MC-18-3761 (2)Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit NO.: MC-12-18-3761
(p - I Permit Type: Mechanical - Residential
LD�Iflh Work Classification: A/C Replacement
,. Permit Status: Approved
Issue Date:01/07/2019 1 Expiration: 06/24/2019
Parcel Number
321 NE 93 ST, Miami Shores, FL 33138 1132060136240
Contacts
ELIZABETH COWEN Owner ELIZABETH COWEN Applicant
321 NE 93 ST, MIAMI SHORES, FL 33138 321 NE 93 ST, MIAMI SHORES, FL 33138
Other:3054580120 Other:3054580120
NEW ERA AIR CONDITIONING INC Contractor
ADRIAN BETANCOURT
295 E 34 ST, HIALEAH, FL 33013
Business:3053052840 newera.airconditioning@gmail.com
Home: 3058854127
Description: INSTALL 5 TON, DUCTWORK, EXHAUST FAN, Valuation: $ 6,900.00 Ins ection Requests:
KITCHEN VENTILATION
TotalSq Feet: 360.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.20
DBPR Fee
$3.62
DCA Fee
$2.42
Education Surcharge
$1.40
Permit Fee
$191.50
Scanning Fee
$3.00
Technology Fee
$6.04
Total:
$262.18
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$262.18
Check # 1492
01/07/2019 $212.18
Check # 1486
12/26/2018 $50.00
Amount Due:
$0.00
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 AFFIDAV T: I rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating o n g. Futhermore, I authorize the abov named contractor to do the work stated.
Aww6rized Signature: Owner / Applicant / Contractor / Agent Date
January 07, 2019 Page 2 of 2
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
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
2 6 2V
UA
FBC 20 I -
Master Permit No. RC- C/-� 13 — 110 7
Sub Permit No. M 0- 1 G_ 37� Q
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
%/� ? CONTRACTOR DRAWINGS
JOB ADDRESS: -3 2- N ` ! /� J
City: Miami Shores �
Z County: Miami Dade Zip: /j 2t
Folio/Parcel#: 1 1 3 -zDlcO 13 �2 2 �Q Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: I FFE:
OWNER: Name (Fee Simple
�T'itleholder): Phone#:
Address: 9-3 )
City: ,SVw-eJ Stater Zip: 33I 38
Tenant/Lessee Name: Phone#:
Email
CONTRACTOR: Company Name: �uAr C8 n `J I O ' Phone#: -3 0 5-- 7-9J (-/Z %
Address: •3 y ✓7
City: cz le4 h state: Zip: -UD 1.3
Qualifier Name: ✓' I C- -A �-� ✓L cJf Phone#: 5 D-5 .3 Js'
State Certification or Registration #:
OD Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: n City: State: Zip:
Value of Work for this Permit: $ �� �(/' Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ /Alteration �� J❑ New /❑ Repai
r/Replace ❑ Demolition
Description of Work: �S"�6� (/ 1 %`� �U��''�O�v\ lc �ayS� Ile- /y' r�
Specify color of color thru tile: 2 ! •5�
Submittal Fee $ �V Q Permit Fee $ L CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 'Z n
4 - DBPR $ �O Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
Bond $
TOTAL FEE NOW DUE $ 2 1 2
(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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature FS; -7PLL�
NER or AGENT
The foregoing instrument was acknowledged before me this
2-40 dayof 20 1' by
.]% ZGr �� �'�^ �J�✓l, who is personally known to
me �— .r-0 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: d' La, &mwa> ✓
Signature A-6y2n.1
CONTRACTOR
The foregoing instrument was acknowledged before me this
2 C day of �E� 2/ , 20 1$ by
✓ic.✓����c o ersonally known to
C5br who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: ^ 1
Print: �`�rl�• �'cc✓LLc u��
Seal: t4OTARY PUBLIC Seal: ^�3r!s '.:=:.:�•�Yt
STATE OF FLOF I NOT♦
C=ni# FFgW?2 t S1., E OF FLCIRIDA
T--b
A
EJOreS 12/V2019 , "Cnn,:,k,-F�oi72
iii#
APPROVED BY lans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)