DEMO-16-2878Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. DEMO-10-1 C-2878
Permit Type: Demolition
t er Work Classification: Building
Permit Status: APPROVED
Parcel Number
Issue Date: 11/2212016 1 Expiration: 05/15/2017
Applicant
750 NE 97 Street 1132060142220
Miami Shores, FL 33138- Block: Lot: INVESTINGHOUSE LLC
WESTINGHOUSE LLC
Address
2061 NW 112 Avenue
MIAMI FL 33172-
2061 NW 112 Avenue
MIAMI FL 33172-
Contractor(s) Phone Cell Phone
ADANAC DEVELOPMENT AND CONS'
/pe of Demo: Building
lditional Info: DEMO PANELING IN BEDROOM 3 AND FAMI
lassification: Residential
-anninq: 3
Fees Due
Amount
CCF
$2.40
DBPR Fee
$2.25
DCA Fee
$2.25
Education Surcharge
$0.80
Permit Fee
$0.00
Permit Fee -Demo
$150.00
Scanning Fee
$9.00
Technology Fee
$3.20
Total:
$169.90
Phone Cell
Valuation: $ 3,500.00
Total Sq Feet: 1000
Available IQ i s:
Inspection Ty
Final
Review Electrical
Review Electrical
Review Building
Review Plumbing
Review Plumbing
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO-10-16-61751
11/22/2016 Credit Card $ 119.90 $ 50.00
10/21/2016 Credit Card $ 50.00 $ 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
construction and ze4ng. FYVZrfuQ ee, I authorize the above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant
Building Department Copy
November 22, 2016
Agent
November 22, 2016
0-4
RECEIVED
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
OCT 21 2016
FBC 20 I `I
Master Permit No. 1�w Q (b- l0
Sub Permit No.
❑ REVISION ❑ EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
® N C
Y2c_
Folio/Parcel#: f 1 O—--7^�%ll Is the Building Historically Designated: Yes
Occupancy Type: -5 5c Load
OWNER: Name (Fee Simple Titleholder)
Address: (;� I
Construction Type: Flood Zone: BFE
f/.11.
NO
FFE:
ne#:
City. Yv�l� ��"�� State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 4 C-'\'o'C � z re.I n%%� --I' Phone#: -YbS 5�0
Address:
�� iT �"c7�
City: �'� . �ti� `` State: ��'- Zip: A
Qualifier Name: Phone#. b S� �I �c
State Certification or Registration #: CCrG f 5��� Certificate of Competency #:
DESIGNER: Architect/Engineer: J`f Phone#:
Address:
City:
Value of Work for this Permit: $ S� Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Demolition
Description of Work:
Specify color of color thru tile:
�
Submittal Fee $ �.1Q� Permit Fee $ ( �50 CCF $ Z . yo co/as
Scanning Fee $ -1 . Radon Fee $ 2. • Z DBPR $ 2 • 2s Notary $
r��r 2O
Technology Fee $ J • Training/Education Fee $ • '3 0 Double Fee $
Structural Reviews $
Bond $
jo—
TOTAL FEE NOW DUE $ I I Cl . 9=—
(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
2.
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, PLU ING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... czA/_
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in co i�'?
ll
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT
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 aoinspection fee will be charged.
Signature Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
25 day of �r 20 (c , by
vr L11JA who is personally known to
me or who has produced rL 0L . as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
CONTRACTOR
The foregoing instrument was acknowledged before me this
\da of � D -� L 20 `(y by
who is personally known to
me or who has produced w)k/as
identification and who did take an oath.
NOTARY PUBLIC:
Seal ro"'a�QP FRANCISCO IVAN ABAD Seal:
MY COMMISSION#FF022893 aQ'�00"¢i+ Notary PubUcStataofFlorida
Brenda Bello
EXPIRE June 2, 2017 � ,� My Commission FF 987682
E OF FAQ; .
**rl * ** * ** * * **********
APPROVED BY Z� �� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)