MC-19-1393Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit No.: MC-06-19-1393
Permit Type: Mechanical - Residential
Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 07/12/2019 1 Expiration: 01/08/2020
Location Address Parcel Number
278 NE 103RD ST, Miami Shores, FL 33138 1132060134860
Contacts
HB Growth Properties LLLP Owner
278 103
TEST AND BALANCE AIR CONDITIONING Contractor
CORP
AGUSTINE ALVAREZ
Business: 3052181798
Inspection Requests:
Inspec ion Re
Inspection Requests:
Inspec ion Re
Description: GARAGE CONVERSION INTO LIVING AREA.
Valuation:
$ 7,000.00
49
KITCHEN & BATHROOMS REMODELING
TO REPLACE MC17-1476
TotalSq Feet:
600.00
Amt Paid
Payments
Date Paid
Fees Amount
50% Renewal Fee $122.50
Total Fees
$122.50
Total: $122.50
Credit Card
07/12/2019
$122.50
Amount Due:
$0.00
Building De i6tment Copy
In consideration of th issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto an in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting his 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 / Applicant / Contractor / Agent Date
July 12, 2019 Page 2 of 2
,
BUILDING
PERMIT APPLICATION
Miami Shores Village
0
Building Department JUN 18 19
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 2011
Master Permit No. I Q = j -z- `�
Sub Permit No. m C-ob-1 I 1 S IG J
❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 2!]RENEWAL
❑PLUMBING MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
'' nn CONTRACTOR DRAWINGS
JOB ADDRESS: 2 �O V(2 1� 5�
City: Miami Shores County:
County: Miami Dade Zip:
Folio/Parcel#: i i 720I 60 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee
City:
Titleholder): 14 J (oyot.cA Phone#: t'SA--'l." - b jb
W bIy6 V1-,&y
State:
Tenant/Lessee Name: Phone#:
Email:
p: "�)3 ( WO
e#:
State Certification or Registration #: CAC- 1 V A 5 A t Q Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: City:
Value of Work for this Permit: $ '4,, (17 Square/Unear Footage of Work:
Type of Work: ❑ �.
Addition VXJ Alteration 1-1New ❑ Repair/Replace
Description of Work: IJEt,U 1z. =i fou UU l S-V S 6�
Zip: 7i3 L_T—
Zip:
❑ Demolition
Specify color of color thru tile: t-;Ooj °
Submittal Fee $_qi=::: Permit Fee $ �u�J - CP CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
DBPR $
Notary $
Double Fee $ %, k
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 2 L .
(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 Signature
OW ER or AGENT CONTRACTOR
The foregoing instrume W
knowledged before a this
day of 20 1 by
YhA ► k )'7Axog' ois, .aer onallv known to
me or who
rP
iden 'ficati
NOT Y PU
Sign:
Print:
Seal: I
ssssssssssssssss
APPROVED BY
(Revised02/24/2014)
06,
Structural Review
The foregoing instrument was acknowledged before me this
day of _ 120 T1 by
6��LiJ who is personally�known to
as me or who has pr d as
identification a KA" INEPINCHEI
RA
#R #GG079431
NOTARY PUB I ` ' Insuranc
Sign:
Print:
Seal:
ssssssssssssssssssssssssssssssssssssssssssssssss
Zoning
Clerk