WS-18-342Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Parcel Number
Permit NO. WS-2-1 8-342
Permit Type: Windows(Shlutters
orkCiassfioatiora: Window/Door Replacem
Permit Status: APPROVED
Issue Date: 311/2018 1 Expiration: 08/28/2018
Applicant
1569 NE 104 Street 1122320320160
ALAIN &CARLY GONZALEZ
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
ALAIN & CARLY GONZALEZ 1569 NE 104 Street (786)277-9756
MIAMI SHORES FL 33138-
1569 NE 104 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
SLUYTER CONSTRUCTION (970)379-9730
Type of Work: 16 WINDOWS AND 5 DOORS REPLACEMENT.
No of Openings: 21
Additional Info:
Classification: Residential
Scanning: 4
Fees Due
Amount
CCF
$12.00
DBPR Fee
$4.65
DCA Fee
$3.10
Education Surcharge
$4.00
Notary Fee
$5.00
Permit Fee
$310.00
Plan Review Fee (Engineer)
$80.00
Scanning Fee
$12.00
Technology Fee
$16.00
Total:
$446.75
Valuation: $ 20,000.00
Total Sq Feet: 0
Pay Date Pay Type Amit Paid Amt Due
Invoice # WS-2-18-66403
03/01/2018 Credit Card $ 396.75 $ 50.00
02/09/2018 Credit Card $ 50.00 $ 0.00
Avauaoie inspections:
Inspection Type:
Window Door Attachment
Final
Review Building
Review Structural
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 ztbnina. Futhermore. I authorize the above -named contractor to do the work stated.
March 01, 2018
Authori%d gg6ature: Owner / 0i nt / Contractor / Agent
Building Department Cop
March 01, 2018
1
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
FEB. 0 k2018
FBC 201
BUILDING Master Permit No. ' n 1-4 C /��
PERMIT APPLICATION Sub Permit No.W':;(S - 3 T2_
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION EJRENEWAL
❑ PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
DRAWINGS
JOB ADDRESS: tf & t K-Ye, L 1Oq S�•
City: 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): Q A.it3 Phone#:i63(0 •—,07 /25(�Q
Address: IS 01c, 104 S
City: 6J J A=44 f S L N- S State: `:L • Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: t '�4' n— C',J ST_ Phone#: Q71 b
Address:
City: lyr ` /IL 5 State: FZ Zip: 3> I3
Qualifier Name: 60€q Phone#:
State Certification or Registration #: g L :LC 0 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ �zo M0 • M Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 7�'f " W�� DC.t/ ✓� '�
Specify color of color thru tile:
Submittal Fee $ �. Permit Fee $ 3 �' r� CCF $ CO/CC $ CJ
Scanning Fee $ Radon Fee $ 3 • io DBPR $ 6� Notary $ CJ' W
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ c90 • Go Bond $ jo
TOTAL FEE NOW DUE $
(Revised02/24/2014)
H
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 reinspection fee will be charged.
Signature --C= =
OWNER or AGENT
The foregoing instrument was acknowledged before me this
C_ day of 20 (G by
Altlln� GO��, who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PU
Sign:_
Print:
Signature ".1L
ONTRACTOR
The foregoing instrument was acknowledged before me this
Oq day of iZ.0 J Py" , 20 Q5 by
GPG StJJiL , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY
Print:
as
Seal: , tl�yyttPu�h Notary Public State of Florida Seal: rn
y ? Sindla Alvarez ;off ueG^ Notary Public State of Florida
,pMy Commission FF 156750 Sindia Alvarez
Expires 09/0312018 oF c� C e MY Commission FF 156750 rt
' ' Expires 09/03l2018 .(
4.�#
APPROVED BY ` Plans Examiner Zoning
Y Structural Review Clerk
(Revised02/24/2014)