RC-11-19-2844, 94 NW 95th St (4)BUILDING
PERMIT APPLICATION
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
FBC 20
Master Permit No. C-
,,���////`I I —� C1 - Z y y `'+
Sub Permit No. r`�zy_ (` � 23 - 9--71
❑BUILDING ❑ ELECTRIC ❑ ROOFING j REVISION ❑ EXTENSION ❑RENEWAL
�*LUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
1 �qq CONTRACTOR DRAWINGS
JOB ADDRESS: � l iV
City: Miami Shores County: Miami Dade Zip: 7 y
°�
Folio/Parcel#: 1 0 1 y Is the Building Historically Designated: Yes NO /(1
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): - +z r\ L-L L Phone#: -7 2 ,:) " 29 % — 3 3 V
Address: AA �� �` C �, ,+
/�.J� City: �� a State: F \ w -,1 c,. Zip:
22
Tenant/Lessee Name: �^ Phone#: :� ,2 tia '2-Cj 7
Email: (A- ✓N �� Z t�� �`l , C -a: M
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CONTRACTOR: Company Name: Cif V ���V� �"t Phone#: �g6 3`l'0 S 3 Z
Address: t O o Z N W 4:� 1 C
Email: �w
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Qualifier Name: C-C. Y10J Ca b+,,+—,o Phone#:
State Certification or Registration #: CEC tq-3 Oq O Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ A d O • Do Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: jf'Z F U- U 2 - 2 c4 S 7
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $ _
Scanning Fee $ DCA Fee $ DBPR $ Notary $
Technology Fee $
Structural Reviews $
Training/Education Fee $
Double Fee $
P&Z Review $ Bond $ r�
TOTAL FEE NOW DUE $
v�
(Revised04/05/2022)
f'
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
WE
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 01i
OWNER or AGENT
The foregoing instrument was
acknowledged before me this
day ofT//,L 20 , by
who is personally known to
me or who has produced /� - /Zl as
identification and who did tak_ ath.
NOTARY PUBLIC-
Print:
—!I
Seal: ;'"� RUBYFERRO
MY COMMISSION # HH 2M73
^.s K ; EXPIRES: March 2, MS
##########
APPROVED BY
C
Signature 0,,� J
CONTRACTOR
The foregoing instrument was acknowledged before me this
day ofl° ,20 by
C--- CA&1_r-V1-JQ , who is personally known to
me or who has produced
as
identification and who did take
an oath. ,�"` 11160$1114A�i�/
NOTARY PUBLIC:
Sp, i0....r'q� i
�` �CIO
y eER
13?
Sign:
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A
Print: L`4 t, 0� -
a t66242
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q
Seal:
p )del `-
Plans Examiner Zoning
Structural Review Clerk
(Revised04/05/2022)
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
94 NW 95TH ST, Miami Shores, FL 33150 1131010340090
Contacts
IMMOBILIEN LLC Owner D-AIR CONDITIONING COMPANY Contractor
GARCIA CARLOS CASTANO
7602 NW 2nd Court, Miami, FL 33150 1002 NW 99 CT, MIAMI, FL 33172
Home:9544106364 gnd2@msn.com Business:7867786380 carlosalbertocastano@icloud.com
Other:7202975338
Inspection Requests:
Description: ADDITION, FLORIDA ROOM Valuation: $ 100.00
TotaISq Feet: 224.00
Fees
Amount
Payments
Date Paid Amt Paid
Revision: Major Change of Plans
$90.00
Total Fees
$93.00
Scanning Fee (Manual)
$3.00
Credit Card
04/18/2023 $93.00
Total:
$93.00
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.
OWNTr5;
at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulaFuthermore rize thea e named contractor to do the work stated.
Authorized ign ure: Owner / Applicant / Contractor / Agent Date
April 18, 2023 Page 2 of 2