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RC-08-20-1868, 137 NW 106th StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 137 NW 106TH ST, Miami Shores, FL 33150 1121360090290 Contacts ESTEBAN BETANCOURT Owner MOMENTUM SOLAR Applicant 137 NW 106TH ST, Miami Shores, FL 33150 CAMERON CHRISTENSEN 6001 Hiatus RD 3, Tamarac, FL 33321 Business: 3212476073 hrose@momentumsolar.com MOMENTUM SOLAR Contractor CAMERON CHRISTENSEN 6001 Hiatus RD 3, Tamarac, FL 33321 Business: 3212476073 hrose@momentumsolar.com Description: Installation of photo voltaic solar panels on Valuation: $0.00 Ins ection Re uests: roof. Total Sq Feet: 0.00 Fees Amount Payments Date Paid Amt Paid DBPR Fee $2.00 Total Fees $4.00 DCA Fee $2.00 Credit Card 11/18/2020 $4.00 Total: $4.00 Amount Due: $0.00 Applicant Copy For Inspections, Call (305) 762-4949 or Log on at hops://bidg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. November 18, 2020 Page 1 of 2 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 201-1�'� BUILDING Master Permit No. FL_- X_?z 'ln-- PERMIT APPLICATION Sub Permit No. P.c-6Y ?Z- la_eY BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS 10B ADDRESS: 137 NW 106 ST City: Miami Shores County: Miami Dade Zip: 33150 Folio/Parcel#: 11-2136-008-0290 Is the Building Historically Designated: Yes NO X Occupancy Type: RES Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): ESTEBAN MONTES BETANCOURT Phone#: 321.247.6043 Address: 137 NW 106 ST City: MIAMI SHORES Tenant/Lessee Name: _ State: FL Zip Phone#: CONTRACTOR: Company Name: MOMENTUM SOLAR Address: 6001 HIATUS RD ST #3 33150 ne#: 321.247.6043 City: TAMARAC State: FL Zip: 33321 Qualifier Name: CAMERON CHRISTENSEN Phone#: 321.247.6043 State Certification or Registration #: CVC57036 Certificate of Competency #: DESIGNER: Architect/Engineer: MINA MAKAR Phone#: 551.589.5068 Address: 61WINDLING WOOD DR APT 8B City: SAYREVILLE State: NJ Zip: 08872 Value of Work for this Permit: $ 22,215.38 Square/Linear Footage of Work: Type of Work: ❑ Addition ® Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Installation of photo voltaic solar panels on roof. Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $_ DBPR $ CO/CC $ Notary $ Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ __ (Revised02/24/2014) 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 — 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, o 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. J Signatur Signature OWNER or AGEN CONTRACTOR The foregoing Instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of Auaust__.. 2d 20 m. by 17 day of August, 20 20 .�• by Esteban Mantes who is personally known to Cameron Christensen , who is personally known to me or who has produced _ DL identification and who did take an oath. NOTARY PUBILIQ Sign: Print: I (,A r1G G •r ) Seal: pypCHRISTINA FAIRLESS _ ^ MY COMMISSION #GG975179 t EXPIRES: APR 01, 2024 ««««s«« «io«sd+ *�1F9NG�i+isi+E4w APPROVED BY (aevisedo2/24/201.4) as me or who has produced Known v� as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: O h(,L-3 ,, na Seal: Plans Examiner Structural Review CHRISTINA FAIRLESS MY COMMISSION #GG975179 EXPIRES: APR 01, 2024 Zoning Clerk