DEMO-17-1032 (2)FtoRioA
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. DEMO-4-17-1032
Permit Type: Demolition
Per ' Work Classification: Electric
Permit Status: APPROVED
Parcel Number
Issue Date: 5/9/2017 1 Expiration: 11/05/2017
Applicant
175 NW 100 Street 1131010230320
Miami Shores, FL 33138- Block: Lot: CHRISTIAN LANSER
Owner Information Address Phone Cell
CHRISTIAN LANSER 175 NW 100 Street (305)772-4313
MIAMI SHORES FL 33150-
175 NW 100 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone
MAX ELECTRIC CORPORATION (305)498-5422 (786)277-6278
of Demo: Electric
itional Info: REMOVE KITCHEN APPLIANCES REMOVE WA
;sification: Residential
nning: 1
Fees Due
Amount
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.40
Total:
$111.80
Valuation: $ 3,000.00
Total Sq Feet: p
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO-4-17-63689
04/13/2017 Credit Card $ 50.00 $ 61.80
05/09/2017 Credit Card $ 61.80 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Electrical
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 foregoing infor4iia n is Acctirate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-na ed corV for to do the work stated.
Authorized Signature: Owner / Applicant /
Building Department Copy
/ Agent
May 09, 2017
May 09, 2017 1
RECEI SEE
i
BUILDING
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
PERMIT APPLI TION
❑BUILDING ELECTRIC ❑ ROOFING
APR 13 7'?17
S
�-FBC 201`{
Master Permit No. V—t— 9 y1
Sub Permit No.'pe" 19 — 103 Z
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
J CONTRACTOR DRAWINGS
JOB ADDRESS: ,ke� N W Ion c,� V'C�iT'
City: Miami Shores County: Miami Dade Zip: I S a
folio/Parcel#: 1 I — 31'Q 1 — O Z3 03 20 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone:. BFE: FFE:
OWNER: Name
(Fee Simple Titleholder): �CY ► csy\ V Phone#:
Address: T) W W �C)v �7
City: 11-A Ch`A
Tenant/Lessee Name:
Email:
State: 0 Zip: -3 3 ( Sc>
Phone#:
CONTRACTOR: Company Name: b'x EA PA rL� e—W Phone#: 3 CJ 5� ZZ
Address: �J�P�-� `--�`� �'U -
City: 1M�� State: Zip; •1 33� SS
Qualifier Name: l�nc i �` Aw�r�1BZ Phone#:
State Certification or Registration #: �e�'JCX7 �oa(o• Certificate of Competency #: _
DESIGNER: Architect/Engineer:
Address
City: State: Zip:
Value of Work for this Permit: $ 3000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration, ❑ New ❑ Repair/Replace
Description of Work:
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
M1*1910
L
Permit Fee $ 1L7P,'O19 CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
❑ Demolition
LA-� 6.1-
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ SnI ' W
(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 n nd a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CO RACTOR
The foregoing instrument was acknowledged before me this
C day of Q r 20 1 by
6tGh 'rn� e V , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
5a0c6 Vq*�ZUSWX�
Print:
• - SANDRA VALDES DAUSSA
Seal: ''' MY COMMISSION A FF 195194
-t� • Y
H' a EXPIRES: February 27, 2019
Bonded Thru Notary Public Undembrs
as
The foregoing instrument was acknowledged before me this
10r" day f >Z ` , 20 I � by
itG ay. who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal : LA, g� EXPIRES: DULY 21,2017
�•,,,,,,;�;P° WWW.AARONNOTARY.wm
************************************************************************************************************
APPROVED BY _ > Y Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)