MC-18-1315Miami 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
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
FBC 201 1eTh
Master Permit No. bR `% 4 31 T
Sub Permit No. IV us -151 S
❑ REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING Q MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 347 NE 98 ST
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 11 -3206-013-5621 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type:
OWNER: Name (Fee Simple Titleholder):
Address: 347 NE 98 ST
City: Miami Shore
Arthur Baker/Annette Felder
Flood Zone: BFE: FFE:
State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Regency Pool and Spa of FL Inc. Phone#: 954-583-7373
Address: 6507 NW 13 Ct
City: Plantation State: FL z
Qualifier Name: Rafael Imbert Phone#:
State Certification or Registration #: CPC056811 Certificate of Competency #: _
DESIGNER: Architect/Engineer: Aquadynamics Design Phone#: -
Address: 5000 SW 75th Ave Suite 103 City. Miami State
Value of Work for this Permit: $ two ` Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration■❑ New ❑ Repair/Replace
Description of Work: 120,000 BTU Heat Pump
Specify color of color thru tile:
Submittal Fee $ '5�;0-1=5K% Permit Fee $
Radon Fee $ 7^
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Training/Education Fee $
CCF $.
33313
FL Zip: 33155
❑ Demolition
CO/CC $
DBPR $ a ' Q Notary $.
Double Fee $
Bond $
TOTAL FEE NOW DUE $ GG -�
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.
l
r„
Signature Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
ID day of tae/ 20 /d by
who is personally known to
me or who has produced FL /– - A—.,i>e4 as
identification and who did take an oath.
NOTARY PU
Sign:_
Print:
NTRACTOR
The foregoing insslrw %nt was acknowledged before me this
day of A-eCq 20 le by
.lm who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: n
Z Print: Hzl Ca�qS'
Seal: '�' Commission # FF969034 Seal: '`'""Ue�All
Y8 Gonzalez
*' Expires: March 8 2020: Commission # FF969034
Bonded thru Aaron Notary oP Expires: March 8, 2020
Bonded thru Aaron Nota7
APPROVED BY Vans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)