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MC-18-827Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit No, MC-3-18.827 Permit Type: Mechanical - Residential Pen "t Work Classification: Addition/Alteration Permit Status: APPROVED Parcel Number issue Date: 4/18/2018 1 Expiration: 10/15/2018 Applicant 85 NW 103 Street 1121360131080 Miami Shores, FL 33150-1233 Block: Lot: DM INVESTMENT SERVICES LLI owner mtormation Address Phone Cell DM INVESTMENT SERVICES LLC 85 NW 103 Street (786)473-5959 MIAMI SHORES FL 33150- 85 NW 103 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone AA MASTERS MECHANICAL AIR MOV (305)244-0667 Valuation: $ 4,700.00 Total Sq Feet: p Tons: Additional Info: NEW AC LIKE PLAN INDICATE REPLACE A Classification: Residential Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: NEW AC LIKE PLAN INDICATE REPL Scanning: 1 Fees Due Amount CCF $3.00 DBPR Fee $2.47 DCA Fee $2.00 Education Surcharge $1.00 Permit Fee $164.50 Scanning Fee $3.00 Technology Fee $4.00 Work without Permit Fee $164.50 Total: $344.47 Pay Date Pay Type Amt Paid Amt Due Invoice # MC-3-18-66982 04/18/2018 Check #: 254 $ 294.47 $ 50.00 03/29/2018 Credit Card $ 50.00 $ 0.00 Avaname inspections: Inspection Type: Final Rough Duct rou 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 ELECT5tC-Ai,, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFI AV c ify that e foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an n F er r , I jutppri,', the(�po d con ctor to do the work stated. ('+ll `�-'��' q"� a Aoril18.2018 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy April 18, 2018 1 Miami Shores Village MAR 2 % Iola 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 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. F-IBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP X CONTRACTOR DRAWINGS JOB ADDRESS: _ `, w 2 J S� City: Miami Shores County: Miami Dade zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood fZone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �9� ���\C(�(� �QY \i\clz�- Phone#:Bl/ ! LOS'SO691 Address: SD k »J SZO ASl City: ��0.N.\ State: \� �- Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: � � _4tk\P%hone#� U IQ Address: ` Q City: «.tom\ State: Zip: Q�r�\ Qualifier Name: LurkPhone#:� U to 1 State Certification or Registration #: ��(��_��� Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ �(� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration - ❑ New \ ,� ❑ Repair/Replace -❑ Demolition Description of Work: kwC \ o `� d d\ 1\d\(` \� Lke) �o- A\ 1)0u\ O NC m\u Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ a Cj�) DBPR $— Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ (`O `-i • SD Structural Reviews $ Bond $ TOTAL FEE NOW DUE $--TAT"i (Revised02/24/2014) E 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 Zi 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 appro d and a reinspection fee will be charged. L Signature Signature W11 OWNER or AGENT ONT ACTOR The foregoing instru en as acknowledged before me this The foregoing instrument was acknowledged before me this day of f. 20 l 1? by 01 day of &OS A 20 Y? by ir7 who is personally known to `eK)S gOk.,A who is personally known to me w o has produced as me or who has produced as i en i ica ion and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY WBLIC: Print: / (� / %�`�� ��.Print: 1C11rI ComriWmIGG Seal: 40to rd4�b titheF�PtANDE7 Seal: �''�orP ea^�°dTn`ueu�p�► senica N'Y CO. -. ISSN-DN ; FF :C3,52 EX.P19ES: ji�y 12, 20 i8 N.:ary Servi;es ************************** ************** *************************************************************** APPROVED BY ans Examiner Zoning Structural Review Clerk (Revised02/24/2014)