MC-04-22-1036, 162 NW 108th StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
162 NW 108TH ST, Miami Shores, FL 33168 1121360100060
Contacts
Jovens Degage Owner
ANOTHER CREATION HOME INC Applicant
162 NW 108 ST, Miami Shores, 33168
NATHANIEL CURRY
Mobile: 3058499102 JOVENS.DEGAGE@YAHOO.COM
1535 NW 180 TER, MIAMI, FL 33169
Business:6782494730 NATECURRY@ANOTHERCREATIONHOM
ES.COM
40 Degrees Air & Refrigeration, Inc Contractor
Adrean A Scott
7027 W Broward BLVD, Plantation, FL 33317
Business: 954.613.5155 service@40degreesac.com
Mobile: 4049970491
Description: INSTALL NEW DUCTWORK/EXH FAN Valuation: $ 1,200.00 Inspection Requests � E
E1�i E� S "1 E
Total Sq Feet: 500.00
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
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
04/25/2022 $50.00
Credit Card
04/25/2022 $61.10
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.
I certi hat I he foregoing information is accurate and that all work will be done in compliance with all applicable laws
and zwWQ. ore, I authorize the above named contractor to do the work stated. j
Z-)
Authorized X,gnature: Ov ner V / Applicant / Contractor / Agent
Date
April 25, 2022 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPEC11ON LINE PHONE NUMBER: (305) 762• 4949
PECEIVBD
APR 2 5 `U2Z
By:_ffU__--11
FBC ZO
BUILDING Master Permit No. R/C�raor n
PERMIT APPLICATION Sub Permit No. I ,�V (t_ -0/— ZZ— 1030
❑BUILDING ❑ ELECTRIC ❑ ROOFING 0 REVISION ❑ EXTENSION ❑RENEWAL
[]PLUMBING gMECHANICAL [:]PUBLICWORKS [] CHANGE OF [:]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: N VV t oy f,!,-+
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: I I - 1 _7% C, _ O 10 - O G GO Is the Building Historically Designated: Yes NO V
Occupancy Type: reside .'a Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): SOyeV1S �A�_ Phone#: (305)' 5549 -`VO &
Address: I lOg S
City: M (OLYVI ( S �_I G ce 5 State: rL- Zip: 3I> ram
Tenant/Lessee Name:
Email: VyEA!5 . cAeGc
�— —.j
CONTRACTOR: Company Na/me:
Address: �� W
City: ,-
Qualifier Name:
K-1
e: Zip: -33 3 /7-
Ixt
Phone#: g5�- 6,1'3 _
State Certification or Registration #: Gl£ /9 / d? Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ �r�6 / _C, t Square/Linear Footage of Work:
Type of Work: ,W Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ _
TOTAL FEE NOW DUE $ (iP C I ��
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
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 wiN 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.
"D Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrurm-ent was acknowledged before me this
1 ��h r day of e Lna 20 a , by
aoyt✓1n5 13c qe. who is personally known to
me or who has produced N 1A as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
The foregoing instrument was acknowledged before me this
_ day of 20 �Z'� . by
whop is personally known to
me or who has produced A as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: //���A—
Print• N�1^ '` L.
'►� �' Notary Public Sttt! OFJnd
Seal:Seal:
(ommission p HH 19My Comm. Fxphes Nov ty+Bonded through National Nota�P N �
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)