MC-11-19-2792, 27 NE 94th StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 02/24/2020
Location Address Parcel Number
27 NE 94TH ST, Miami Shores, FL 33138 1132060130540
Contacts
Permit No.: MC-11-19-2792
Permit Type: Mechanical - Residential
Work class/, fi'cation: Pool Heater
Permit Status: Approved
Expiration: 08/24/2020
KRISTINE A GEORGE TRS Owner AQUATIC ENVIRONMENTS Contractor
27 NE 94 ST, MIAMI SHORES, FL 33138 LUIS ESPINOSA
11767 S DIXIE 203, PINECREST, FL 33156
Business: 7863909029 aquadesignl@bellsouth.net
Description: NATURAL GAS HEATER Valuation: $ 1,850.00 Inspection Reguests:
305-762-4949
Total Sq Feet: 578.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Building. Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.10
Check # 4981
02/24/2020 $111.10
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 AFFIDAVIT: I certify that all the foregc/qfi gn is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I a , r'3tion
6ove named contractor to do the work stated.
Authorized Signature: Owner / Applicant / dontracVW Agent Date
February 24, 2020 Page 2 of 2
•.
Miami Shores Village
21 2019
BY:
FBC ton
BUILDING Master Permit No. F9" j /" 0 " 7u)'
PERMIT APPLICATION Sub Permit No. U—/H9 — Z3�
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING �§ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
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
JOB ADDRESS: a�+ 1A E7 9 Lk St EFT
DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: l I — 3Z06-013-0 5 4-D Is the Building Historically Designated: Yes NO
Occupancy Type: A9W Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): KF <3h M E Phone#:7gG -39a-c�
Address: N t✓ q 4 zt-Rr_ -r
City: Cl(1 l Ot MI S'hp(ZS State: � � . Zip: '33 1 �_
Tenant/Lessee Name: I) a Phone#: % IM— '390-9029
Email: G9U6tdAee.,lGlr l4V 6G115en, n
CONTRACTOR: Company Name: 'N AFr lG o7wil N-ON mct4 rS Phone#:
Address: S,1JiYL1E, 41A )j lV_-203
City: State: zip:
Qualifier Name: ��) i [J��/ Phone#:
State Certification or Registration #: Cf. _" 0_57+-.'a2 Certificate of Competency #:
DESIGNER: Architect/Engineer. Vt C.L-r+ Te r—KANc-O L(C• GZ531 Phone#: 3,_)5— 30JR) — 3�
Address: 66QD N W n ) 09 C.OUR + City: D MAL_ State:Ff Zip:
Value of Work for this Permit: $ l,f��0. Dd Square/Linear Footage of Work:
Type of Work: ® Addition ❑ Alteration ❑ New L❑ Repair/Replace ❑ Demolition
Description of Work: Gyfi t-~, iaG (_-�oa Pc}Ji2/1\ C1CiSr t�1 I nstOl\\a� 0y\ pA qQT
Specify color of co or thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Technology Fee $
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $
PA
Bonding Company's Name (if applicable)
Bonding Company's�
^^ Address N
City tV ) -
N*
04
Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address _ 0 P
City
State
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. n n
ASignatur Signatu
OWNER or AGENT
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Cl day of nVQdA r 20 , by _1q day of 1-2� L- , 20 Iq by
IJ?tSTI MG &�ffl 40- , who is personally known to W fS � FINJQSA , who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal
as
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Commission # FF 924095 Seal:
My Comm. Expires Dec 13, 2019
Bonded through National Notary Assn.
Commission # FF 924095
My Comm. Expires Dec 13, 2019
Bonded through National Notary Assn.
as
*********************** ******* *************************************************************************
APPROVED BY Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk