MC-19-2120Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
-1 1 -
W- 161
ftmiuq
Issue Date:
Location Address Parcel Number
1079 NE 96TH ST, Miami Shores, FL 33138 1132060143670
Contacts
Permit No.: MC -09-19-2120
Permit Type: Mechanical - residential
Work r~lossrfication: Alteration
PermiTstotus: Approved
Expiration: 03/17/2020
JONATHAN FELDMAN Owner AIR SYSTEMS CONTRACTOR INC Contractor
1079 NE 96 ST, MIAMI SHORES, FL 33138 ALEXANDER SANTANA
Other: 7869720336 9300 W FLAGLER ST 202, MIAMI, FL 33174
Business: 3052243972
Inspection Requests:
Description: INSTALL VENTILATION HOOD Valuation: $7,000.00 r I �
— 110S
7,000.00S 76 4949
Total Scl Feet: 120.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.20
DBPR Fee
$3.68
DCA Fee
$2.45
Education Surcharge
$1.40
Permit Fee
$195.00
Scanning Fee
$3.00
Technology Fee
$6.13
Total:
$265.86
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$265.86
Credit Card
09/19/2019 $265.86
Amount Due:
$0.00
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 con,4truction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Signature: Owner / Applicant / Contractor / Agent Date
September 19, 2019 Page 2 of 2
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
gECEIVED
S p 12 2019
BY.
FBC 20;x_
Master Permit No. �� -cn - `�q
Sub Permit No. w�" 6 1 t� — 24
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBADDRESS: V)ICI tJC- 4,0-'AQeZA-
City: Miami Shores County: Miami Dade Zip:`3
Folio/Parcel#: 1P ,32C- - L7 )L, L--qc�o' Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder)) )nllG—�t-woo e AGI►' o n Phone#:
Address: 10 JIG ql0 S IP C —
City: WiC:4(CZP �Q State: C-1 Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:: Company Name: A it C6141:Gc-A;,C T,,6,c. Phone#: ?r
T3
Address: 130() %-j F(a�ie_{ • ('e -�—
City:
r
State:
Qualifier Name: Phone#:
State Certification or Registration #: 2 ( Certificate of Competency #: _
DESIGNER: Architect/Engineer:
Address:
Value of Work for this P rmit: $ Squ
Type of Work: ElA dition ❑ Alteration ❑ New
Description of Work:
_Zip:
-731-)
City: State: Zip:
Linear Footage of Work:
❑ Repair/Replace ❑ Demolition
�o«er3...a �. *•.«�.. a.«...r•.n..F;w.nw.:..A'i..rAi..4..1Y ae"�,aay.. d+ +r+: -, ,.-.w�tt�,. re..s��e,..ww..
�� .. ( 1 • � to t, i .•1� ly
Specify; olor. of co/or'thru tyle .
Submittal Fee4- i#fee$
�$CC-
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $ '12 ( 5, (9 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..... 1� f
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.
Si
The foregoing instrument wa3;rcknowl edged before me this
—1 day of 20 by
,%UnG h,y n �{Mg� who is 6rsonally kno to
Signature
,e4-7
CONTRACTOR
The foregoing instrument was acknowledged before me this .
01 day of Se mho 2Q 20 by
i�leJc��2 �, who i ersonally know to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign- Sign:
Prin L; (I I Print. 1 i 1�1GZ (112 ,
Seal: ,5.0-Y °ti•. JASMIN MAllARESE Seal:
i*a� "�:` JASMIN MAllARESE
Notary Public - State of Florida°: Notary Public . State of Florida
` Commission X GG 346758 `. Commission x GG 346758
•.............. �.. My Comm. Expires Jun 19, 2023 ?or A My Comm. Expires Jun 19. 2023
Bonded through National Notary Assn. Bonded through National Notary Assn.
**************** * * * * * * * * * *********************** *******
APPROVED BY Plans Examiner Zoning
1
Structural Review Clerk
(Revised02/24/2014)