MC-18-3692Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
s � <
�r _ _611
issue Date:12/14/2018
Parcel Number
70 NE 99 ST, Miami Shores, FL 33138 1132060131050
Contacts
Permit NO.: MC-12-18-3692
Permit Type: Mechanical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 06/12/2019
JAY YAGODA Owner JAY YAGODA Applicant
70 NE 99 ST, MIAMI SHORES, FL 33138 70 NE 99 ST, MIAMI SHORES, FL 33138
Other:3056577859 Other:3056577859
NEW ERA AIR CONDITIONING INC Contractor
ADRIAN BETANCOURT
295 E 34 ST, HIALEAH, FL 33013
Business:3053052840 newera.airconditioning@gmail.com
Home: 3058854127
Inspection Requests:
Description: INSTALLATION OF BATHROOM EXHAUST FAN . Valuation: L216.00j
305-762-4949
Total Sq Feet:
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Building Department Copy
Payments Date Paid
Amt Paid
Total Fees
$110.30
Check# 1482 12/14/2018
$110.30
Amount Due:
$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: /11 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulalWyreo il�trydon ing. Futhermore, I authorize the above named contractor to do the work stated.
Signature: Owner / Applicant / Contractor / Agent
Date
December 14, 2018 Page 2 of 2
Miami Shores Village C_17) ram.-1-5
Building Department WC1 ,s
10050 N.E.2nd Avenue, Miami Shores, Florida 33138Tel: (305) 795-2204 Fax: (305) 756-8972 BYINSPECTION LINE PHONE NUMBER: (305) 762-049
FBC 2
BUILDING Master Permit No. JzL- fl ^ ) 8 - 7-0
PERMIT APPLICATION Sub Permit No. iw, %j 369 Z
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING MECHANICAL PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
L CONTRACTOR DRAWINGS
JOB ADDRESS: /� 9�`► J-
City• Miami Shores County: Miami Dade Zip: 13 a; V Dr't
Folio/Parcel#: / 13 Z 0 (o 0 %3 O S 0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: 1 Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):/ r C C� dam. ___ Phone#:3 0_5% 6 r7 1I ¢,7�,Y
Address�
`: ,
City: 1Vl i cv�-�`� r�i S� State: r Zip: -7
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:r a Phone#: ��.f - 73�5 l Z7
Address,: I z �� � -� y / �'
City: 11;'* 1 eS /"7 State: �� Zip,,-3=l? ��3
Qualifier Name• '�i 4A AA .tea l oy /— Phone#� .3Pr� Z BYC�
State Certification or Registration #: C -A L I -3 I % V JO Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: S J z2 9 `ov Square/Linear Footage of Work:
Type of Work: % Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: ,i.� s kA114 '�, ..r J f �j / lj/y, eJ ��✓t .
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 00 .3o
(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
Zip
State 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 charge
Signature
OWNER AGENT
The foregoing instrument was acknowledged before me this041 j
day of r20-C-P Vk r , 20 / V , by
�[ v who is personally known to
me who has produc 1— / 4 .0 1rr s
identification and who did take an oath.
d.
1
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
_jdayof�Q*'rbeC 20_ -9 by
rsonall o
me or who has produced Gt Gt� as
identification and who did take an oath.
NOTARY PUBLIC NOTARY PUBLIC:
Sign �— E;7—� Ti Sign:
a�z
Print: Cis/ Gt �7e uA- Print:(/}
e,y 6, 13 ✓1�
Seal: Seal: NOTARY PUBIC
`•��",STATE OF FLORIWI STATE FFiW72
Comff* FF942372 � as 12J 2019
sssssssssssssssss�ss�sssi,lcplC�Qsi�O>10asssssssssssssssssssssssssssss sass Was
APPROVED BY
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk