WS-18-3416� WS D�-3416
BUILDING
PERMIT APPLICATION
Miami Shores Village
7--
FBCTT
Building Department v
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 ``11 20 tt
Master Permit No. u s o 6�/ 6
Sub Permit No.
&BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
1 CONTRACTOR DRAWINGS
JOB ADDRESS: *:a ivw cia eq
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: l i '3iD1 -OV3 r os'v Is the Building Historically Designated: Yes NO
Occupancy Type: SFtZ. Load: Construction Type: Flood 7Qne: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): I l aL - W"Moc t: an
Address: 212- Nw 94 4
City: rl i Aly- 1 5State: ft, Zip: )
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: ri1sTfUC;fi !y-� Phone#: V� ` 2 (-Iro 5
1�,
Address: 03011 tkAlLWF-- -A0 AIZC
City: SS�� State: Fi.� Zip:33 s
� �'
�1� '
Qualifier Name: VHF ' Phone#:
State Certification or Registration #: U&I V1154 19 Certificate of�§pr�petenc #:
s��, ®sue
DESIGNER: Architect/Engineer: I j1 -
Q.� 2
Address:_03-31 'sw 12 +r—,iZ • City: ni"i-
Value of Work for this Permit: $ Aga Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace
Description of Work:
Zip:33) .
❑ Demolition
t.�t��i�uus tt e� It!MM u
Sp�c�fj 'co/or of color t�rulile:
Submittal Fee $ ° 1 Permit Fee $ �JO ` GCF $ ; `'' CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $
Structural Reviews $
Training/Education Fee $ Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $1 152 - co
U�
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 COMt�111 1�'yGE E
Notice to Applicant: As I condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will noj be approved and a Aeinspection fee will be charged.
Signature �
or AGENT
The foregoing instrument
_� as acknowledged before
me this
7 day of cDGZ • 20 1U • by
G oii h�rially known to
me or who has proclu, ' . ' , as
identification and who' did take an oath.
NOTARY&PLIC:
Sign:
Print:
Seal:
***************
APPROVED BY
(Revisedo2/24/2014)
i #atudZ'
CONTRACTOR
The foregoing instrument was acknowledged before me this
/ day of OC4D&t 20 n—ICK ' by
r ' who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PU
Sign:
Print:
r*l
I I
Seal:
Pabb t or Forrda
An . a Marts De Cordova
� �T My Cwmg$WM NA FM7186
a a Exl*" "ISI 010
niner
Structural Review
Zoning
Clerk
Miami Shores Village W�O
ED
Building Department 910050 N.E.2nd Avenue, Miami Shores, Florida 33138 B
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit.No.� A) 341 li
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
[—]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF \j4 CANCELLATION [:]SHOP
CONTRACTOR DRAWINGS
X JOB ADDRESS: qZ N W C1 4 S+
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: J 1-,31O1-Q?A-Q350 Is the Building Historically Designated Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:OWNER: Name (Fee Simple Titleholder): 6Lcr_i4 r IAcS(-iiiG_ Phone#:
Address: gl-NW G_+ `
City: rliA rN 5NO05 State: F t- zip: 33 ISD '
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: I-On(S.TPxTfCA (,ly' Phone#:
Address: 14304 IIJJAL 6;�ANV V
City: r1iAlr State: FL zip: 331S-�
Qualifier Name: luis, AeabFF Phone#:
State Certification or Registration #: Ci6CI SLS4-1°l Certificate of Competency #:
DESIGNER: Architect/Engineer:
one#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: Qli
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair%Replace ❑ Demolition
Description of Work: Q&0Cn Q + \6 4 O n
Specify color of color 'thru We:
Submittal Fee Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $
Structural Reviews $
Training/Education Fee $
CCF $
DBPR $
Co/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
s
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 approved and a reinsoection fee will be charaed.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20, by
, who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before ,this
day of Q&4ek 20 I by
who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: Sign:
Print:
Seal:
Print:
Seal: ,s+• Notary Public State of Florida
'P Ana Maria De Cordova
c� y; My Commission NA FF217186
w w Expires 04/05/2019
************************************+**************************
APPROVED BY 3 1 Plans Examiner
Structural Review
***
Zoning
Clerk
(Revised02/24/2014)
Konstructica, LLC
17304 Walker Ave
Miami, FL 33157
Phone Number: (786)-246-2529
Email: Luisaverhoff@gmail.com
Miami Shores Village
Building Department
10050 NE 2nd Ave.
Miami Shores, A. 33138
MR
RE: WS-11-18-3416
Dear Building Official,
C ICED
AR4 )p19
03/01/2019
I regrettably inform you that effective immediately we will not perform any work under the
window replacement permit number WS-11-18-3416 for Mrs. Gloria Mashack
Our firm entered into an agreement with hurricane windows of Miami to provide the
installation of the windows and doors. Due to irreconcilable differences, we have elected not to
work with this company. We pulled the permit but no work has been done at the property.
I agree to hold the Village of Miami Shores, its agents and authorized personnel harmless and
relieve them from any responsibility or liability to any legal action or damage, cost or expense
resulting from the change of contractor, furthermore we will not oppose a change of
contractor.
Your attention to this matter will be greatly appreciated.
Sincerely,
i
Lu' verhoff
President of Konstructica
CGC1525419
}og,,%Y °u% Notary Public State of Florida
Ana Maria De Cordova
o` My Commission NA FF217186
�` OF Pop Expires 04/05/2019