RC-19-2910Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
issue Date: 01/02/2020
Location Address Parcel Number
715 NE 91ST ST 4A, Miami Shores, FL 33138 1132060440060
Contacts
Permit NO.: RC-12-19-2910
Permit Type: Building (Residential)
Work Classification: Alteration
Permit Status: Approved
Expiration: 06/30/2020
RAFAEL IRA Owner G.Q.M.INC Contractor
715 NE 91 ST 4A, MIAMI SHORES, FL 33138 JOHN VILLAMIZAR
10496 NW 50 ST, sunrise, FL 33351
Business:3054870071 msanchez@premierguestservices.co
m
ns ecti
Description: THE SCOPE OF WOPRK IS TO REPLACE THE Valuation: $ 3,000.00 Ion Requests:
BATHTUB, TOILET AND SINK FAUCET IN MASTER BATHRROM
NO FIXTURES WILL BE MOVD, NO PIPE LINES WILL BE Total 5q Feet: 40.00
EXTENDED. NO ELECTRICAL WORK WILL BE DONE
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$117.90
Payments
Date Paid Amt Paid
Total Fees
$117.90
Credit Card
12/09/2019 $50.00
Credit Card
01/02/2020 $67.90
Amount Due:
$0.00
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
_7 —7n
re: Owner / Applicant / Contractor / Agent
Date
January 02, 2020 Page 2 of 2
ENTERED
0212��
till
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department BY:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 J_+
Master Permit No. �C �Z— 19 - 2-910
FE]BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 715 NE 91 STREET #4A
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip: '33 13$
Folio/Parcel#:11-3206-044-0060 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): PENSCO TRUST COMPANY LLC FBO RAFAEL FELIZ IRA Phone#: 080-502-0392
Address: PO BOX 173859
City: DENVER
State: CO Zip: 80217
Tenant/Lessee Name: Phone#:
Email: PA50dXKEZ Q Offx��Q�ayLS{ S4r�! ct5 Goo^
CONTRACTOR: Company Name: G.Q.M., INC. Phone#: 305-487-0071
AddrPtc: 10496 NW 50 Street
City: Sunrise State: FL
Qualifier Name: John Villamlzar
State Certification or Registration #. CGC1524968
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $ 3 , (3 y d
_Zip. 33351
ne#: 305-487-0071
Certificate of Competency #:
City: State: Zip:
Square/Linear Footage of Work: yb SF
Type of Work: ❑ Addition ❑ Alteration ❑ New A Repair/Replace ❑ Demolition
nacrrinrinn of Work: The scope of work is to replace the bathtub, toilet, and sink faucet in Master Bathroom.
No fixtures will be moved. No pipe lines will be extended. No electrical work will be done.
Specify color of coloc►rytbru tile: r /� %J{
Submittal Fee $ n �w Permit Fee $ too CCF $ I.
�.1 _ CO/CC $ fy
Scanning Fee $ —1 • l_JU Radon Fee $ � • C)d DBPR $ 2—.0y Notary $
Technology Fee $ 2' 15 Q Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ !CJ
TOTAL FEE NOW DUE $ iv
(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
City
State
Zip
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."
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 t
ence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. n
Signature _ Signature
V \
W R or ENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
3 day of pec2M(;19f 20 19 by 22 day of November 20 19 1 by
4,64 Fa l 12 who is personally known to John Villamizar who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
Sign: Sign:
Print: Ale -rondo C.o' ° Alejandro Castillo =fit = Commission#GG247537
T.` ( Print: :+• •�*-
;
P 9 ,r.. , p`,•' fires August , ZW
Seal:«YP•. ALEJANDROCASTILLO
Seal: FOF! :° ' Bonded Thru Troy Fain insurance e00,985.7019
Commission # GG 247537
22
' 9 P Expires August Bonded Thru Toy FaiInsurance 8W385.7019
****************** C *******************************************************
APPROVED BY Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)
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GQM Inc.
10496 NW 50th St.
Sunrise, FL 33351
954.541.5733
mcelis@gqmservice.com
www.gqmservice.com
ADDRESS
Maria Sanchez
Premier Guest Services,
LLC
715 NE 91st St, Miami
Shores, FL 33138, USA
GENERAL MANAGEMENT
DESCRIPTIONAMOUNT
715 NE 91st St, Miami Shores, FL 33138, USA Unit # 4A
............. ............_........ _...._...............................................__..............................._..................._............................_............____............... .... ... _... ................................. --- ............................ ..........................................................._................... ................... _........ ................._..._....................................... .............. ...............
.
Bathroom Replacement- This includes:
Demolition
Replace shower walls
Replace Grout tiles
Replace valves
Replace bathtub
Remove and replace
Install new to ----
Remove and replace
Install new vanity
.........._......_................_..._......._................... .............
Remove and replace
Install new faucet
Accepted By
Accepted Date
Q-2-19
4,710.00
150.00
...................
540.00
45.00
The Shores Plaza East Condominium Asso.
745 NE 915` Street
Miami Shores, FL 33138-3215
305-759-9069
December 5, 2019 info@shoresplazaeastcondo.com
Miami Shores Village
Building Dept.
10050 NE 2nd Avenue
Miami Shores, FL 33138
Dear Sir/Madam,
The enclosed will serve as your confirmation, that GQM INC., General Contractor License:
CGC 1524968, Plumbing License: CFC 1430026, has been contracted by the owner of Unit 4A
at 715 NE 91 Street, Miami Shores, FL 33138. Work to be performed at said unit consisting of:
Painting of whole unit, installation of blinds, and new light fixtures. Bathtub replacement, toilet
replacement, faucet replacement and installation of tile on shower wall. The work to be
performed is fully authorized by the Shores Plaza East Condominium Asso., 745 NE 91 ST,
Miami Shores, FL.
Should you have any questions pertaining to the enclosed, please feel free to contact our office.
Sincerely yours,
fc
��
Carlos Talavera
Vice -President