REV-17-1754P�v r�-ia5u
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BUILDING
PERMIT APPLICATION
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
BUILDING ❑ ELECTRIC ❑ ROOFING
RECEIVED
JUL 0 610A
or-1 54-1�
FBC 2014
Master Permit No. PC- - G - 16, t�4 -�$
Sub Permit No. 2 tty 1-�1
— I J S1
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
`� CONTRACTOR DRAWINGS
JOB ADDRESS: 1 0 3 'C (� �C'--�C f�.CL_
City: Miami Shores County: Miami Dade Zip: 3 3 131B
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder)(Is
((s owl gc rlee. Phone#:
Address: 1o,3 Xn- 9/
City: 1`-'14 gLA-k
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
Address: 2OL60 CQI-C�fi S
City:
Qualifier Name:
ks®
State: 'T7 - Zip:
Phone#:
ne#:�.318 8 ��
:ate: T �-- Zip: J Jr);;c
,>e,.1--0 Phone#:
State Certification or Registration #: I✓&G 'I f 4O. C�9 ,,Ceertificcate of Competency #:
DESIGNER: Architect/En ineer: 61tc c� �+-�c (� � %L"r .L;,A 4e4ti, (�►G Phone#: ,,_�Co � `S�8 - 68S
Address:2,2q I Sf- TE_ ,'�0 City:�JeJ•P/.�4 State: � Zip: 3�p�
Value of Work for this Permit: $ l%--� �
t -c t1
Square/Linear Footage of Work: 100 0
Type of Work: ❑ Addition ❑ Alteration ❑ NNeewl ❑ Repair/Replace ❑ Demolition
Description of Work: i tr\
z2e Cl�1Gi U (ta
Specify color of color thru
L' �1Y
Submittal Fee $ Permit Fee $ TO 2-0 CCF $ //��E0 CO/CC $��_�I-iC� — I�
Scanning Fee $� 3 •. C,� Radon Fee $� DBPR $ 60 3 Notary $ 1/ 1
Technology Fee $ V--t • Training/Education Fee $ 2-ro Double Fee $ „
Structural Reviews $ Bond
TOTAL FEE NOW DUE $
(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 ` 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 P17
ce of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature ZJ�MSignature
NER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of 20 by
persona y kno n to
me or who has prod!�� as
identification and who did take an oath.
The foregoing instrument was acknowledged before this
d y off 20 , by
o is person y k own to
me or who has produced as
identification and who did take an oath.
NOTARYNOTARY
ig
��► p,al cam►► `��
Seal:
APPROVED BY
(Revised02/24/2014)
Jorge Ortlgosa
Notary Public State of Florida
FF M774 - Exp 02.07.2020
Seal: Jorge Ortlgose
Notary Public State of Florida
FF 96Z774 - Exp 02,07.2020
**************************************************************
Plans Examiner Zoning
Structural Review Clerk
Monday 2.6, 2017
City of Miami Shores
Att. Building Department
Ref. Harke Residence Permit (RC-6-16-1778)
As per your request, find below our change order # 004 cost from our project at 1037 NE 915t Terr.
Please let me know if you need any other information.
Change Order # 004 - 2nd Floor 1 $134,500.00
Labor Materials
Demolition drywall ceiling and walls
$6,500.00
$4,500.00
$2,000.00
Electrical as per plans
$23,000.00
$13,800.00
$9,200.00
Mechanical as per plan
$18,000.00
$10,800.00
$7,200.00
Plumbing as per plans
$21,000.00
$12,600.00
$8,400.00
Insulation, drywall and plaster
$19,500.00
$11,700.00
$7,800.00
Floor tiling
$10,500.00
$6,300.00
$4,200.00
Bathroom tiling
$18,500.00
$11,100.00
$7,400.00
Paint
$5,000.00
$3,000.00
$2,000.00
Fixtures and accessories (by client)
$12,500.00
$12,500.00
Total 1 $134,500.00
Since ly,
JJL41-11V
Alison Harke
Owner