MC-18-3564Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit No.: MC-11-18-3564
1,. Permit Type: Mechanical - Residential
�f (� work Classification: Addition/Alteration
Permit Status: Approved
Issue Date:11/30/2018 Expiration: 05/29/2019
Parcel Number
10555 NE 2 CT, Miami Shores, FL 1122310130600
Contacts
JORGE LUIS RIOS Owner JORGE LUIS RIOS Applicant
Other:7862026660 Other:7862026660
TRIUMPH AC & REFRIGERATION CORP Contractor
ARIEL JIMENEZ
8821 NW 112 TER, HIALEAH GARDENS, FL 33018
Business: 7865120548 areyes@triumphac.com
Description: NEW A/C UNIT AND DUCT WORK Valuation: $ 8,000.00 Inspection Requests:
Total Sq Feet: 93.00
8/7/2018 WORK DONE WITHOUT INSPECTION MUST MEET
WITH B 0 FOR SOLUTION -ALEXIS
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.80
DBPR Fee
$4.20
DCA Fee
$2.80
Education Surcharge
$1.60
Permit Fee
$230.00
Scanning Fee
$3.00
Technology Fee
$7.00
Total:
$303.40
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$303.40
Check# 5707
11/30/2018 $303.40
Amount Due:
$0.00
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.
that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
. Futhermpre, I authorize the above named contractor to do the work stated.
�/,, Le/% i� '&J -
/ Applicant / ntractor / Agent
Date
November 30, 2018 Page 2 of 2
Miami Shores Village RECEIVED
Building Department NOV 3 01018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 QJ4-1
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 2014
BUILDING Master Permit No. 16 - 2935
PERMIT APPLICATION Sub Permit No. MC C - 3S(P(A
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING tQ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
�J
JOB ADDRESS: `ri C/
City: Miami Shores County: Miami Dade Zip: .53313-
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Tore e
Address: CO S sts k 601 nCL e.:
iOs
City: & w State: r L Zip: 33188
Tenant/Lessee Name: Phone#: (32:) q"qp -rOSZ o
Email: Oro /.2.i /lam/ /U%h1S�JC�L% • �D/�
CONTRACTOR: Company Name: l/2/ve�'7� �G Phone#:
Address: 99�2Z A--, w &47
City
1 -// Zip:
Qualifier Name: ^A, Phone#:
State Certification or Registration #: • - 101 �6 z Z 9 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
3'3-4F,--,
Address: City: State: Zip:
Value of Work for this Permit: $ �, CDo Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: /t%,y 14fy"i 4 -Z�oj cwc)az
Specify color of color thru the:
Submittal Fee $
Scanning Fee $
Technology Fee $.
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bondi ng.Company's Name (if applicable) _
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) _
Mortgage Lender's Address
City
State
Zip
e
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: Asa condition1to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy the notice of commencement and construction lien law brochure will be delivered to the person
whose property ' su 'ect to ttach ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first in pectin whi ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection w' �* be a rov ro a reinspection fo f will be charged. /
Signatu
Signature
R
foregoing instru=wacwledged beforreme this The foregoing instrumentivas ackn/o�wlledged before mme this
day ofdK 20/ `( by / da of 1VOP-0uCG15 20 U by
who is personally known to who is personally known to
me or who has produced
identi 'cation and who did take an oath.
NOTA PUBIIF-3"-50-�
TANNER DAVIS
M E EXPIRES AugusMISSION t 6. 202028
Sign
Prin
Seal
. //(-/i OS -
_0 -� e_ bads
uov- 71 101
APPROVED BY
as me or who has produced as
identification and who did take an oath.
NOTARY PU IC: ;;��•" •, TANNER DAVIS
�•'';
( 'o, MY EXPIRES August 6 202028
�W'-
Print:
Seal:
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk