REV-18-1768t Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
BUILDING
PERMIT APPLICATION
INSPECTION LINE PHONE NUMBER. (305) 762-4949
FBC 20I `�
Master Permit No. RC-5-17-1209
Sub Permit NoQ 9 _ I
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING FN� MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 443 NE 94th Street
City: Miami Shores County Miami Dade Zip:
Folio/Parcel#:1132060140510 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Nuview Ira Inc Phone#: 305.525.1427
Address:443 NE 94th Steeet
City: Miami Shores State: FL. Zip: 33018
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: Sansone Corporation Phone#: 954.410.4695
addr,,,. 590 Goolsby Blvd.
City: Deerfield Beach state: FL. Zip: 33318
Qualifier Name: Scott Sansone Phone#: 954.275.5466
State Certification or Registration #: CIVIC 1249260 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of work: Revision of Mechanical plan.
Specify color of color thru tile:
Submittal Fee Permit Fee $ qI O - CQ, CCF $_
Scanning Fee $ �1 . `� (� Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Zip --
Demolition
CO/CC $
Notary $ —"
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(RevisedO2/24/2014)
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
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 on estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien low 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 prov and a reinspection fee will be charged.
Signature U'l�v Signature
OWNER or AGENT
The foregoing inst u ent was acknowledged before me this
day of ., v. t 201 �: by
L who is personally known to
me or who has produced
identification and who did take an oath.
NOT
Sign
Print
CONTRACTOR
The foregoing instr1ftnt was acknowledged before me this
6 day of e —,20 17 by
Scott Sansone who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY
Sign: CA
Print: L—GL
as
Seal: r ' °* MY COiiiSSION i FF 188027 Seal: �o�'a .° 8�,�
* LAURA PARLEY
EXPIRES: March 16, 2019 * * MY COMMISSION i FF 188027
Bonded ThruBudpetNotary Baku EXPIRES: March 16, 2019
+rE0 1%. Bonded Thru Budget Notary Servkes
*******sss****s***sss*s*ss****s*sssss sssss s,*Issssss*:sssss*sssss*+r:�tss*ssssssssssss*s****:sssss*ss*ss*
APPROVED BY , *PIdr+SExaminer Zoning
Structural Review Clerk
(Revised02/24/20141
♦ 5t►OR�S GQ
.� n 11112 Miami Shores Village
--o�� Building Department
FLORiDp` 10050 NE 2 Ave, Miami Shores, FI 33138
Tel: (305)795-2204 • Fax; (305)756-8972
RECEIPT
PERMIT #:W,-- Re DATE: (� 12(a I i �
I,
❑ Contractor
❑ Owner
❑ Architect
Picked up 2 sets of plans and (other) G�C )
Address:
� St ---AL PLn N S
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Department to continue permitting process.
Acknowledged by:
PERMIT CLEARK INITIAL'
RESUBMITTED DATE:
PERMIT CLEARK INITIAL:
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT #: 1lZV I0 DATE: � , 1 :—:� ( (6
U
(Name)
❑ Contractor
❑ Owner
❑ Architect
Picked up 2 sets of plans and (other)
Address:
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Department to continue permitting process.
Signature:
(SIGNATURE)
PERMIT CLERK INITIAL:
RESUBMITTED DATE: v� t 8
PERMIT CLERK INITIAL: . t\
3eESPI6RITO SANTO Invoice No. 79552
tYt A tt e:, 0 t t,
275 UNIVERSITY DR, UNIT 2 CORAL GABLES, FL 33134
Phone: 305.461.2882 E-mail: accounting@esmktg.com
Website : www.esmktg.com
BILL TO:
SPECIAL INSTRUCTIONS:
MIAMI SHORES VILLAGES
ORDER BY: ZYNETTE LONG
10059 N.E. 2nd Avenue,
Miami Shores, Fl 33138
Date:
Due Date:
Project / Job No.
11/5/2018
SETH & LYNETTE
11/5/2018
Item
Qty
Description
Rate
Amount
00.00
1
1 ORIGINAL-36X24-1 SET -LOOSE
30.00
30.00
PICK UP & DELIVERY
Sept 2010 - Minimum Order Charge
Subtotal: $30.00
As of 06/01/14, terms of payment are the net amount of the invoice in US currency within thirty
(30) days of the date of the invoice.
A late payment charge of one point five percent (1.5%) of the amount of the invoice will be charged
Sales Tax: (7.0%) $0.00
for each month, or any portion thereof,
that payment is not made within thirty (30) days of the date of the invoice.
Total $30.00
275 University Drive. Coral Gables, FL 33134
Ph: 305.461.2882
www.espiritosantographics.com • plots@esgraphics.net
. Date: 1� l
ES Pi RITO SANTO
M A R K E T I N 5 5 U L U T 1 0 N 5
13ESSIGN
PHQT05RAPHY
PRINT
03.
95
0
Company:
Name:
�1
�% 1
Phone:
Email.
Job Name:
Job Description:
Due Date:
I x �
2- X !�> Co
SIGNS
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