MC-07-19-1762 CanceledMiami Shores Village
Building Department 30,
L10050 N.E.2nd Avenue, Miami Shores, Florida 33138 � J
Tel: (305) 795-2204 Fax: (305) 756-8972 I•,_
INSPECTION LINE PHONE NUMBER: (305) 762-4949
CANCELLED FBc zot��
BUILDING r-ep Icc" by Master PermitNo.mC- 0-0-0(eZ
PERMIT APPLICATION Me" oe 1SE Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING Q MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [—]CANCELLATION ❑ SHOP
CONTRACTOR
JOB ADDRESS: 144 NE 91 ST
DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3101-019-0050 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): DPP3 LLC Phone#:9175399449
,,.,a.,.__. 3718 MORRISON STREET NW
City: WASHINGTON
Tenant/Lessee Name: N/A
Email:
DC Zip: 20015
and@paradisgroup.com
CONTRACTOR: Company Name: AIR & HEAT DOCTORS INC.
Address: 8327 NW 64 ST
City: M IAM I
FL
Qualifier Name: AGUSTINALVAREZ Phone#:
State Certification or Registration #: CAC1819172 Certificate of Competency #: _
DESIGNER: Architect/Engineer: _
Value of Work for this Permit:
Type of Work: ❑ Addition
Description of Work:
6000.00
Square/Linear Footage of Work:
7864864436
33184
3052181798
—Zip:
Alteration ❑New ❑� Repair/Replace ❑ Demolition
IENGE T / REPLACEMENT OF A 4 TONS PACKAGE A/C UNIT
Specify color o thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $ -
DBPR $ Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $ Z.3 4 3b
(Revised 02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lenders Address
City
State
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 einsp lion fee will be charged.
4 Signature Signature A
NERorAGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of �dLii 20 % 9 by
11101144fe'G. 5 S�Wp//Z , who is personally known to
me or who has produce&'i�l�'i'��
identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
3o day of iJr/L� 20 / P , by
96as7;-,--' .Q who is personally known to
me or who has produced A�Xbas
identification and who did take an oath.
NOTARY PUBLIC:
Sign: Sign: -
Print: R Print:
Notary Row - OULU
Seal: : : Commission # FF 922362 Seal:
}� ' My Comm. Expires Sep 29, 2019
••°t��•• Bord,dthroogh National Notary Assn.
Notary Public - State of Florida
Commission M FF 922362
My Comm. Expires Sep 29. 2019
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APPROVED BY U Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)