FW-19-2050IL
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
XV
ft1ju'L111
Issue Date: 09/06/2019
Parcel Number
278 NE 103RD ST, Miami Shores, FL 33138 1132060134860
Contacts
Permit No.: FW-09-19-2050
Permit Type: Fence/Wall
Work Classification: Wood Fence
Permit status: Approved
Expiration: 03/04/2020
HB Growth Properties LLLP Owner
278 103
JR CONSTRUCTION & CONSULTANT INC Contractor
CARLOS 10UBERT
10970 SW 73 ST, MIAMI, FL 33173
Business: 9549934788 project@jrcac.com
Description: NEW WOOD FENCE TO REPLACE 18-3726 Valuation: $ 3,000.00 Inspection Requests:
305-762�t949
Total Sq Feet: 0.00
Fees
Amount
Payments
Date Paid Amt Paid
Scanning Fee (Manual)
$3.00
Total Fees
$63.00
Wire and Wood Fence Fee
$60.00
Credit Card
09/06/2019 $63.00
Total:
$63.00
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, drawin at ments or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work don by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECH,jNfCAL, WIWOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the for
regulating construction and zoning. Futhermore, I
at all work will be done in compliance with all applicable laws
to do the work stated.
Authorized Signature: Owner / Applicant /
Agent
Date
September 06, 2019 Page 2 of 2
RECEIVED
Miami Shores Village SEI 0 1 2019
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
FBC 20 Vq
BUILDING
Master Permit No.
PERMIT APPLICATION
Sub Permit No. VW _ ) q — a-OSv
`UILDING ❑ ELECTRIC
❑ ROOFING
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL
❑PUBLIC WORKS
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
`�1'Q
JOB ADDRESS: v to
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
QConstruction
J lu
o
VI AO V�M to Q Phone#:()—'
Address:
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City:
State:
Zip:
Tenant/Lessee Name:
Phone#:
Email:
CONTRACTOR: Company Name: Q.
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S`i►'it�Gfi
�-0-(4J[ `�� UZ Phone#: -I !2 0410
u
Address: 10 Su-)
J J 7
City:
State:
Zip:
Qualifier Name: � i 7v
VhA
Phone#:
State Certification or Registration #: COC
t5 (4Z
Certificate of Competency M
DESIGNER: Architect/Engineer:
Phone#:
Address: `-� City: State:,+,� Zip:
Value of Work for this Permit: $ S QQV Square/Linear Footage of Work: 240
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace /❑ Demolition
Description of Work: 20- - Ar--�-V L AX-1C- P ( _ ytim
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ ( 0 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
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 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 f*;i�Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
q—: day of i 20 J by
me or who has produced
NOTARY
Print:
who ifpersonally known to
KATHERINE
WAA as, aoa,
78; Vats Insurance
CONTRACTOR
The foregoing instrum t was acknowledged before me this
-2,4- day of �% 20by
6A-V1 A O'-A )A who is Personally known to
as me or who
NOTARY PU
Sign:_
Print:
Seal: Seal:
2421
as
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APPROVED BY � Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)