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RC-17-2322Permit No. RC -9-17-2322 Permit Type: Residential Construction Work Classification: Solar Permit Status: APPROVED issue Date: 10/16/2017 1 Expiration: 04/14/2018 Project Address Parcel Number Applicant 196 NW 95 Street 1131010330660 ANATASE CINEUS ALEX VITAL Miami Shores, FL 33150- Block: Lot: Owner Information ANATASE CINEUS ALEX VITAL 196 NW 95 Street MIAMI SHORES FL 33150-1712 196 NW 95 Street MIAMI SHORES FL 33150-1712 Contractor(s) Phone Cell Phone ENERGY SMART SOLAR LLC (954)228-4902 In Review Comments: Date Approved:: In Review Date Denied: Tvoe of Construction: SOLAR PV Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Fees Due Miami Shores Villageg{ORESL,! F 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 DCA Fee Phone: (305)795-2204 F ORtDp' 0.20 Permit No. RC -9-17-2322 Permit Type: Residential Construction Work Classification: Solar Permit Status: APPROVED issue Date: 10/16/2017 1 Expiration: 04/14/2018 Project Address Parcel Number Applicant 196 NW 95 Street 1131010330660 ANATASE CINEUS ALEX VITAL Miami Shores, FL 33150- Block: Lot: Owner Information ANATASE CINEUS ALEX VITAL 196 NW 95 Street MIAMI SHORES FL 33150-1712 196 NW 95 Street MIAMI SHORES FL 33150-1712 Contractor(s) Phone Cell Phone ENERGY SMART SOLAR LLC (954)228-4902 In Review Comments: Date Approved:: In Review Date Denied: Tvoe of Construction: SOLAR PV Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Fees Due Amount CCF 0.60 DBPR Fee 2.00 DCA Fee 2.00 Education Surcharge 0.20 Permit Fee 100.00 Scanning Fee 3.00 Technology Fee 0.80 Total: 108.60 Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Phone Valuation: $ 100.00 Total Sci Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # RC -9-17-65176 10/16/2017 Credit Card $ 108.60 $ 0.00 Available Inspections: Inspection Type: Final Solar 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 n ing.-her ore, I horize the above-named contractor to do the work stated. October 16, 2017 Signature: Owner / Applicant / Contractor / Agent Building Department Copy October 16, 2017 1 Miami Shores Village RFcE, Building Department sFP? VFo 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ?j9r Tel: (305) 795-2204 Fax: (305) 756-8972 zw INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 2014 BUILDING Master Permit No. EU1_1 --2 PERMIT APPLICATION Sub Permit No. C— 11—o 3oio UILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL F-IPLUMBING MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP rr CONTRACTOR DRAWINGS JOB ADDRESS: b N W` S—k Folio/Parcel#: ©% a Is the Building Historically Designated: Yes —NO. Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): 1 l Q b \ z Phone#: 30 s 4.7 2/ S S;; _r Address:_ l q 16 tj 14 2 S ST" City: M 1 A N 1 414 0, 14A State: FL Zip: 3 '/ 4-a Tenant/Lessee Name: Email: hone#: CONTRACTOR: Company Name: 9` 115 r=y . j' J m L.l4i Phone#: Address: 1+cfrj/ AW -9# k9ay City: C 049 P" 6 I/ r')) State: SGL Zip: s i5nrey Qualifier Name: /Q /v/L s5A 6-1-,p '; Q Phone#: State Certification or Registration M _ "4 61 61 Ile0-5 Certificate of Competency #: DESIGNER: Architect/Engineer: Address: Value of Work for this Permit: 5 i a) -L-' hone#: City: State: Zip: Square/Linear Footage of Work: Type of Work: Addition Alteration New Repair/Replace Demolition Description of Work: n5nL V Specify color of color thru the: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Revised02/24/2014) Permit Fee $ M • 0:_' CCF $ Radon Fee $ __7 '00 DBPR $ G 63 Training/Education Fee $ CO/CC $ _ Notary $, Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ 109 • C00 ti — a 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 toning. 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 on 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. Signatur Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 5- dayof Ag , 20 /% by 1,"_ q Cra L who is personally known to me or who as produce _I)L. as identification and who did take an oath. NOTARY PUBLIC: 5 day of .4 U c;_Lt .S'T 20 17 by jqC/i 1 I:R:' $A 4-rb'i'o , who is ersonally known o me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign:/PtAnp&4LSign: 44"Zt, ti . Print: &,ruaggl ya "1s11i o hm'k Print: ALC44AZ d- A(&W L k Seal: r.Notary Public State of Florida Seal: i.0 0 Notary Public State of Florida Alexander Pavllnek llvf Alexander Pavlinek My Commission GG 03 71 My Commission GG 035271 or *0 Expires 12/19/2020 A , O1Poa Expires 12/19/2020 rrL/I as APPROVED BY rVr Plans Examiner Zoning Structural Review Clerk Revised02/24/2014)