MC-19-2888Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
° �rbu J l
issue Date: 04/07/2020
Parcel Number
10634 NE 11TH CT, Miami Shores, FL 33138 1122320280440
Contacts
Permit NO.: MC-12-19-2888
Permit Type: Mechanical - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 06/02/2020
JENNA RASSIF Owner
10634 NE 11 CT, MIAMI, FL 33138
Other: 3053084774
UNITED RESTAURANT EQUIPMENT & Contractor
SERVICES CORP
REINALDO LOPEZ
509 W 27 ST, HIALEAH, FL 33010
Home: 3052190427
Description: REPLACE A BATHROOM EXHAUST FAN Valuation: $500.00 Inspection Requests:
(EXTRACTOR) ON TEO BATHROOMS AND KITCHEN EXHAUST.
Total 5q Feet: 2,000.00
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
04/07/2020 $60.30
Credit Card
12/05/2019 $50.00
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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
COVID-19
Authorized Signature: Owner / Applicant / Contractor ! Agent Date
April 07, 2020 Page 2 of 2
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 0 MECHANICAL [:]PUBLICWORKS
JOB ADDRESS: 10634 NE 11 ct
gECEIVED
DEt 0 5 2019
BY:
FBC 20 1
Master Permit NozC" OU _ 1q 1 e3 U
Sub Permit No�' -12 — F— 2-ge9
❑ REVISION ❑ EXTENSION RENEWAL
❑ CHANGE OF ❑ CANCELLATION SHOP
CONTRACTOR 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): Jenna Rassif Phone#: 3053084774
Address: 10634 NE 11ct -
City: Miami Shores State: EI Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: (/ N ' ``' Phone#:3�
Address:�6ot cq.27-sr _
' ` C
City: A/M State: Zip: � !
&d4.D —� ,,ma
Qualifier Name: /0f,� ��p�Z Phone#:.�S 7Lay v2 4r7t�)�
�-,/tG cif'/�-
State Certification or Registration #: Certificate'
of Competency #:
DESIGNER: Architect/Engineer: _ Phone#:
Address: City: State: Zip: y
Value of Work for this Permit: $ X �� — . Square/Linear Foot ge of Work: y ?
rr��
Type of Work: ❑ Addition u Alteration ❑ New Repair/Replace ❑ Demolition
Description of work: Replace a bath room exhaust fan (Extractor) on two bath rooms. '` I�recN EXWa�T i�,'yir.
•sr '.
Specify color of color thru tile:
l
Submittal Fee $ w �F' Permit Fee $ _ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ _ DBPR $ Notary $
Technology Fee $ _Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ ?,
TOTAL FEE NOW DUE $ �/
(Revised02/24/20141
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
9
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,"th
inspection will not be approved and a reinspection fee will be charged. I
r
Signature Signature ""Ail
11
OWNER or EN CON RACTOR
The
qforegoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this :
day of MCP-le-'1 20 ! by n7�7~ day of _ �OJ'c , 20J by
SS( who is p rsonally known o �2t ,r, / J0 ��� who' er o o
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
identification and who did tpWan oath.
NOTARY PUBLIC:
Print:
f Ana Maria Perez Print: Lm:Marla Perez
Seal: fora Expires 02/28/2022 Seal: xPi es 02/28/2022
a
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i
a
BY ` Plans Examiner Zoning ,.
APPROVED
r
Structural Review Clerk
(Revised02/24/2014)
Local Business Tax Receipt
3 Miami -Dade County, State of Florida
THIS IS NOT A BILL DO NOT PAY
6279137 LB
BUSINESS NAME(LOCATION mEYT NO Tif
EXPIRES
S
UNITED RESTAURANT EQJIPMENT AND SERKE5 RENEWAL SEpTEMPI R 2 20
59 09 7498 4t Must be displayer at place of busitwss
W 27TH ST Pursuant to County Code
HIALEAH EL 33010 Chapter 8A - Art. 9 & TO
OW WR SEC, TYPEOf BusiNESs r'
UN'TED RESTAURANT EQMT & 5Rb CORP 196 SPEC MECHANICAL CONTRACTOR 'AYMENT MEW
C/O ROBERTO MORENO CAC 1818782 eYMCOL.tECTOR
�45.00 09%11/2019
1 Worker(s) 1 _ CREDITC.ARD-19-073620
Ms Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license,
permit or a certification of the holder's qualifications, ti do business. Holder must comply with any governmental s
or nongovernmental regulatory laws and requirements which apply to the business, t
The REs EIPTND, above most be displayed on all commercial vehicles - Miami -Dade code sec 8a-276.
Formore. information, visit www.mii&MAI (tal yctgf
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