MC-18-2975Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: MC-09-18-2975
Permit Type: Mechanical • Residential
Work classification: Pool Heater
Permit Status: Approved
Issue Date:01/17/2019 Expiration: 07/16/2019
Location Address Parcel Number
639 NE 97 ST, Miami Shores, FL 33138-2470 1132060171880
Contacts
JUAN DIAZ Owner
639 NE 97 ST, MIAMI SHORES, FL 331382470
JENNIFER DIAZ Owner
639 NE 97 ST, MIAMI SHORES, FL 331382470
JUAN DIAZ Applicant
639 NE 97 ST, MIAMI SHORES, FL 331382470
FLORIDA POOL PATIO CORP Contractor
CLAUDIO SEBASTIAN VALERO
12241 SW 99 ST, MIAMI, FL 33186
Business: 3058150181
Description: HEATER Valuation: $ 3,200.00 Ins section Requests:
305-762-4949
TotalSq Feet: 566.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$2.40
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$112.70
Payments
Date Paid Amt Paid
Total Fees
$112.70
Credit Card
01/17/2019 $112.70
Amount Due:
$0.00
Building Department Copy
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 bract �Ph� work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
January 17, 2019 Page 2 of 2
Miami Shores Village
g
Building Department RECEIVED
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 S P 2 8 2018
Tel: (305) 795-2204 Fax: (305) 756-8972 ^ "1 ,
INSPECTION LINE PHONE NUMBER: (305) 762-4949 (�C�
{{��41
FBCC 20M
BUILDING Master Permit No. ,—Pp^ I(R- C,
PERMIT APPLICATION Sub Permit No. I " I C 18 —12 0
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING -k MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
1 �" �� CONTRACTOR DRAWINGS
JOB ADDRESS: 6Zi / 45 v 1")
City: Miami Shores County: Miami Dade Zip: 1)����
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name
(Fee Simple Titleholder):-)CIVI C C)m2 Phone#:
6 Address: 5CA MG - \ m
City: N t'c� r � � r �� � State: � Zip: �13
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Floytc(A POOL Phone#: 3y5 �ts
Address: t2- Lq f �SL� C01 5Z
City: M t Gr m i State: + Zip:3�J
Qualifier Name:
(v UPwYO
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Ad
of Competency #:
Phone#:
/ State: Zip:
Value of Work for this Permit: $�3 2 00 v Square/Linear Footage of Work:
Type of Work: ❑ Addition �❑ Alteration I—]NewElRepair/Replace
"- Description of Work: 1�� �-v
City:
❑ Demolition
Specify color, ofo/or`thru tile: r^ •_, __ __ + y" °`"' �` ~ A '
Submittal Fee $ - ` Permit Fee $`Y r �ifi�t� _ 0 90 CCF $ ° CO/CC $
Scanning Fee $
Radon Fee
Technology Fee $ Training/Education Fee $
Structural Reviews $
DBPR $ • (IO Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such d notice, the
inspection will not pproved and a reinspection fee will be charged.
Signature Signatu
OWNER or AGENT CONTRACTOR
The foregoing instrument
was acknowledged before me this
2g day of 20 cJ9J by
10QvI G (FIZZ— who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: ,, ,1
Print: (S.ia,Cloiz AojUaS
Seal:
NADINE AGUAS
MY COMMISSION M G0090407
***** * *****E#*PIRE$ AfOl 04, *2021**�e
APPROVED BY
The foregoing instrument was acknowledged before me this
�( day oItn'
20 by
t U fwho is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
N1
Seal:
4(•;: NADINE AGUAS
MY COMMISSION* GG090407
DNA E RCyS 4 2 2.
*************** * *****EXrI i� A 61
/y�
Aps Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)