MC-05-87Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 6/14/2005
Mechanical Permit
Permit Number: MC2005 -87
Page 1 of 1
Applicant: SHAUN FULLER
Owner: FULLER SHAUN
JOB ADDRESS: 973 NE 96 ST
Contractor DIRECT A/C
Local Phone: 305 - 596 -2666
Parcel # 1132060143230
Contractor's Address: 12921 SW 27 ST
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 11 & LOT 12 BLK 77 LOT SIZE 100.000
Fees: Description Amount
FEE2005 -8170 Building Fee $140.00
FEE2005 -8171 CCF $2.40
FEE2005 -8172 Notary Fee $5.00
FEE2005 -8174 Technology Fee $3.50
FEE2005 -8175 Training and Education Fee $0.80
FEE2005 -8176 Scanning Fee $3.00
Total Fees: $154.70
Total Fees: $154.70
Total Receipts: $0.00
6037
Permit Status: APPROVED Permit Expiration: 12/7/2005 Construction Value: $4,000.00
Work: CENTRAL UNIT A/C
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Z$
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date 06 lib 105
Type hoot Ai r Condi 4-toni
%mit No. MC.C15 — 81 • •
Nam 5incxx--)
Address 9-4 c16 br
company Y-c.c...+ A /C.
Phone # 005 ) 145'4 --0(;) 1
Inspection Dote
Approved
Concede*
Re 1=01 Fee 0
Miami Shores Village's *a
6
Building Department 411 n
10050 N.E.2nd Avenue, Miami Shores, Florida 33131(
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
Permit No.
Master Permit No.
Electrical Plumbing
Mechanical
Roofing
Owner's Name (Fee Simple Titleholder) l . kki (Id Phone # 90S-- 7S.7--6
Owner's Address 9Y-3 p .t . 947' Aett
�
City / A 't Guest - r 3161.403 State re, /,
Tenant/Lessee Name S �k ��'V j'� Phone #
Zip
3313$
1
Job Address (where the work is being done)
City Miami Shores Villa • e
Is Building Historically Designated YES
ze D( keel"- C
idibat c 0 a ,✓e-
County Miami-Dade
NO L-
Contractor's Company
Contractor's Address
City
Qualifier
Zip
Phone # � r) s 9 - OC
State A Zip 5/ ? i •
State Certificate or Registration No. L kso '' p Certificate of Competency No.
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
Phone #
'd L' ' '''" Square Footage Of Work:
Type of Work: ['Addition ['Alteration . ['New
Describe Work: (— tJ , - „.2.4.44.44° , JVY1 er, /.1/
f
l L'.. I.
Repair/Replace ❑ Demolition
* *, *, * * * * * *, * * * * * * ** * *** * ** e * ** *** * * ** * * ** *** * * * * * * * **
[ J [
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
Scanning $ Radon $
Code Enforcement $
Total Fee Now Due $
CCF $
CO /CC
Technology Fee $
Zoning Bond $
Structural Plan Review. $
(Continued on opposite side)
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 comm ' cem _ nt must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. I he abs -ce of such posted notice, the
inspection will not s e approved and a reinspection fee will be charged. 0 i
r ( '
� o
Owner or Agent •tractor
The foregoing instrument was ac owledged before me this 1 The foregoing in as acknowledged before me this 1�
Y y pp
day of 2 b � `�°� .)L V day of 2 b
who ►e_ . %nally known to me or who has produced who • rsonally kn• to me o has produced
As identification and who did take an oath.
a
Signature
NOTAR
Sign:
Print:
My Co mission Exp
* * * * * * * * * * * * * **
b�1 V'dX�a� OTARY PUBLIC:
,tmiSSion d 023 00
xPiTe5, ��
ond
rr
* * * * * * * **
* * * * * **
************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
Sign:
Print:
tification and who did take an oath.
Mgbe
11155
argas
n,= 'DD2J1984
Ju 3,2007
My Commissio - xpires:
Co.: Ins
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* * * * * * * * * * * * * *
Plans Examiner
Engineer
Zoning