DEMO-17-1033�F�ORLDA
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. DEMO-4-17-1033
Permit Type: Demolition
erm I Work Classification: Mechanical
Permit Status: APPROVED
Parcel Number
Issue Date: 5/9/2017 1 Expiration: 11/05/2017
Applicant
175 NW 100 Street 1131010230320 CHRISTIAN LANSER
Miami Shores, FL 33138- Block: Lot:
owner mtormation Address Phone Cell
CHRISTIAN LANSER 175 NW 100 Street (305)772-4313
MIAMI SHORES FL 33150-
175 NW 100 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone
SANTOS A/C MECHANICAL CONTRA( (305)450-8238
Type of Demo: Mechanical
Additional Info: REMOVE AIR HANDLER UNIT
Classification: Residential
Scanning: 1
Fees Due
Amount
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.40
Total:
$111.80
Valuation: $ 3,000.00
Total Scl Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO-4-17-63690
05/09/2017 Credit Card $ 61.80 $ 50.00
04/13/2017 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Mechanical
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
construction and zoning. Futhermore, I authorize the a
Authorized Signature: Owner / Applicant /
Building Department Copy
rate and that all work will be done in compliance with all applicable laws regulating
;tor to do the work stated.
/ Agent
May 09, 2017
1
Miami Shores Village RE�Ej CFIV-Er
EIVED
Building Department APR 13 1017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 'h
FBC 20Iq
BUILDING Master Permit No. ,bProD rnt
PERMIT APPLICATION Sub Permit No. DT=)(��3
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 7RENEWAL
❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip: 3 I �—Q
folio/Parcel#: I I — 3 101 OZ3 -03 ? (:) Is the Building Historically Designated: Yes NO
Occupancy Type: Load: 11Const`ruction Type: Flood Zone:. BFE: FFE:
OWNER: Name (Fee Simple Titleholder): C n 1ST % aY'\ �anj Q V Phone#:
Address: Bst'jW1 U
City: I —A It "' off) State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: `Phone#: 3 t J qST 62-3
Address: 2-8 /o ?tw M V
City: _State: Zip:I It
Qualifier Name: Phone#:
State Certification or Registration #: v"'LC-�[ Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address
City:
ne#:
Value of Work for this Permit: $ 3000 Square/Linear Footage of Work:
e: Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Demolition
?CM w /� Description of Work: 1(4 if lwo'(--tey, UY Y
Specify color of color thru tile:
r
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Technology Fee $
Structural Reviews S
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ Gl • , Z)
bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zi
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." y.
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.
SignaturC2K]3 Signature
NERorAGENT CO RACTOR
The foregoing instrument was acknowledged before me this
I 0 day of AD�'4l , 20 1 - by
l/i�t7%S�tctrl �lnit who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
0 - day of Aer►U , 20 1�\- by
N0 LAQ who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
Sign: Ycu� Sign:6�AAayO
W
Y LIC
M2k
Print: Print:
33y
P��
Seal: Seal: :+%i VaVoS/WDRAVALDESDAUSSA
✓ 5!9/018 r_ MY COMMISSION s FF 195194
� S�btdnreoIRE,,FBndeed ThiuNoPak ue�n
**************************************** *(***************************** *** ************
APPROVED BY 1 lans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)