RC-14-1630S111 1.q . �liq o
,Oro�p
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: (30S) 762-4949
BUILDING ❑ ELECTRIC ❑ ROOFING
92014
fBC 2b (
I()
Master Permit No. - � �'- IGS®
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: �� �� /�� �� �' R-
Il—,3
Occupancy Type: Load:
®14 W co P® Is the Building Historically Designated: Yes
Construction Type: Flood Zone: BFE: _
N0>
FFE:
OWNER: Na a (Fee Simple Titleholder): Y �` Phone#:
Address: �a 1 p Ob S`
City: M; Cx'ml SL►CqA State: i Zip:
Tenant/Lessee Name: Phone#:
Email:
l'Co
CONTRACTOR: Company Name: W�'3i OT'� 6AA CQ��orle#:
Address: AS01 tJ 4J 1 tZ `_
City: j�j/d State: Zip:
Qualifier Name:c�`lt_-� ® ����� Phone#:"
State Certification or Registration #: Certificate of Competency #: 2
DESIGNER: Architect/Engineer: TOS O *151_7Phone#: 3y `S 7�
Value of Work for this Permit:
Type of Work:
A, --'
Addition
Description of Work: lack
_ % I .
of Work:
e: Zip: QJ
100
❑ Alteration ❑ New A Repair/Replace
d C0. � iYl S . rp_,D r 0. c,42, Sin 1� + OU,-,
Specify color of colorA,thru tile: /
Submittal Fee $ Permit Fee $ 0
4so °
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
❑ Demolition
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
_ Bond $ _
TOTAL FEE NOW DUE $ . ��
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
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 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature E"&'—
OWNER or AGENT
The foregoing instrument was acknowledged before me this
C� 0 day of i 20 �h� , by
IqDILA
who is personally known to
me or who has produced OVI V&h L((,CKM- as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: , ' iJ•'•- 1141M AAESTEP
MY COMMISSION i FF:2018
3975
rr EXPIRES: March 29
eded Thw N0t0y PuWb uW&M
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
v�2 day of 20 by
who is personally known to
me or who has produced8� ' /��- as
identification and who did take an oath.
NOTARRY�PUI
Sign`"'LUI
Print: L= i
Seal:
APPROVED BY '� Plans Examiner
Structural Review
(RevisedO2/24/2014)
�— ELCIDA CEBALLOS
..."U''.
A.F
Notary Public - State of Florida
My Comm. Expires Jun 1, 2015
i Sion # EE 61875
Bonded rTh�rou6 ational'�i}°t1l�'��`$li.
Zoning
Clerk
SPECIAL SERVICES CUSTOMER INVOICE
Store 6310 N HOLLYWOOD/STIRLING Phone: (954) 922-7886
3401 OAKWOOD BLVD Salesperson: PSU37Q
HOLLYWOOD, FL 33020 Reviewer:
This is only a QUOTE for the merchandise and services printed below. This becomes an
Agreement upon payment and an endorsement by a Home Depot register validation.
Name
•
PA
Home Phone
LMA AMY (305) 733-8702
Address 9015 NE 4TH AVE RD Work Phone (561) 715-6905
0,
11 APT 9015 Company Name
•
C MIAMI SHORES Jab Description
State FL Zip 33138 Count` MIAMI-DADE
Page 1 of 3 No. 6310-522573
MENIN D.
QUOTE is valid for this date:04/21/2014
VENDOR DIRECT SHIP #1
MERCHANDISE AND SERVICE SUMMARYWe
reserve the
sold toc stomersghttoiimitthequantities handise
TO: CUSTOMER
S/O - MERCHANDISE TO BE
SHIPPED: S/O G.E. APPLIANCES REF # S01
REF #
SKU
OTY ..
