WS-18-174�sKO1S y� Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
F�ORLDP
Permit /VO. WS-1-18-174
Permit Type: Windows/Shutters
Pen tork Classification-. Window/Door Repiacem
Permit status: APPROVED
Issue Date:1/23/2018 1 Expiration: 07/22/2018
Project Address Parcel Number Applicant
349 NE 99 Street 1132060135510
MIAMI SHORES 349 NE 99 STRE
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
MIAMI SHORES 349 NE 99 STREET 349 99 (786)333-9096
---- MIAMI SHORES FL 33140-
Contractor(s) Phone Cell Phone
ALZATE CONSTRUCTION INC (954)599-8434 (305)949-4526
�e of Work: INSTALL WINDOWS 14
of Openings: 14
iitional Info: INSTALL WINDOWS 14
ssification: Residential
inning: 1
Fees Due
Amount
CCF
$9.60
DBPR Fee
$3.60
DCA Fee
$2.40
Education Surcharge
$3.20
Permit Fee
$240.00
Scanning Fee
$3.00
Technology Fee
$12.80
Total:
$274.60
Valuation: $ 16,000.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # WS-1-18-66202
01/23/2018 Check #: 1085 $ 50.00 $ 224.60
01/23/2018 Check#: 1086 $ 224.60 $ 0.00
Available Inspections:
Inspection Type:
Window Door Attachment
Final
Review Building
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
constructio and zoning. Fut a more, I authorize the above -named contractor to do the work stated.
January 23, 2018
Authorized Signature: Owner / Applicant /
Building Department Copy
January 23, 2018
/ Agent
Miami Shores Village
Building Department DECEIVED
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JAN 2 3 2018
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4%9
FWC 20 -I
BUILDING Master Permit No. C,C I-�tC�%
PERMIT APPLICATION Sub Permit No. NS I —
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 3,11f
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: F/FE: 2 Q
OWNER: Name (Fee Simple Titleholder) �f •� �% Phone#:
Address: -54Z
City: / /r'I/ s��l State: F Zip: 5 Z!Z2
Tenant/Lessee Name: Phone#:
Email: `
CONTRACTOR: Company Name: RVZKII� �Q(�S'�R�tk'�1CY1 Phone#: SqR 84M4
Address: 21S 14 v i l Ay * \A Z\ \ O
City: ikI A'M l . Stater Zip:
Qualifier Name: t oyy 'Nyvprl-u� Phone#:
State Certification or Registration #: IZ-( Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ (, , U 1/' Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 1) S �-i1 ��►.Sdi,KS S 14 \ 1
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
W
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. 1 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 on 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 a proved and a reinspection fee will be charged.
r-
Signature SignatureLa kn-�t.
O NER or AGENT CONTRACTOR
The foreg ing instrument was acknowledged before me this
day of �,73 PU kJ/,} 20 by
C • Cro fl of'i✓ , wl5oispersonally known to
The foregoing instrument was acknowledged before me this
day of � 20 by
�—,o who is p rsonally kn n to
me or who has produced t=c- Dt1z-Zec#fl9-1JD93PKfi40 me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Print: ��/��9i✓y��/�G(T7
Seal: l9MMANUELREGI8
MY COWAISSION 0 00 074M
'ems EXPIRES: Apd 44, 2024
s******s13F W IF
APPROVED BY
identification and who did take an oath.
NOTARY PUBLIC:
MAHARAI K. GONZALEZ 11
SI �'A 602
` EXPIRES: November 2, 2110
Pflnt: ':; 'O' icUnderwriters
Seal:
ss**sssss**ss**ss***ss*s**s******s************s*****s***s*****
Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Inspection requirements for:
Windows, Doors, Skylights or Fixed Glass (cladding) Permits
Upon issuance of permits for the scope of work involving the removal, changing and/or
replacement of any type of windows, doors, sidelites, skylights or fixed glass (cladding)
the permit holder or qualifier bearing his signature on the permit application shall abide
by the requirements of this department and comply with the following statement:
Upon obtaining window and/or door permits for the installation of same, it is the
responsibility of the permit holder to request window/door framing in -progress
inspection, prior to concealment of any horizontal or vertical clip mullion, bucks, shims,
etc. Inspector will also verify anchor type, edge distance, embedment and spacing. The
purpose for this inspection, is for the verification of conformance with Product
Approval (NOA).
rcknow dement:
A (�-3 1 �
Qualifier/Owner Signature Date
_NN A- 4�-? (A fiZ>
Print Name