MC-10-17-2590 �\
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�,�,�u���s� Miami Shores Villag� � � � � �.' �''���'� ������"�� ����k1��� � °
� � � 10050 N.E.2nd Avenu�NE � �� � ���
� �`.�, . t�.�'�� ll�iamE Shares, FL 33138-400Q t �� � �. � ` �� � ����������� ��������������:
-�,.; ,�. � ���\�,� i 1� � 1 ��f+"� ��i�
'�� �� Phon�: (305)795-22d� ��3� � � � ��� � ���� ���`���a����:::
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�X Ir�ttt�n: ����������
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Praject Address Rarcel Numbee Applicant
� 1270 N� 97 �tr��t��,� ��� �.a ���.�, ���20�oo�o�so �.� �,..�� a� �� �� � �v m��� �a�� �r,n�a
� R1111CT11 �hQ�°�S, FL 3313��25�0 BEc�ck: L�t: CA�fllk.l��YEC1`C}�IA VtLLEGA�
ti•:\�"�'k'«�•�"`�'`"�•��'6 . �. . . _ ��`� . . . `�rt.'A13.� .. . .-zbS1�.�`kid.`3§\3;�?+"S�2k'��.C"c`�1`x.\.`�R�.`�'akb'Q�Yh.."3,'�3s�,`.SCl�`.!`.�A.'b.�Y"\'C`S�W,l"�.yi.�i"'"x1.k:kS`k.l.��"i��:�kT`.a#,bt".5`Y'»Ua}Y.�SN9;.21�'�;:4:��25��."�".EZ:Ae"�"�
Owner ir�fQrmatian Address i�hon� Gel(
� ��,� � n�. .��rc ��� �v���.,��a��.�.��. n�n�. 4..,.����� �_..n� �.�.� .�� .. .��. b_,��n4 _ww�� v�.�
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� �A(VIILQ�VICTORIA VILI.�GAS 1270 N�9T atreet
MIAM1�HC?��S Fl�3313�-
s?k.'v4�SR,5"`�U�rz�.�a. . . ...k� . _ . . �b4,j�3,�,.''�Yz�V'P��a�R�'�.yF'�.�.°�a3'N�ki`:X6`tBt�.Y'Shi.��.."�l�YftE3��.5':::d`SS.+�X��9;��'3� �`3}C�1�R33:ik[.`'i,Y,n2.fa+.�YAi;m41`+NUt:.`+;::tth.,fi`3`S.`,�k4.'ti�'�.`YtE� .
12TQ N�97 Street
MIAlVII SHC>R�S Ft�33138-
Ce�ntractc�r(�} Phone �ell Phone { �Vai�afi�on;�� ��.��4,Q00 00��9�W_
T�ST ANR �ALANCE�41R�(�NDITION (305}218-1T98
_._ . _ _ _ _. _ .. = T'otal Sq Feet, p
i
•.•'tfi..Cat'�;.L�TYCR1iaR,Z�@'�'E.e1Yt�":a1:�'.�.`Sbu�`�O\`Y.,'�°�ik'3Ci�,�v�`.YYaF?�%A5%#'�.R.C'2GftAYv.Yfzx.�;,iiti�.k�l3:, ..
Tons:5 Availa�Ie Inspections:
Additionai Infca: EQURL F2EP�ACEMENI"QF R 5 T�N A/C UN ��������Q�T�p�:
Ciassificati�n: Re�id�ntial Final
Appraved; In Revi�w �
Review Nlechanical
Comments: Dat�Appraved: : In Review Review Mechanical
Date Qenied: Type of Work: EQUAL REPLACEMENT OF A 5 TON
Scanning:3
Fees �u� Amouttt Pa Dat� Pay Type Amfi Paid A�nt Rue
ceF ��ao
Change of Contracto€Fee �11Q.QQ IFIYQI�e#� MC-10-17-655Q$
DE�PR Fee ���� 11(02f2Q17 Gheck#:7540 $ 109.5Q $ 50.00
DCA Fee $2.Q0 1Ql3112Q17 ChecK#:7537 $ 54.Qq $Q.44
Edueation Surchare�e $0.80
P�rmit Fee $144.00 �nY�lG�# N�C-3-1$-66976
Seanning Fee �`�QQ p4/16(2d18 �redit Card $ 110.QQ $d.QO
TechnoiQgy�ee $320
�rot��: �ass.�o
!n cansideration of 4he issuance to me af 4his permit, i agree to perform the wark covered h�reunder in compliance with alI ordinances and regulat�ons
pertaining thereta and in sirict confarmity with the plans,drawings, statements or specifications submitted to the praper authorities of Miami Shares Village. �n
accepfing this permit I assume responsibility for all work done by either myself, my agent, servants, ar employes. I underst�nd that separate p�rmits are
required for ELE�TFtICAL, P�tJft��ING, MEt;NANICA�,WERiDf?WS,DOORS, RUQFING and SWIMMING POOL work.
