MC-19-2085Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit No.: W-09-19-2085
ftmtPermit Type: Mechanical - Residential
Work Classificn: Addition/Atteration
Permit Status. -Approved
Issue Date:
Parcel Number
374 NE 104TH ST, Miami Shores, FL 33138 1121360130170
Expiration: 03/ 10/2020
Contacts
MARIE MYRTHA WROY Owner MIAMI MECHANICAL CONTRACTORS INC Contractor
374 NE 104 ST, MIAMI SHORES, FL 331382018 10SE F BATISTA
5005 COLLINS AVE #1018, MIAMI BEACH, FL 33140
Business: 7864024457
Description: NEW DUCTWORK AND A/C AS PER PLANS Valuation: $ 9,350.00 Inspection Requests:
TO REPLACE EXPIRED PERMIT 305-762-4949
Total Sq Feet: .0.00
Fees
Amount
Payments
Date Paid Amt Paid
100% Permit Renewal Fee
$327.25
Total Fees
$332.25
Notary Fee
$5.00
Credit Card
09/12/2019 $332.25
Total:
$332.25
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, 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 information is accurate and that all work will be done in compliance with all applicable laws
regulatintruction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Winer / Applicant / Contractor / Agent
September 12, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
Miami Shores Village nncEivED
Building Department Lo 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138i\`�A
Tel: (305) 795-2204 Fax: (305) 756-8972 BY:
INSPECTION LINE PHONE NUMBER: (305) 762-4949
Mr
G21019
M
Master Permit No. r
Sub Permit No. �C " 615 )Pi `
❑BUILDING
❑ ELECTRIC
❑ ROOFING
,REVISION
❑ EXTENSION
❑RENEWAL
❑PLUMBING
6&MECHANICAL
❑PUBLIC WORKS
0 CHANGE OF
❑ CANCELLATION
❑ SHOP
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Cor}struction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
c
City:
Tenar
Email
,tIGL �.u� 1Ci
ne# i%�S'/yd � �/A
CONTRACTOR: Company Name: 0*'cwr4 &P,,6r..� Phone(..—
Address`: �5P0f (at'/i�1 /�� SLl o ) Y
t City: 6 State: /7c- Zip:
Qualifier Name: JO."(— ` /?A" Phone#:'1)%4
State Certification or Registration #: Certificate of Competency #: OOG o?3,
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ i 3 p Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration I,� ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: � V-1.1j.:' j)Q CV0 Y r' ct�'t CC SP4Y T 6 Ni S
t.
+t> 6-e P VN C-k- ir-e C --T)-�LY M ;-1- 1 - -18 0 Z
Specify color of color thru tile:,
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Permit Fee $ CCF $_
Radon Fee $ DBPR $
Training/Education Fee $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 2 Z�
(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
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 Signature , /� Zq I
OWNER or CO TRACTOR
The foregoing instrument was acknowledged before me this
6P day of C-:�] 20 / by
�QdZ I �.1 �T�?ti<b who is personally known,
me or who has produced
identification and who did take an oath.
INOTA PUBLIC:
The fo going instrument was acknowledged before me this
IR day of 20 by
me or who has produced
who is personally known to
as
identification and who did take an oath.
NOTARY B IC:
Sign: l"--
Print: �� (� (�_(�)0 -LIA" Print:
Seal: �a".. PERLAM.GARCIA
HPV P %
SINDIA ALVAREZ Seal: ' MY COMMISSION 0 GG 142111
LIY COMMISSION #GG 238273 EXPIRES: Januery7,2022
EXPIRES: Se � m"' wm PuM Undwwftn
September 3, 2022
=.,.....• P� P
APPROVED BY
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk