FW-19-2183Fw-oq-�9- Z183
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74
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
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Issue Date: 09/20/2019
Location Address Parcel Number
1270 NE 97TH ST, Miami Shores, FL 33138 1132050090560
Contacts
Permit No.. FW-09-19-2183
Permit Type: Fence/Wall
Work Classification: Wood Fence
Permit Status: Approved
Expiration: 03/17/2020
CAMILO & VICTORIA VILLEGAS Owner HOME OWNER Contractor
1270 NE 97 ST, MIAMI SHORES, FL 33138 HOME OWNER
Inspection Requests:
Description: INSTALLATION OF A FENCE 5FT, MATERIAL WTC
Valuation:
$ 5,925.00
305-762-049
COMPOSITE TO REPLACE PERMIT#FW-02-19-349
11
Total Sq Feet:
0.00
Amt Paid
Payments
Date Paid
Fees Amount
50% Renewal Fee $118.50
Total Fees
$118.50
Credit Card
09/20/2019
$118.50
Total: $118.50
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 th tall the foregoing information is accurate and that all work will be done in compliance with all applicable laws
egulating onstruction and zo ng. th ore, I authorize the above named contractor to do the work stated.
Authorized ignature: Owner / Applicant / Contractor / Agent Date
September 20, 2019 Page 2 of 2
RECEIVED
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
SER , 8 20
i
FBC 2014
Master Permit No.N"� 1` i —✓
Sub Permit No.Fv\% ` U cl ' (�-2( v3
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1 �� t' j E !'�) j ^� p
City' Miami Shores County' Miami Dade Zip: 2 > �l
Folio/Parcel#: t �' al !7 0Q '- W b C) Is the Building Historically Designated: Yes NO _
Occupancy Type: �i�. Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):I I C222 -t& ✓ 1 4 5.Phone#: � b 7 17 J 5 O O
Address:
ti
City: -t a �F7 �.S Stater-- Zip-33
Tenant/Lessee Name:
Email:
ne#:
CONTRACTOR: Company Name: —Phone#:
Address:
City: State:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Certificate of Competency #:
hone#:
Zip:
Address: .., City: State: Zip:
Value of Work for this Permit: $y v v 1 Square/Linear Footage of Work:.
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace -�-❑ Demolition
Description of Work: ) IV�J I i I 1 -f sue` M-) Off' =K ,L. 'S iA - 1
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $ C !�
TOTAL FEE NOW DUE $
(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 on 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 I S "Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 120 by day of , 20 , by
V1 GibEiP OP\�—e"1�10who is personally known to who is personally known to
me or who has produced JDfLI�P Q �` tf
as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: :'z°�° SINDIA ALVAREZ
.- My COMMISSION # GG 238273
EXPIRES: September 3, 2022
-�'eOFF`•oP� Bonded 7h ru Notary Public Undenvrile
****************************
APPROVED BY
NOTARY PUBLIC:
Sign:
Print:
Seal:
******************************************************
Gv/ ` Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)