F°7 ��J
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UWN�RS AFF�D�VIT: I ee t�y Eh�'��C�fhe f g�ing infarmatian is aecurate and that aI�woek will be done in compliance with aif appficable laws regulating
�
construction nd zoning. F err�ra;`!auth,etr�z�the above-r�amed cantraetor to da the work stated.
{F.;
� � �--�` April 16, 20`18
Authori � Sign ur�: �r2 I fippficant ! Cta tracQar l Agent €3ate
��aildin p�a �� � �nt C�pY
A�ril '16, 201� � �
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>>a`\`���a1���\����\1����� �\��l`�L��\ ?�\��\4ti 41`z�`�\�:\{� � �� � ��� �
�y�4)�.'S ' 3� ,. �`l�j��,� iti �����\\����l , ? ����� �\��.�� ���� �� �dF��.,���F+d`�'�� ���`�� �
,� ,«<-.��, r� Miam��hoees Villag� , �� �� � �` � �ti;�� � � � �
�' � 1QQ50 N.�.2nd Avenu�NE � � t � t` . ,� z ��� ��t � � � �������
�""��'��� Miami Shores, F�33138-OQ00 \ \\��, � ��� � V �� �`��� "�`���������" �� � �'�����
vt i\ yi � A l\ � 3� ��.t sy1 �t t �V �1 � i �� } �
�y � � <3� ti �\��:.1 ����� � V� ��, .��.�� � ? �."�"����������k��`������r����na������
"'k�""�'�� Phone: 3Q5 795-2244 ' �� �� �`� ��,'��.t��, � �� �.`,� s�"�t � ,� �
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� �� �\`� Z� ��� �l�L �` ��� 3��'��` \ `�.����� �"y uy /+� g,¢ppe4�{$�qg+�� gp�$ ��gg
`���\ \ � �` i��L��lS `�` �y \l\ ����� G.I� ��6dl��V�� 6R0�d�9 �S�II��6P
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Project Address P�rcei Number Apptdcant
` 1�70 N� 97 Str�et������� ���������,�����3aosoososso ��
�.��.a�w�..�� �.��_n c�,nn��c��vt�-ro�ta v������as�
: Miami ahcrr��, FL 3313���56Q �i�e�: �.ot: �
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Qwner information Addres� Rhon� CeEI
R� �� a �,,. W.���m�.��,��._a.��. ,��.,_��,��,�.�x���e.,,m.,��.� ��m��� ..�n���,.����.�a��.�...,���,��m.a�.���mv.� ��...�,. . ����
` CAMILO�VIGTORlA YIL.�EC�AS 1270 fVE 97�tr�et �
� I�IIAMI SHURES Fl�33138�
_ �� � ����������a,���.����
1270 N�9T�tr�e�
MIAM1 SHQRE a F�33138-
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Contractor(s� Phone C�li Phone � $ 4�,000 QO �
V�luation: �
METRQPOLITAN A1R CQN�ITIt3NB�i� 305-264-4646 �
__ � Total Sq Feet: p
t
�����������;�
Tans:5 �vailable 6n�p�ctions:
Additionai lnfa:EQUA�REPLAC�MEN7 OF A 5 TON AIG UN IttspeCtiott Typ�:
Classificatian�Resid�ntial Final
Approved: In Revi�wr
�eview Mechanical
Comments: I�at�Appreav�d: : In Review
E?ate Denied: �YPe of Woek: EQURL FtER�.ACEMEf�T f}F R 5 TQN
Scanning:3
Fe�s �u� Am�unt �� Dat� �ay'C r�ae Amt Paid Amt�ue
GCF $2.4Q
InvOiCe� M�-10�17@65508
DBPR Fee $2.1Q
DCR Fee ���a 1110212Q17 Check#:7540 ."b 1Q9.5Q $54.00
Educ�tion Si�rcharge �p.gp 10l31(2017 Check# 7537 $ 5Q.00 $O.QO
Permit Fee $140.Q0
Scanning Fee �g,pp
Techncalogy Fee $3.2p
�Q���: ����.��
In consideratior� af the iss�ance t� me Qf this permit, I �gree fo perEarm the w�ork cov�red Mer�und�e in complianc� with a(I ordinane�s and regul�tians
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted ta the proper auEhorities af Miami Shores Vill�ge. In
aceepting this permit I assume responsibility for �II work don� by either myself, my agent, servants, ar �mployes. E understand that separ�te permits are
required for EL�CTRICAL,PLUMBING,[VIECHANIC��,WINDOWS,DOORS, RQ�FING and SWIMMING P�C}G wark.
