PL-20-514Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
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Issue Date: 03/17/2020
Location Address Parcel Number
465 GRAND CONC, Miami Shores, FL 33138 1132060170320
Contacts
Permit NO.: PL-03-20-514
Permit Type: Plumbing - Residential
Work Classification: Gas
Permit Status: Approved
Expiration: 09/14/2020
Julian Montero Owner
465 Grand Concourse
GAR Y BERNHARDT CONSTRUCTION Contractor
GARY BERNHARDT
7700 SW 114 ST, MIAMI, FL 33156
Mobile: 3059347320 GARYBCONSTRUCT@AOL.COM
Description: INSTALLATION OF GENERATOR Valuation: $ 995.00 Inspection Requests:
305-762-4949
Total Sq Feet: 0.00
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
$12.00
Technology Fee
$2.50
Total:
$119.30
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$119.30
Credit Card
03/17/2020 $119.30
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.
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 Aontractor to do the work s� ted.
Authorized Signature: Owner / Applicant / Contractor /
Date
March 17, 2020 Z Page 2 of 2
Miami Shores Village
Building Department
EN'rE jR +EjDD50 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
MAR 0 9 020 INSPECTION LINE PHONE NUMBER: (305) 762-4949
BY. -
BUILDING
PERMIT APPLICATION
❑BUILDING
PLUMBING
❑ ELECTRIC ❑ ROOFING
FBC 201-1 b+ L7
Master Permit No. q rr-OS —70 S v
Sub Permit No. 'Pl- -0 3 - ZJ -Si 74
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ MECHANICAL OPLIBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: q (0 5 (<� C4LJ/--SY'
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: /I - 3 2a 3 2-0 Is the Building Historically Designated: Yes NO _,e:fj'
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): /�6ea- k6 Phone#:
Address:_ cR �y C 00'49 X-<
City: S state: A_- Zip: 33 l34`
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: *-7 70 0 ;>,
City:
Qualifier Name:
State Certification or
hone#: / ` 7
hone#: 3 S/� Zb
#: Z Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ ! �� Square/Linear Footage of Work: L%O
Type of Work: ❑ Addition Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 1141.9.36
(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
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 $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, the
inspection will not be approved and a reinspection fee will be charged.
Signature 6�) . �Iw Y -e/���
OWNER or AGENT
The foregoing instrument was acknowledged before me this
%7 ` "`—day of 20 �� , by
/t't 0 o i personally know o
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Seal: ''`r:�`"'ARIEL A MUSIBAV
MY COMMISSION # GG079337
EXPIRES March 05, 2021
as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
d av of by
o is ersonally wn to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: 'JZ
Print:
Seal: =i
ARIEL A MU91BAY
MY COMMISSION # GG079337
EXPIRES March 05, 2021
*********************************************************
APPROVED BY :�! /ZZ /� Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)