WS-20-238Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
9330 NE 12TH AVE, Miami Shores, FL 33138 1132050070160
Contacts
Permit mo.: WS-02-20-238
Permit Type. WindowS/Shuttet
P�'�'ji-sssftcaffvn: Window/Door Repiacement
Permit Status. Approved
Expiration: 08/17/2020
WEI CHEN Owner A QUALITY BUILDERS INC Contractor
9330 NE 12 AVE, MIAMI SHORES, FL 33138 JESUS MANUEL JIMENEZ
27541 SW 139 PL, HOMESTEAD, FL 33032
Business: 3053003937 jjqualitybuildersinc@gmail.com
tiRe
Description: REPLACE (1) WINDOW IN KITCHEN Valuation: $ 700.00 Requests:
Inspection Re
Total Scl Feet: 380.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.20
Scanning Fee
$3.00
Technology Fee
$2.75
Windows/Shutters Fee
$60.00
Total:
$120.55
Payments
Date Paid Amt Paid
Total Fees
$120.55
Credit Card
02/03/2020 $50.00
Credit Card
02/19/2020 $70.55
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.
Authorized Signature: Owner ,7 Applicant / ,Contractor / Agent Date
February 19, 2020
Page 2 of 2
Miami Shores. Village
Building Department F 33
10050 N,E,2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 BY:
INSPECTION LINE PHONE NUMBER: (30S) 762.4949
BUILDING
PERMIT APPLICATION
,BUILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
FBC 20
Master Permit No. V -CS - Z (4
Sub Permit No. `%is' a-Za --738
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ® CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 30 ET Z -4V`e
Z12:33Z,3b
Folio/Parcel#: is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: 8FE: FFE:
OWNER: Name (Fee Simple Titleholder): VV e! 2r 1 en- Phone#:305 45q-G0s 2
a 3.3 0 Address: /UC- / Z f/,
,1
City: ►"t a m ( Sho QS State: FG Zip: 33(3 b
Tenant/Lessee Name: Phone#:
Email;
CONTRACTOR: Company Name; IQ02 Phone#;
Address: Q>� �o 5W S i'
City: M i UYYI l state, Zip:
Qualifier Name: . Q"3\-) M malea Phone#; ?(`T)
State Certification or Registration #: 07n, (3 152, 15522 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $�'! ' Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑
Description of Work: k R-,Lz
❑. New
❑ Repair/Replace
❑ Demolition
Specify color of color tJhru tile:
Submittal Fee $ I U Permit Pee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ ?Q
10-0-AN) NAI MI 41
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 I 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 $200, 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, o cartifled 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 reinspectlan fee will be charged
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
' CA day of 00 - , 20 _ 20 by
.
w o Is personally known to
me or who has produced. QL as
identification and who did take an oath,
NOTARY PUBLIC:
Sign;
Print:
� Y P REYNA A MATED
Seal: �t!R..,LB
°� MY COMMISSION #GG176896
s y 1 EXPIRES. JAN 18, 2022
� Bonded through 1 st State Insurance
Signature
_06
C/ONTRACTO
v
The foregoing instrument was acknowledged before me this
761 day of -- J-l.a! r -�, 20 _2j by
,L(arl '4-- who Is ersonally_known to
me or who has produced as
Identification and who did take an oath,
NOTARY PUBLIC:
Sign: V
Print, l.lt
Seal: REYNA A MATEO
'`�Y P MY COMMISSION #GG176896
EXPIRES: JAN 18, 2022
Of" Bonded through 1st State Insurance
*ww*wwwwww*w*wwwww*ww*ww*www**wwww*wwwww*wwww*www***w*w*ww*wwww*wrww*ww*ww*ww*w**ww*ww*****www***w*******w**
APPROVED BY Plans Examiner Zoning
Structural Review Clem
10ro 1,wAM 11 AMA1 Ai
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795,2204
Fax: (305) 756.8972
Inspection requirements for:
Windows, Doors. Ski lights or Fixed Glass (claddin Permits
Upon issuance of permits for the scope of work involving the removal, changing and/or
replacement of any type of windows, doors, sidelites, skylights or fixed glass (cladding)
the permit holder or qualifier bearing his signature on the permit application shall abide
by the requirements of this department and comply with the following statement:
Upon obtaining window and/or door permits for the installation of same, it is the
responsibility of the permit holder to request window/door framing in -progress
inspection., prior to concealment of anyho_nzonta or vertical, clip mullion bucks; shims,
etc. Inspector will also verify anchor type, edge distance, embedment and spacing. The
purpose for this inspection, is for the verification of conformance with Product
Approval (1`vOA).
Acknowledgement:
9,1/'/
Qualifier/Owner Signature Date Print Name