RC-08-1126 . �.
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Miami Shores Village .:;:.;;: ��#.'# �:•:: �'...>;: �:# ��� •:.�'..�..)111 ::.::•;
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N.E. 2nd Avenue
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Miami
Shores FL 331
38 -0000
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Phone:
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305 795-
2204
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Ex iration> 1 �2'��2 8
2 �€�
Project Address Parcel Number Applicant
°_....
162 NE 107 Street 1121360070190
Miami Shores, FL 33161 -7032 Block: Lot LUIS GUERRA
S? Nl ne[.l nt4[l tl �ti4t! ... ............................... ........................Address ................ ............................... Phone.................... ............................... Celi ..............................
LUIS GUERRA 162 NE 107 Street
MIAMI SHORES FL 33161 -7032
.»xa:::xr,:•» n. <....... ... e,...,.:�^ ,•......K..,w, gag,' :i:faA.i3a.'s:o.......:.R.Ee K.:�4.�a .........a>s>s .... .. . v. A•.....& d•.> AKc:.::. a' �ffi:;... �+$.•.•,, .•...:.cyy.,.asn.? :riii•;;4:::: ....
........................................................ ...............................
Contractor(s) Phone Cell Phone $ 1 ,000.00
JC ELECTRIC INC (305 }754 -6949 `Valuation:
_ ............. ......_.. __......... Total Sq Feet
K ': t' oe' ha �s° ic`¢ F;• �nkr' r' r° e' �..' �;:`:..: ;•r,4::r:•..;.:::•:;;;�......,i c ::::....................
Approved: In Review Available Inspections:
Comments: Inspection Type:
Date Approved:: In Review Final
Date Denied:
Type of Construction: PUBLIC WORKS Occupancy: Single Family
Stories: Exterior:
Front Setback: Rear Setback:
Left Setback: Right Setback:
Bedrooms: Bathrooms:
Plans Submitted: No Certificate Status:
Certificate Date: Additional Info:
Bond Return : Classification: Residential
Fees Due Amount Total Amt Paid Amt Due
CCF $0.60 .........................
Education Surcharge $0.20 $ 0.00 $ 0.00 $ 0.00
Notary Fee $5.00 , .x ::<.•-------.:..,.:..
Permit Fee - Additions/Alterations $100.00 Payment Type:
Scanning Fee $3,00
Technology Fee $2,50
Total: $111.30
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JUL 0 3 2 008
l
c 1
MIAMI SHOE VILLAGE
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 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning . Futhermore , I authorize the above -named contractor to do the work stated .
June 24, 2008
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
Tuesday, June 24, 2008 1
REEVE
A Ju 18 zeal
Miami Shores Vi 11age
Public Works Department
10050 N.E. 2nd Avenue Miami Shores, Flonda 33138
Tel: (305) 795.2204 For (305) 756.8972
Public Works
Permit Application
FBC 2004
PetndtType: PWdtcWaft WATER '"1 � � Ptwne€: -� � � � ✓ `�
ownees Address
Owner's Name (Fee S'�tple T�tddat'}
CIL,e Lo
TaunKesaw Native Pion S:
.Mb Address (tee to work Is being d,,) � CO a � V � � C-)
city, mimm Shores y maus Cc" NNW D aft zip
is building HbtmkMy Dedpatect
/ YES No
ConVacWs Company Nam l/ — � � � Phan #. .
Contraaor"s AM. d �`� 3 `7
` e stale - zip 3 31 to
A,ddtectfEngineers Nariie (if mvfPcabie) Pt►ane #.
$ value of work For ttds Permit Uneal.Foumge Of worts
T of work p Addition O Alteration CI New ❑ Repamepieoe F-1 ownamon
Describe work
Fees
SubmHtal Fee $ Pern* Fee S lo V � CCF O` � 4� Cd/CC
Notary $ e TrainhOTAueation Fee $ 0 7eefinotogy Fee i v
Scanning $ It"ion $ Zoning Bond $
Code Enforcement $ sfiud and Plan Review $
Total Fee Now Due $ m
(Continued on opposite side)
JUL 0 3 3008
CK04- ,
MIAMI SHORES VILLAGE
ondira - NORM Oflapplicable)
it Crfmparhs AIlct M1 ress NIA o
state zip
Mortgage Lenders Name of applies) NIA
Mortgage Lenders Address
City State zip
de to obtain a permit to do the work and Installations as indicated. l c artify that no work or Installation has
lssuance of a permit and that'a6 work will be performed to meet the standards of all laws reguleft cwr�uc1lon in
rstand tat h a separate permit must be segued for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC....
OWNER'S AFFIDAVIT:1 cwfify that all the foregoing information Is accurate and that all work wits be done In comptiahoe with all applicable
lays regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR aNPROVEIIAENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice Ito Applicant: As a condMbn to this issuance of a PWNC Works pwn* with an esftm* f v*Aw exom ft $2600, the 8PPIC011t .must
prondse in good faith that a Copy of the notice of commencement and co nskmKonr Garr law bnodum wN be #69vered to the pwwn whose
pmpeiy is subject to afledw arrt Also, a cedGffvd oopy of the neCauded mite of co mmencernent nwct be posted at the}oob ace 1brihe lust
kqmft whk h omn seven (7) d atlerthe bt&ft pemrit is band In ilia absence of sruith posted no&*, the brspet UM wN not be
approved and a rel five
Signature S
r or Contractor
The foregoing instrumerit was acknowledged before me thIs The foregoing insUumeM was acknowledged before me thi
d C , o�btr 77iriM tGrIOS
who is rsonally known to me who s pmduc ec Who is rally know o me or has produc ed
aside and who dial take an oath. as identification and who did take an oath.
NOTARY PUB C: NOTARY PUB -
Shgn Sign:
MONICAI
Prmt:
ZAtiA Print ` L . !� •. 1SSION # DD 483995
# 640675 EXPIRES:Octo r ue
My Commission Expires: B F�� My Commission Expir , S Na+arY Puux
APPLICATION APPROVED BY: S &40 r bAWC4 Public Works Director or
his designee.
(Q 1161
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11/17/2005