MC-19-1990Miami Shores Village
10050 NE 2 Ave
Miami Shores Fl. 33138
305-795-2204
Location Address
Permit NO.: MC-08-19-1990
-► '�" y ' Permit Type: Mechanical - Residential
cx
Work Classification: Alteration
Permit Status: Approved
Issue Date: 09/19/2019 1 Expiration: 03/09/2020
Parcel Number
10618 NE 11TH CT, Miami Shores, FL 33138 1122320280420
Contacts
ARTURO RODRIGUEZ Owner
10618 NE 11 CT, MIAMI SHORES, FL 33138
Other: 3058770897
UNITED RESTAURANT EQUIPMENT & Contractor
SERVICES CORP
REINALDO LOPEZ
509 W 27 ST, HIALEAH, FL 33010
Home: 3052190427
Description: REPLACE EXAHUST FAN IN BATHROOM /INSTALL Valuation: $ 500.00 Ins ection Requests:
KITCHEN EXHAUST FAN. 305-762-4949
TotalSq Feet: 425.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$110.30
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
09/19/2019 $110.30
Amount Due:
$0.00
Building Department Copy
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 c9,99Vction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Owner / Applicant / Contractor / Agent
Date
September 19, 2019 Page 2 of 2
R 'CEIV %]D
81'361`01) 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
G 2 S 2019
BY.
FBC 20
Master Permit NoV_ - (11 r 1122,
Sub Permit No. mc-oq-a:j q 0
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING FE-1 MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: 10618 N E 11 CT
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Arturo Rodriguez Phone#: 305-987-7444
Address:10618 NE 11 ct
City: Miami Shores State: FI Zip: 33138
Tenant/Lessee Name: Phone#:
Email: �`� Q
CONTRACTOR: Company Name: �T � ��%�}�(���%`"—C ' Phone#: 0,0t; '
Address: ff69Wa';; %/
City: �l�-LE�� State: le:L- Zip: -F3if�ve��)
Qualifier Name: —1J1� Phone#:
State Certification or Registration #: X? (?7 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 150 U ..moo Square/Linear Footage of Work:
Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: Replace exhust fan in bathroom/ Install Kitchen exhust fan
�r
Specify color of color thru tile: Submittal Fee $ Permit Fee $ U C, 01' O" %�
CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ b '30
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
City State 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 AGENT
The foregoing instrument was acknowledged before me this
day of nn �v�,uS'�' 20 . by
wti personallyknown,to
me or who has produced
identification and who did take an dit .
NOTARY PUBLIC:
i
Sign:
Print: 4P
P of bho State of Florida
z
y Co fission GG 1910B4
Seal' Expires02128/2022
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of /q v &IL 20 by
7, , wh per os nally know to
as me or who has produced
identification and who did t ke an oath.
NOTARY PUBLIC
Sign:
t Ana Maria Perez
Seal: a. My Commission GG 191004
a� Expires 0212812022
as
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)