DEMO-17-941 (2)Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
toatoA
Permit NO. DEMO-4-17-941
Permit Type: Demolition
n " Work Classification: Building
Permit Status: APPROVED
Issue Date: 5/9/2017 1 Expiration: 1 V05/2017
Project Address Parcel Number 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
AP WELDING AND STEEL MANUFACI (305)825-4511
/pe of Demo: Building
dditional Info: REMOVE KITCHEN AND BATHROOM REMOVE
lassification: Residential
tanning: 3
Fees Due
Amount
CCF
$3.00
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$1.00
Permit Fee
$100.00
Plan Review Fee (Engineer)
$80.00
Scanning Fee
$9.00
Technology Fee
$4.00
Total:
$201.00
Valuation: $ 5,000.00
Total Sq Feet: 250
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO-4-17-63584
04/05/2017 Credit Card $ 50.00 $ 151.00
05/09/2017 Credit Card $ 151.00 $ 0.00
Avaname inspections:
Inspection Type:
(Final
Review Electrical
Review Electrical
Review Mechanical
Review Plumbing
Review Building
Review Structural
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 inf rma is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above\nar�'o eWgntractor to do the work stated.
May 09, 2017
Authorized Signature: Owner / Applicant / \ Contractor / Agent Uate
Building Department Copy
May 09, 2017 1
�v Miami Shores Village RECEIVES
Building Department APR 05 201,E
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 201LI
BUILDING master Permit No. bf1P 1
PERMIT APPLICATION Sub Permit No.
rUBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [—]SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I` S N W I d O �JG' Y��G�-
City: Miami Shores County: Miami Dade Zip: �� 5; 0 _
Folio/Parcel#: 1 I- 'A I 0 I - 02 03 ZO Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: SFE: FFE:
OWNER: Name (Fee Simple Titleholder): 1. Ff11�► T
Address: 13TL N W I C) � t�
City: M-A: a►, M % 1+oy-t% State:
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: _f
Address: z�3 we-%J
City:
Qualifier Name: G
State Certification or Registration #:
OY11
V
of Competency M
p: 331so
DESIGNER: Architect/Engineer: Phone#:
Address: ��-�,,.\\ City: State: Zip:
Value of work for this Permit: $ S dW Square/Linear Footage of Work: -7-l! ;y
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace , VDemolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ L S% - 00
(Rev1sed02/24/2014)
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must bie posted at the job site
for the first inspection which occurs -seven (7) days after the building permit is issued. In -the -absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR,
The foregoing instrument was acknowledged before me this
— day of n 1 20 1 7 by
G�IriSfign �btnSf,- ,who ispersonally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC-
Sign:
Print:
Seal:
*****************
APPROVED BY
(Revised02/24/2014)
ANY PUBLIC
STA
E OF FLORIDA
Comm# FF098337
r:—I_
The foregoing instrument was acknowledged before me this
6V day of Cr2 t J) 20 /7 • by
.J-D&-C who is personally known to
me or who has produced U(ec•��f���y-v�/t'��es
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
o
Print:
Seal: N Notary Public State of Florida
Beatfiz Sardinas
My Commis$ion GG 032710
%4 Expires 1y17l2020
Plans Examiner
Structural Review
Zoning
Clerk