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WS-16-273Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Fes;, Phone: (305)795-2204 F40RtDA Permit NO. Ws-2-1 6-273 Permit Type: WindowstShuttars er oit rkClassification: Window/Door Replacem Permit Status: APPROVED Issue Date: 2/2/2016 1 Expiration: 07/31/2016 Project Address Parcel Number Applicant 9730 NE 5 Avenue Road 1132060171470 Miami Shores, FL Block: Lot: JOHN & MARIE PERIKLES Owner Information Address Phone Cell JOHN & MARIE PERIKLES 9730 NE 5 Avenue Road (786)236-0254 MIAMI SHORES FL 33138- Contractors) Phone Cell Phone MAT CONSTRUCTION (305)785-7107 e of Work: REPLACEMENT OF 15 WINDOWS AND 5 D00 of Openings: 20 litional Info: Classification: Residential Scanning: 9 Fees Due Amount CCF $9.00 DBPR Fee $4.50 DCA Fee $4.50 Education Surcharge $3.00 Permit Fee $300.00 Scanning Fee $27.00 Technology Fee $12.00 Total: $360.00 Valuation: $ 15,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # WS-2-16-58521 02/02/2016 Credit Card $ 360.00 $ 0.00 Available Inspections: Inspection Type: Window Door Attachment Final Review Building 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 foregoingrove-n ion is acc construction and zoning. Futhermore, I authorize the med contr� Authorized Signature: Owner / Applicant / Contractor and that all work will be done in compliance with all applicable laws regulating to do the work stated. Agent February 02, 2016 Building Department Copy February 02, 2016 Miami Shores Village Building Department FEB .02 2016 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 F3Y. Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 7— , BUILDING PERMIT APPLICATION M(UILDING ❑ ELECTRIC ❑ ROOFING FBC 20 ('A Master Permit No. 1,:Q :I k / -t Sub Permit No.� nt s lj(�-- d- _ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 7 -7 Y _ `� ✓ �`'' VC0 Folio/Parcel#: I t -120 (o I I-) I Occupancy Type: Flr Load iami Dade Tin- \ 1 YV 1 ( v Is the Building Historically Designated: Yes Construction Type: Flood Zone: BFE: _ FFE: OWNER: Name (Fee Simple Titleholder): `04,011 f ` `L_� Phone#: I-0�+ �l Address: " City: - \• �ti l Cr J State: Tenant/Lessee Name: Email CONTRACTOR: Company Name: A4 I , Address: i OL'3 ♦ CO ��/` r^ �Y / " City: Qualifier Name: 104o**J1X J ;O State: L (7 LUL a% 06k It Phone#: Phone#:-7(. l ©G zqyj Phone#: State Certification or Registration #: C 5 L to d 13 J 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: WZ(Amom/ Specify color of color thru tile: p: —3 —3 Zip: ❑ Demolition Submittal Fee $ Permit Fee $ 3� ' C'o CCF $ CO CO/CC $ Scanning Fee $ 0�2> (� Radon Fee $ f, DBPR $ �' Notary $ Technology Fee $ (Z C) Training/Education Fee $ Double Fee $ G� Structural Reviews $ _ Bond $ Q� TOTAL FEE NOW DUE $ _` .0 - CO lu (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 pproved and a reinspectio wi charged. bzi7�wz//Z�-/o Signature Signatur OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this (2 4day((o��f �e pY�y, 20 _S, by qo) AA�1'kr � �.d , who is ersonally know o me or who has produced identification and who did take an oath. Seal: C APPROVED BY (Revised02/24/2014) as The fo�re/ ping instrument was acknowledged before me this ""l.,day of WyYk-� , 20 by Al a d6 , ho tt:: o me or who has produced as identificati nd who did take an oath. NOTARY UBLI : I Sign: i 1� �p Print: NK, 1658 Seal: �,� PRkITA COMES LORETTA COMES 21, 20+ MY COMMISSION #tEE181668 MY COMMISSION EXPIRES: MAR 21, 2016 EXPIRES: MAR 16 " Bonded thr#Wh lot State Insurance *1QI#IR9RlIl1,?e _ ral** ******************** ******************* )2471 Plans Examiner Structural Review Zoning Clerk