MCC-18-3568Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: MCC-11-18-3568
- - " Permit Type: Mechanical - Commercial
Work Classification. Alteration
Permit Status: Approved
Issue Date:11/30/2018 Expiration: 05/29/2019
Location Address Parcel Number
9600 NE 2 AVE, Miami Shores, FL 33138 1132060132510
Contacts
PALAZZO LEONI LLC Owner PALAZZO LEONI LLC Applicant
TODD LEONI TODD LEONI
PO BOX 381703, MIAMI, FL 33238 PO BOX 381703, MIAMI, FL 33238
DYNAMIC AIRFLOW CORP Contractor
ARASH KHAYMEDOOZ
13727 SW 152 ST 213, MIAMI, FL 3317
Description: DUCR WORK Valuation: $ 2,000.00 Inspection Requests:
r-162-4949
Total Sq Feet: 617.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
11/30/2018 $111.10
Amount Due:
$0.00
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 ccyistructjon and zoning. Futhermore, I authorize the above named contractor to do the work stated. i
zY k4f4k ` P4' 7U(2 < V �5O
Authorized Signature: Owner / Applicant / Contractor / Agent Date
November 30, 2018 Page 2 of 2
Miami Shores Village
RECEIVED
Building Department NOV 3 0 2018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 I
FBC 201--4
BUILDING Master Permit No. aC -I - Zz -5 0
PERMIT APPLICATION Sub Permit No. MC VQ,
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PLUMBING S MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 195 OE 96 S T-
Cit : Miami Shores County: Miami Dade zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone:: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �d✓ L e� P �� Phon� �� 3� ��q 2.
Address: .9600 PE Z V(Po (Qak 30ao
M
City: ,' l "0' M, State: t L Ziipp:p, 3 3 23 `b j
Tenant/Lessee Name( ilJ� �C� Phone#:
Email: 'i. l)@ c VC(xl1���`�G S• com
CONTRACTOR: Company Name: _ �7N��J �i Ait r�I'I/ row PhoneM: 30�1 510 4�1�
Address:
City: i%l/e1 . State: — Zip: 3 3 / 77
Qualifier Name: 4ArASv��,.. _ ���� Phone#:L2b,{i�� L
State Certification or. Registration #: r 4 pp ':778rz Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
ne#:
State: Zip:
Value of Work for this Permit: $ 2Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New 05 Repair/Replace ❑ Demolition
Description of Work: �64c h�ff:k
Specify color of color thru the:
Submittal Fee $
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
DBPR $ Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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, proved and a reinspection fee will be charged.
Signature Signature
OWNER or AG T CONT OR
The foregoing instrument as cknowledged before me this
3o day of V 20 by
TOM 111�b /" / , who is personally known to
me or who has produced
identification and who did take an oath.
as
The foregoing instrument was acknowledged before' me this
� -�day of �((��20 16 by
p€rsTina May to
me or who has produced , as
identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIV-
Sign:MAHARAI
i
Print:
Print:
Y PU&"
COMMISSION # GG 044602
EXPIRES: Novem
Seal: DW V�TII+
Seal:
+.....•o''
BondedThniNotaryPUblicUnderwrllers
MY COMMISSION # FF919683
It
%�,°,! ;: •'
EXPIRES: November 25, 2019
************************************************************************************************************
APPROVED BY
Plans Examiner
Zoning
Structural Review
Clerk
(Revised02/24/2014)