OWiVERS AFFIC?AVIT: I e�rtify that �IE the foregoing information is aceurate and that alI wrork wili be dan� in compliance with aIi applic�ble laws regulating
construetion and aoning. Futhermore, I authorize th�af�ov�-name niractor f da e wr,prk�tated.
�o�����r a�, 2a��
Authorized 8ignatuee: Owner ! Applicant / Gontraetor t Age t D�te
Building ��p�rtment �apY
Novemb�r 02,2Q17 �
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r . 8�.�� h�'��"$ �f��«.°�„S; 4
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[� I C'
14050 N.E.2nd Avenue, Miami Shores, Florida 33138
Te�:(�os}��s-2zoa ���;(�os)���-s��z
[€�SPECTf01V CIt�E PF�OIVE[4U[���R:{3Q5)762-49�t9 ��
��...f�
� � ast�r Perrmi� IV�. �..� � ���'�
� � �ub Perrnit �o. ���` �
�gu�«o�� � E��c-r��c � �ooFE�� � �Ev€s�o� , � Ex-r��sfc�� �Erv��vA�
❑��u��i�v� � M�er����c�� ��ua�.fcw�R�s ❑ c�arv�� a� � c��c�����-�ar� 0 s���
C�NTR�CTQR = DRAWINGS
1llGl MLfVISC.SS. ) � a. � f .• 9.0
Cit� Miami Shores County: Miami C}ade Zip::�.":> � ��'�
F�lio/Parcel#: Is fihe�uilding His�orieally[?esignated:Yes NO
Occupancy Type: Load: Canstruction Type: Ffood Zone: �§FE: FFE:
Ot�t��R; R1ame{Fee Simple�itEehalder): �,�� �- �'�` f f'~� �r� t ��-��'- t�. �_a Phone#:�"f ,_t}'� � ` �~�� ���~°���
�ddress: � �2 ,��
�, , _,__. }
City: �fd���t�E-�.,�6 �'�������`-'� State: "� l..: Zip: ����� �—�
Te^ant/�.essee Name: Phone#;
EmaiE:4� ' ``� �'� t�F !�� ;�� ��:�°�r``"�"l��` ,�.�"�..�' �.�.'�'�9``�
� �
�tJ�1TRACTt�R. Ca�npany Name: � � Phone#:, �' "`s�f `7 �`� ��
Address: �.'% " �( � �Ty
City: '� � � State: ��� Zip: .�'� ....
QuafifierName: �C��� �"� ��C���;��._�� Phone#: ��"�;�������'�
State Certificatian ar Registration#: �� � � �� Certificate af Gompe�ency#:
t�ESIGiVEId:,0.rchitectJEngineer: Phane#:
Address: City: State: Zip:
ttaEue of Vltc�rk for�his Permit:$ � �Square/Eir��ar Fo�tag�of�ork:
'fypeofVtfcarEe; ❑ Addition ❑ Alteretian ❑ New ❑ Repair/Replaee ❑ De��olitian
Description o#lAtark:
�
�� �� � ��� �� �" �
� �-�����' ��— c�� ��� �
S��c%�y���1�r o,�c�l����a�e� ti��a
� .
Subrnittal Fee$ Rerrnit Fee$ CCF$ CC}JCC$
Scannang Fee$ �adon Fee$ �:�-� �`��' D�PR$ Y� , �� �IatarY$
Teehnalog�Fee$ TrainingjEducation Fe�$ Doubie Fee$
Sirtacturat Reviev�s$ ��nd�
i ��;:"`� ��,:��
�rc��ra�.����vo�t�u�$ �ti� �
{RevisedQ2/24f2Q14} f
�
,,4y�
,�
�onding Company's Name(if applicable)
Banding Campany's�ddress
e��v s��t� z� _
Mor�ga�e�enaer's Name(if applicabie}
Martga�e Lender's Address
CitY State ���
Application is hereby made ta obtain a permit ta da the work and installations as indicate�. i certify�hat no��vcrk or instailati�n h�s
commenced priar to the issuance of a permit and that all work wiil be performed to meet the standards oi ail (aws regulaiing
construction in Chis jurisdiction. ! understand that a separat� permit musi be secured for ELECTRI�, PI.UN1Bi�1G, SIGIVS, POQLS,
FURNACES, �C?[LERS,NEATERS,�Al�I<S,A(R CONDITIC?NERS, ETC.....
