MC-18-1615REy��L��Y
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. MC-6-18-1615
Permit Type: Mechanical - Residential
Per m it Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 6118/2018 ( Expiration: 12/15/2018
rrojecc Aouress Parcel Number Applicant
1139 NE 105 Street 1122320280400
Miami Shores, FL 33138-2107 Block: Lot: WELSER TORRES
Owner Information Address Phone Cell
WELSER TORRES 1139 NE 105 Street (305)972-1481
MIAMI SHORES FL 33138-
1139 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
TONY A/C INC (786)587-9339
Valuation: $ 4,500.00
Total Sq Feet: 0
Tons:
Additional Info: NEW HVAC SYSTEM FOR NEW ADDITION
Classification: Residential
Approved: In Review
Comments: Date Approved:: In Review
Date Denied: Type of Work: NEW HVAC SYSTEM FOR NEW ADD
Scanning: 1
Fees Due
Amount
CCF
$3.00
DBPR Fee
$2.36
DCA Fee
$2.00
Education Surcharge
$1.00
Permit Fee
$157.50
Scanning Fee
$3.00
Technology Fee
$4.00
Total:
$172.86
Pay Date Pay Type Amt Paid Amt Due
Invoice # MC-6-18-67910
06/18/2018 Credit Card $ 122.86 $ 50.00
06/12/2018 Credit Card $ 50.00 $ 0.00
Avauame Inspections:
Inspection Type:
Final
nde
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 AFFIDAVI ertify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoni q. thermore, I authorize the above -named contractor to do the work stated.
June 18. 2018
AuthorizeKg�artment
ture:Owner / Applicant / Contractor / Agent
Building a Copy
June 18, 2018
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
RECEIVED
JUN 12 2018
Fsc 20--'1-
Master Permit No. RC1-18-76 -1
Sub Permit No. 1 � ' C t& I( a I
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑■ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1135 NE 105TH ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 -2232-028-0400 Is the Building Historically Designated: Yes NO X
Occupancy Type: RES Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): WELSER TORRES Phone#:
Address: 1135 NE 105TH STREET
City: MIA SHORES State: FL
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: TONY AC INC
Address: 19714 NW 47TH CT
City: M IAM I State: FL
Qualifier Name: ANTONIO LOPEZ
State Certification or Registration #: CAC 1814282 Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ 4500.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑■ New ❑ Repair/Replace
Description of Work: NEW HVAC SYSTEM ,FOR NEW ADDITION
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $,
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
Zip: 33138
Phone#:
Phone#: 786-587-9339
Zip: 33055
Phone#: 786-587-9339
Zip:
❑ Demolition
tCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Lompany'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 approv nd a reinspection fee will be charged.
Signature Signature
�ZqNER or AGENT CONTRACTOR
The foregoing instrumenntlwas acknowledged before me this
day of /��rt� 20 Z� by
Of (eft who is personally known to
me or who has produced w���20
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
RNP
Seal: ' z •y Notary Public - Sta
Commission �, G
a 7 My Comm. Expires
Borded through hatior
APPROVED BY
The foregoing instrument was acknowledged before me this
day of fl-06 1 120 by
()Lcyr � ^ , who is -personally kn _own to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Print:
i Commission GG 100005
Seal: :";��y tee`,. My Comm. Expires May 1, 2021
°.,;•' Bcrdedthrou&NaticraltsctaryAssr.
as
Examiner Zoning
(Revised02/24/2014)
Structural Review
Clerk