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DEMO-15-550Project Address Parcel Number Applicant 1002 NE 105 Street 1122320280010 NOAH 8 AUBREY KESSLER Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell NOAH & AUBREY KESSLER 1002 NE 105 Street (917)579-8541 MIAMI SHORES FL 33138- 1002 NE 105 Street MIAMI SHORES FL 33138 - Contractors) Phone Cell Phone ACCLIVITY CONSTRUCTION LLC (305)397-8033 (305)358-7878 of Demo: Building ional Info: INTERIOR DEMOLITION AS PER PLANS AR Acation: Residential nina: 4 Fees Due Amount CCF Miami Shores Village 10050 N.E. 2nd Avenue NE "" Miami Shores, FL 33138-0000 DCA Fee Phone: (305)795-2204 Project Address Parcel Number Applicant 1002 NE 105 Street 1122320280010 NOAH 8 AUBREY KESSLER Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell NOAH & AUBREY KESSLER 1002 NE 105 Street (917)579-8541 MIAMI SHORES FL 33138- 1002 NE 105 Street MIAMI SHORES FL 33138 - Contractors) Phone Cell Phone ACCLIVITY CONSTRUCTION LLC (305)397-8033 (305)358-7878 of Demo: Building ional Info: INTERIOR DEMOLITION AS PER PLANS AR Acation: Residential nina: 4 Fees Due Amount CCF $3.60 DBPR Fee $2.70 DCA Fee $2.70 Education Surcharge $1.20 Permit Fee $180.00 Scanning Fee $12.00 Technology Fee $4.80 Total: $207.00 Valuation: $ 6,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -3-15-54781 03/13/2015 Credit Card $ 50.00 $ 157.00 04/01/2015 Credit Card $ 157.00 $ 0.00 AVallaDle Inspection Type: Final Review Electrical Review Electrical Review 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: 1 Fttf a forecoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin a oY amed contractor to do the work stated. 101, 2015 liAGfhorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy April 01, 2015 1 z BUILDING 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 PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 1002 N E 105th Street I MAR 13 2015 FBC 20 )0 Master Permit No.�/Iil� Sub Permit No ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County Miami Dade Zip: Folio/Parcel#: 11 -2232-028-0010 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Aubrey & Noah Kessler Phone#: (917) 579-8541 Address: 1002 NE 105th Street City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name. NONE Phone#: N/A Email: ladybreezy@gmail.com CONTRACTOR: Company Name: Acclivity Construction Phone#: 305-358-7878 A,Mrr�,- 2000 Ponce De Leon Blvd, Suite 600 City: Coral Gablesstate: FL Zip: 33134 Qualifier Name: Eric Hochman Phone#: State Certification or Registration #: CBC1258180 Certificate of Competency M CBC 1258180 DESIGNER: Architect/Engineer: ov►ai Phone#: C?oS) (P Address: Sf 1 SW 79K,S�f- L,,c yos H� City: S.a`i9.�...; State: �G Zip: 33153 Value of Work for this Permit: $ f!or O®o. ® o Square/Linear Footage of Work: _ ,—,% Type of Work: ❑ Addition El Alteration ❑ New ❑ Repair/Replace I Demolition Description of Work: ,", er �{��..��%yam+ 4s r?w -.'fX-z— Specify color of color thru tile: Submittal Fee $ '-O ?% Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address N/A City None State Mortgage Lender's Name (if applicable) N /A 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 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 —� Signature OWNER or AGENT The foregoing instrument was acknowledged before me this Cday of "�� 20 6 by J4 S (2 ✓ , who is personally known to me or who has produced �2' �c�'-79'1's8 identification and who did take an oath. NOTARY PUBLIC: Seal: APPROVED BY (Revised02/24/2014) CONTRACTOR The foregoing instrument was acknowledged before me this Xf� p �0 '' °�1-�� , 20C , by `-b lMCi_n ,who is personally known to me or who has produced identification and who did take an oath. .. , rv� 0 0 0, ffli�w� - Print. 02� _ Seal: JESSICA ANERO Notary P - state of Ftolda CLAUDIA PATRICIA HOCHMAN +, . MY Comm. Expires Oct 25, 2018 Bonded Thigh National Notary Assn. ��?� rye, EXPIRES September 17, 2018 as V ''t F1 Plans Examiner -- g r Zoning sp.. Structural Review Clerk