�1�(�ER'S AFFIC��llIT: I certify that all the foregoing iriformation is aceurate and that all wark will be done in ec�mp(iance with al!
applieable laws regulating construction and zoni��g.
�` �ll�� �' E m � t1 F��LCIRE T EC � T"iCE F � E �E E � ��
ES LT � Y �!R P YI� T ICE F 1 P l�E E 1"S 7" � C1R �R RE 7"1'a iF Y � 1'E
1" TA1 F6 �N�� �, � SE��T IT�1 ��E�� L� �E� � ��E� EF �E �EC �
Y` t1R 1`�CE F � E1��E E�Te„
Notice to App(icant: As a conc�it�on to the issuanee of a bui/ding permit with vn estimated va/ue exceeding$25Q0, the appNcant must
prorrrise in gaod faitt� that a copy of ihe noPice of cammencement and construetion lien !aw brochure wit!be delivered to the�aerson
whose property is sutajeet to ottaehment. Als�a, a e�rtifiec�eopy Qf the reeord�d no�tce of corr�rr�P.ncerrrent must be,�a�ted at the job site
for the first inspection which occurs seven (7) days after the building permit is ;ssuecl. ln the absenee �f such posted notice, the
inspection will not be approved and a reinspection fee vJi(1 be charqed.
S
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Signat�ar� `., - i����tur� �
s�
CJWNER or AGENT CO{VTRACT�R
The faregoin�instrumer-�t was aeknowledged before m this The foregoing instrument was acknaw(edged before me this
�� a�y o� ���"t�- � �Q �� � �y ` ��? d�y o� ��� zo �� , r�y
�.��t�����>�-i �y���� S who is persQnally known eo �{E..-��.��"� ��`1`2��..�who is personaily known to
me or wha has prt�duced � ���i� � ����,?€.t.�� as me or wl�a has produc�d ��t��"���� �''`� as
identification and wha did take an oath, identification and wha did take an aath.
�C}T�RY Rll�LI�. M1�Oi"A,RY PU�LIC:
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Sign: 5ign: � .,+�
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Print: Prinfi:
� �' � �a� ida
Seal: S�rF� �°��� Seal: � c� � ���n�F�c�dr� �
�����ni�i ��o�o��o
`� ° ` �'c; �-.P2��,�l�E� ��� ��a� �a����z�z�
A2 s vQ�2R2�3 �.y:#p'F2 1b042
`�� F.�4�titF4 'ei3tiu�t�r I3,2Q1$
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�F���##�k#�#��#�# �k��ak# %&������>k�.&#����&ae%��%�:k�.Y#�k��#��k#�R'+k�&�###���k�&�#�#�%:�A�#���#���sk���k�kk�kat��
APFftOVEQ BY � � �� (ans Examiner zc,�i��
�
�
' Struetural Review Clerk
(Re�iseaoziz�/zo���
i i r s ill
� �
��� � � uiI in rt r�t ; ���� � �
�
�G�°� '� 20Q50 N�E.2nd Avenu�, Miami Shores, Florida 3313� � . �� � �
m� Tek{305}795-22Q�F�x;(3Q5} 756-8972 �� ,� ,
�* � INSPE�'F�QIV LfNE PHOt�tE NtlMBEE2:(3U5}762-�9�9 �-� ��... •.._w a_ _..e.,,�_ ���
1'�i� ���,
'L ' Master Perrnit No. ��� �
�� ��._
E IT P LI 1 sub �ermit tvo.�����; �� _���{�:*� �
��uoL���G ❑ ���c-rR€c � �a��E�� ❑ R�visEo� ❑ Ex�rE�s�a� ����v��nr��
�-
�P�u����� ���c�a�aca� ��ug��cwo��cs 0 cr��r��� c�F � caNc���a�r�c�� � s�oP
�Qh1TRACTOR DR�WIPV{�S
If}B ADDRESS: ?�� ���..�- �'`� . ��� �_�
Citv: Miarni Shares Countv: Miami Dade Zip�
Fcalio/Rarcel#: 1s th��uildin�Nistarically Designated: Yes N�}
Occupancy Type: Load: Construction Type: Flood Z�ane: BFE: FFE:
OWNER. Name Fee Sirrt le Titlehealder : l�'=� '��t ��
f P } � �f�� �1�t.�` �? �. ���Phone#:
,0.ddress: ���ac:�� � � � �� � ��.
