MC-18-884�` yKo�s opt
F�tORtDp`
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit No. MC-4-18-884
Permit Type: Mechanical - Residential
Per
'' t Work Classification: Pool Heater
Permit Status: APPROVED
Parcel Number
Issue Date: 51412018 1 Expiration: 10/31/2018
Aoolicant
157 NE 101 Street 1132060131951
Miami Shores, FL Block: Lot: RACHEL & COLIN RILEY
Owner Information Address Phone Cell
RACHEL & COLIN RILEY 157 NE 101 Street (716)807-1312
MIAMI SHORES FL 33138-
157 NE 101 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
PARKWOOD POOLS AND PAVERS LL (954)583-3355
Tons:
Additional Info: POOL HEATER
Classification: Residential
Approved: In Review
Comments: Date Approved:: In Review
Date Denied: Type of Work:
Scanning: 1
Fees Due
Amount
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.40
Total:
$111.80
Valuation: $ 2,850.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # MC-4-18-67048
04/05/2018 Credit Card $ 50.00 $ 61.80
05/04/2018 Credit Card $ 61.80 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Mechanical
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 AFFIDAVITffa
ll the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoni authorize the above -named contractor to do the work stated.
/-aL1 Desna '03AI May 04, 2018
Authorizeb Signature: Owner / Applicant / Contractor / pent Date
Building Department Copy
May 04, 2018
1
Miami Shores Village
Building Department A 05 ois
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305)•762-4949
FBC 20 i"t
BUILDING Master Permit No. (9J 08
PERMIT APPLICATION Sub Permit No. `v `C( U - E39
i,
❑BUILDING ,IDECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[--]PLUMBING MECHANICAL ❑PUBLIC WORKS [::]CHANGE OF ❑ CANCELLATION ❑ SHOP
i CONTRACTOR DRAWINGS
JOB ADDRESS: Ah\ �k
City: Miami Shores
��rr County: Miami Dade Zip: 33139
Folio/Parcel#:\\— —a"'� Aq s I Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): k \E:ll Phone#: 7110 C)
Address:
City: -MI UM 1 — State: V L zip:. ?11
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: MAY,--jW_3.Ta J' M LXTj t-l\L—JY, Phone#:�-"}i \—Ps�--i-3 ft1�
Address: � �� �7 'tl �m
City: T��� State:
*y L Zip:
Qualifier Name: Phone#: %A--5 1-
State Certification or Registration #: lj Z Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ oP S -1). -- Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ® New ❑ Repair/Replace ❑ Demolition
Description of Work: R)oi ""gi.l
Specify color of color thru tile:
Submittal Fee $ Tn • OD Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
CCF $
CO/CC $
Radon Fee $ d W DBPR $ Notary $
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ I ' Go
(Revised02/24/2014)
Bonding Company's Name (if applicable) t j A
Bonding Company's Address
City 0 — State
Mortgage Lender's Name (if applicable) ►� A
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 he notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to tach nt. o, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection ich oc rs eve (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will n l proveQ spection fee will be charged.
Signatu
OWNER or
The foregoing instrument was acknowledged before me this
day of 20 18 by
ej who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
cZ day of Mares. ,20 18 by
kl)cw / 61 moo who is personally known to
me or who has produced Jrl JQrs l i cans..0— as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: Seal:,,
.M" Notary Public State of Florida
Adrian Rojas Plerrend
+�N My Commission GG 183868 �f
Explra02107/2022
APPROVED BY Plans Examiner
Notary Public State of Florida
Adrian Rojas Pierrend
My Commission GG 183868
Expires 02/07/2022
****************
Zoning
Structural Review
(Revised02/24/2014)
Clerk