REV-19-2617RECF TED
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
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING Q MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 299 NE 99th Street
p T 3 _oti9
BY
0j
FBC 20 �_-�
Master Permit No. RC-4-18-984/��/� _ 2��2
Sub Permit No. MC-07-19-1669/ j/ -tc, :
Q REVISION ❑ EXTENSION ❑RENEWAL C>q-0 (4
❑ CHANGE OF []CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): Trevor and Krystle Hague
Address:299 NE 99 Street
City: Miami Shores
Tenant/Lessee Name: NA
Email: krysbar@aol.com
Flood Zone: BFE: FFE:
hone#: 305-613-5978
State: Florida Zip: 33138
hone#:
CONTRACTOR: Company Name: CHALEX COOL AIR OF MIAMI, CORP Phone#: (305)582-1917
Address: 3335 SW 79 CT
City: MIAMI State: FL Zip: 33155
Qualifier Name: ALEXANDER REYES
one#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Ralph Tait Phone#: 954-592-2841
Address:11820 Miramar Parkway, S 121 City: Miramar State: FL Zip: 33025
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: 0 Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of work: Mechanical Revision. Please see clouded area with revision 5 indicated. Review
consist of relocating the ahu from floor space in storage area to ceiling space above the pool bath
Specify color of color thru tile:,
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $ / I
TOTAL FEE NOW DUE $ I�'
(Revised02/24/2014)
Banding Company's Name (if applicable) NA
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) NA
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 171rryt.
OWNER or AGENT
The foregoing instrument was acknowledged before me this
�J ( day of rr `` 20 ( � , by
TT�o is personally known to
me or who has produced T_ UX W F6- LA—QE-- r'a�
Signaturej "- L
CONTRACTOR
The foregoing instrument was acknowledged before me this
I day of QG �&-/ 20 / 1 by
Al t �cGjA e%� who is personally known to
me or who has produced
identification and who did take an oath. identification and who di t e an oath.
NOTARY PUBLI NOTARY PUBLIC:
Sign: Sign:
Print: S ip � Print: ` ` �,W� COMMISSION#FIF
• EXPIRES: June 21, 202
Seal: '•`�' ��
INDIA ALVAREZ Seal: s+r+ •pUndMwrlbrs
' p,Iy r;i)t:aMISS10N # GG 238273
September 3, 2022
• n..... •, e� .. . . ... . ..... u„+oN Public Undenvriter6
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APPROVED BY
as
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Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk