3 .D \LA2 �c�
Qualifier Name: \ 1� (i Jac J Phone#:(,�S)Z" \)1�C8
State Certification or Re istration #: CAC 1B\54" \ ( Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ ' 0 dr t Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ".0 Repair/Rep ac ❑Demolition
Description of Work: -....714„,f/A/CricAte i
C
Specify color of color thru tile:
Submittal Fee $ " �A Permit Fee $0 L 0" CCF $ CO/CC $
Scanning Fee $ Radon Fee $ r rR) DBPR $ r G Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
/...V
TOTAL FEE NOW DUE $ ' G 1
(Revised02/24/2014) Y
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 reinspectio,Tfee will be charged.
Signature
OWNER or AGENT
The forgoing instrument was acknowledged before me this
day off, (C 20 by
(13
\1Va ),V\i\,who
or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
********
CHRISTINE STEVENS
Notary Public - State of Florida
Commission 5 GG 120541
ppMy Comm. Expires Jun 29, 2021
**>ir >ikg11t2jn Vi 44/;****
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of /1\ ( 7 , 20 I E by
U')'1 V•-• Al If rer2 avho is ersonally known to
who has produced
identification and who did take an oath.
NOTARY PUB C:
Sign:
Print:
Seal:
******,*************
✓'t
ITE
as
* HEIDI CID
• ti� - I MY COMMISSION # GO 121619
fig? EXPIRES: September 2, 2021
o► ' Bonded Thru Notary Pubic Unde witer>
** *
*
*
* * ************
APPROVED BY � '2 �IPnS�Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)