MC-18-995,5�°S t�� Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
FCORtDA
Permit No. SIC -4-1$-995
Permit Type: Mechanical - Residential
Pilo 3, " r I Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 4123/2018 ! Expiration: 10/20/2018
Protect Address Parcel Number Applicant
187 NE 100 Street 1132060132071
Miami Shores, FL Block: Lot: JESSICA WADE PFEFFER
Owner Information
JESSICA WADE PFEFFER
187 NE 100 Street
MIAMI SHORES FL 33138-
187 NE 100 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
CYCLONE MECHANICAL INC (305)607-6682
Additional Info: ADD A/C DUCT IN UTILITY ROOM
Classification: Residential
Approved: In Review
Comments:
Date Denied:
Scanning: 1
Fees Due
Amount
CCF
$0.60
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$150.00
Scanning Fee
$3.00
Technology Fee
$0.80
Total:
$158.85
Cell
(305)804-8424
Valuation: $ 700.00
Total Sq Feet: 0
Date Approved:: In Review
Type of Work: ADD A/C DUCT IN UTILITY ROOM
Pay Date Pay Type Amt Paid Amt Due
Invoice # MC -4-18-67174
04/13/2018 Check #: 115 $ 50.00 $ 108.85
04/23/2018 Check #: 117 $ 108.85 $ 0.00
Avauaoie inspections:
Inspection Type:
Final
Rough Duct
Review Mechanical
Underground
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
construction and zoning. Futhermore, I authpfizEjth#,above-nam_d contractor to do the work stated.
Authorized Signature: Owner
Building Department Copy
/ Cfiktractor / Agent
April 23, 2018
1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
❑PLUMBING f
MECHANICAL
JOB ADDRESS:
Folio/Pa
NMI
Miami Shores Village RECEIVED
Building Department APR 13 1018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 (-C
BC 201
Master Permit No.
Sub Permit No._�
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
c>4 TU 1.. Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholde
S 1 CO,- Phone#:305' �PL S`I 2`{ .
Address: I - i'` --JF— lam/ J � '
Cify: Y4-15 State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: , S -:� W
Qualifier Name: G
State Certification or Registratio
DESIGNER:
`` Arch itect/Engineer:
Address:`1'nI;;n �1
Value of Work for this Permit: $
Type of Work: Addition ❑ Alteration
Description of Work:
Specify color of color thru tile:
ate: T lam Zip: 31'-30 1 O
i Phone#:
0 t • Certificate of Competen
City:y(SW 1 �C State: V�t Zip:3
Square/Linear Footage of Work:
❑ New ❑ Repair/Replace ❑ Demolition
Submittal Fee $ Permit Fee $ ^4 l)v '-'- CCF $ CO/CC $
Scanning Fee $ Radon Fee $ O� - � DBPR $R • QL Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ U
(Revised02/24/2014) 6�)G
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.
Signature
OWNER or AG T
The fing instrument was acknowledged before a this
11� day of r 20 by
'T0 ho i sonally known to
me or who has produced ( i as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The foregoing instrument wasracknowledged before me this
( day of �2 { I t 20, by
Iwho is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
MAFiAMI K. GONZALEZ
Sig : ;i:v
': ISSION # GG o44602 Sign:_
114Print: .ota Public
Print:
Seal: Seal:
MY COMMISSION # GG 044602
Bonded Thru Notary Public underwriters
res*sss*s*:*s**s****�*ra***r*�** **ss*** *:ssss:: s� ,s*****rr•s****sr*****r***•sir*rsss�ss:*tsss*:ssssss
APPROVED BY Plan Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)