City: �.����.� St�te: ��� , �ip: ��
Tenan�f Lessee Name: Phone#:
Email:
� 1 ��CC�NTRACTOR: Company Name: � � � ���� ��. �-�t � ;,� �� , Phone#:'� � `�-�'C��������`
Add ress: ����'`� ��}(�.-�' �L'� ,��"
•--�. ._.. _
City. ��'�1 1e�t�°t t State: �_� � Zip: .-��'�° �'
Qu�lifierName: `�C�.C�.�/"4f���tT`�``��_��"'�:���_F� �-.�- Phone#:
State Certifcation ar Regis�ration#: � � � �..C�`..% � �f �� Certifieate o#Competency#:
C�ESEGNER:Architect�Engineer. Phc�ne#:
Address: ty: �Stat�. Zip:
Value of Work for this Permit:$ °'� , ..� :��� � ��ri � �
` Square L� ear�ootage af Work:
Type of Work: ❑ Additie�n ❑ Alteration ❑ New ❑ RepairJReplace ❑ [�emolitian
' _
DescrEptic��t of Work: �°� � t"' � u� �` 'r`�'�� � s _ ...� �s� � � t
� �� ..�.,
� � e�"
Specify�olor c�f color thru t°ile:
������ � ������.��
Submittal Fee$� �'� �< � i�ermit Fee$ <� CCF$ .� � CajCC� "�
�� � l�
Scannin�Fee$ Radon F�e$ � DBPR$ ����� Notary$ "'�'"�..����°�""`�",�� `��
T�cfinolcagy Fee$ TrainingjEducation Fe�e$ � � �� D�auble Fee$ �������°���°.�
Steuctural Reviews$ �""�.`". ���������.��.�_ _ Bond$ "-""��'� ������ �
TQTA�FEE R1C�W QE1E��-~ ���`�
m����
(�e�r��edo�/za/zo�n� �,��� �'�
�
�anding Company's Name{if applicable)
Bonding Company's Address _
City State Zip
M�rtgage E�ender`s Name(if applicable)
Mortgage Lender`s Address
City � State �ip
Applieati�n is hereby made to c�btain a permiC ta da the work and installatians as indieated. I eertify that no w�rk oe instaliation has
commeneed prior to the issuanee of a permit and that all work will be perfarmed ta mee� the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for E�ECTRIC, P�UMBING, SI(aNS, POCJLS,
FUftNACES, BOIL.ERS, HEATERS,TANKS,AIR CC�NDITIC?NERS, ETC.....
QWNER'S AFFEDAVIT: I certify that all the foregoing information is accurate and that all wark will be done in eampliance with all
appiicab(e laws reg�alating eonstruction and zonin�.
"WARIVING TQ aWNER: YOUR FAI�.URE TQ RECtJRD ,� NQTICE QF CC}MMEtVCEMERIT AY
RESULT IN Yt�UR PAYING TWICE FOR IMPR01dEMEfVTS TC� YQUR PRQPER°TY. IF YOU IEVTEND
TQ �BTAIN FINAIVGING, CQNSl1�T WITN YC}U CENDER OR AN t4TTQ►RNEY BEF{JftE RECC}RQING
YOUR NQTICE t'�F C�M�f(ENCEMENT."
Notice to Appl�cant. As a conditian to the issucrnce of a butldir�g�ermit with an est�mated vc�lue exceedrng$25QQ, the applicant must
promise in goad faith that a capy of th�* notice c�f cammencement anef cvnstructian lien lawv 6rochure will be deJivered to the person
whose property is subj�ct to attachment. Atsa,a certified copy af the recorded notice of comrraencement must be pasted at the job site
foe the first inspection which t�ccurs seven (7) days cafier the burlding permit rs rssued. !n the a6senee of such posted natice, the
inspection wifl not be appraved and a reinspect+on fee wilf be charged.
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OWNER or AGENT �'" �N���-����CORITRACTQR
The fore�oing instrument was acknowledged before me this The foregoing instrument was acknowledged before m�this
.,.� day�f ��" � ���.����'`�.�.___, 20 f � by _� day of ��'�� �[.��� � , 20 `� � by
_������`� �d�'����,wha is persanally known to ��f�`'�� �� ����1 ���`� wha is pers�anally known ta
me ar wha has procluced ���.5���� ��"��"�� as me e�r wha has produeed 1 �r��s������ �`�-��'�`��"� as
identificatian and who di . �� identificatian and who did take an oath.
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APPROVED BY � ` Plans Examin�r Zoning
Structural Review Clerk
(Revisedo2/24J2014}