UM
DESCRIPTION
PI
CE EACH
EXTENSION
S0101
0000-174-602
1.00
EA
M901 / M901 -HAUL AWAY YOUR OLD APPLIANCE / M901 -HAUL AWAY
YOUR OLD APPLIANCE
D
$0.00
$0.00
S0102
0000-205-954
1.00
EA
M939 / M939 -DISHWASHER INST KIT & ADAPTER / M939 -DISH
INST KIT & ADAPTER
A
Y
$19.99
$19.99
S0103
0000-206-436
1.00
EA
M936 / M936 -DISHWASHER 110V CORD / M936-DI§00KQ1 110V CORD A
Y
$9.99
$9.99
S0104
0000-174-602
1.00
EA
M901 / M901 -HAUL AWAY YOUR OLD APPLI N -HAUL AWAY
YOUR OLD APPLIANCE
A
Y
$0.00
$0.00
S0105
0000-206-332
1.00
EA
M933 / M933 -RANGE POWER CO ANGE POWER CORD
A
Y
$21.96
$21.96
S0106
0000-863-701
1.00
EA
DELIVERY / APPLIANCE DEL EIGHT
A
N
$0.00
$0.00
S/O - MERCHANDISE TO BE SHIPPED: S/O ELECT REF # S02 ESTIMATED ARRIVAL DATE: 04/24/2014
REF #
SKU
QTY
UM o DESCRIPTION
PI
TAX
PRICE EACH
EXTENSION
S0201
1000-008-618
1.00
EA FGBD24 D2438PB / FGBD2438PB
A
Y
$429.00
$429.00
S0202
0000-537-886
1.00
EA FF 01 FFEF3018LB / FFEF3018LB
A
Y
$599.00
$599.00
*** CONTINUED ON NEXT PAGE' ***
two
D
O
Check your current order status online at
www.homedepot.com/orderstatus
Page 1 of 3 No. 63.1.0-522573 Customer copy
1111111
(9801) 0100850555
SPECIAL SERVICES CUSTOMER INVOICE - Continued
Last Name: PALMA Page 2 of 3 No. 6310-522573
VENDOR DIRECT SHIP #1
(Contnued)
TO:CUSTOMER
VENDOR WILL SHIP MDSE TO: AMY PALMA
ADDRESS: 9015 NE 4TH AVE RD CITY: MIAMI SHORES
APT 9015
STATE: FL ZIP: 33138 COUNTY: MIAMI-DADE SALES TAX RATE: 7.000 ® • $1,079.94
PHONE: 305 733-8702 ALTERNATE PHONE: 561 715-6905 PAGER:
END OF VENDOR DIRECT SHIP
ITOTAL CHARGES OF ALL MERCHANDISE & SERVICES
Policy Id (PI):
A: 90 DAYS DEFAULT POLICY ;
PAYMENT TERMS :
DD
'The Home Depot reserves the right to limit/ deny returns. Please see the return policy sign in
stores for details.'
i END OF ORDER No 6310-522573
o
1
Page 2 of 3 No. 6310-522573
Customer Copy
155.54
Page 1 of 1
https:Hisp. st6310.homedepot.com:13040/MMS VAdmsStore/servlet/com.homedepot.mm. s... 4/21/2014
a
SPECIAL SERVICES CUSTOMER INVOICE
Sicre 6390 N HULL
4 YWOODI 7114LING Phone: (364) 922-7888
g` 3401 OAKWOpD SLVt?
Salesperson:
HOLLYWOOD, FL 33020
Reviewer:
This is onlyQUOTE for Reviewer:
I9reemen# u #W merchandise end services printed below. " his becomes an
n payment and an endorsement by a Home Depot register validation.
4PALMA, AMY
(pus) 733-Wo2
Address 9016 NE 4TH AVE RD
* APT 0016
MIAMI SHORES
FL ap
HOME DEPOT DELIVERY #'
wan` ( 1) 71
MERCHANDISE AND SERVICE
1
,m s
—VALIDATION AREA!—
QUOTE
REA —
QUOTE is valid for this date: 04122MM4 {
We. reserveto Urno the q
mercuuti customers
O
E'R CE EACH EXTENSION
Y 1 $97.001 $194.001
A I Y 1` $77.001 $77.06
A I Y 15.00. $215.001
A' I Y 1 $108.001 $108.001
A Y W.00 60.00
A Y S104.00$1104,00
MERCHANDISE TOTMtl t7 RSD
N $79.tf0
IEUVERY SERVICE SUBTOTAL:
COt INUED ON NEXT *PArG.V"�
..,..... ZIP: 33138
PHONE: (305) 733-8702 ALTERNATE P
Last Name: PALMA
COUNTY:
Policy Id {P*
A: 90 DAYS DEFAULT POLICY ;
The Home Depot reserves the right to limit /deny returns. Please see me retum policy sign in
stores for dells.
END OF ORDER Nct. 6310-5229
SALES TAX RATE: 7
Quintero General Contractor Corp.
LIC # CGC 1515292 General Contractor
CCC 1329992 Roofing Contractor
Bernardo Quintero 8801 NW 112 TERR. Hialeah Gardens, FL 33018
Phone 786.487.5738 Fax 305.362.5966
Email: ggcontractor@yahoo.com
To ANYPALMA
9015 NE 4 AV ROAD
MIAMI SHORES FL
W.O.#1270
DATE: JULY 24, 2014
We hereby submit specifications and estimates for:
Kitchen work and permit
SIGNATURE OWNER ---------------------------- SIGNATURE CONTRACTOR ------------------------------ DATE-------------------------
'TOTAL
Scope work
New plans approve by the city and get master permit. ------------------------------- $ 650.00
_ Electric permit and work in existing kitchen according to the plans by code.
Install four new smoke detector by code. ----------------------------------------------$1550.00
Plumbing permit and work by code. ----------------------------------------------------- $750.00
_ Removeasome tile for electric rk and wood finish counter.
_ Finish cab ets (small work), not r lode paint.
Repair ceiling d popcorn kitchen area. ----------------------------------------------- $g �OO
The contractor include all license and insurance, all permit by contractor &
subcontractors, labor, materials and pass all inspection.
Not included permit fee by the city.
Sig contract 50% Final inspection 50%
3OZDro
TOTAL
$
QlrV
WE PROPOSE HEREBY TO FURNISH MATERIAL AND LABOR COMPLETE IN ACCORDANCE WITH THE
ABOVE SPECIFICATIONS FOR THE SUM OF:
SIGNATURE OWNER ---------------------------- SIGNATURE CONTRACTOR ------------------------------ DATE-------------------------