RC-15-2288 R 14
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Miami Shores Village P8n13/t Typeieslderltlal ion$ l
10050 N.E.2nd Avenue NW - n
"riikon `..
Miami Shores,FL 33138-0000
Phone: (305)795-2204
F'�r rt Status APPROVED
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" Expiration: 03114/2016
�ued p�
Project Address Parcel Number Applicant
119 NW 110 Street 1121360030550 2620 ACQUISITIONS LLC
Miami Shores, FL 33168-4320 Block: Lot:
Owner Information Address Phone Cell
2620 ACQUISITIONS LLC 600 BRICKELL Avenue
MIAMI FL 33131-
600 BRICKELL Avenue
MIAMI FL 33131-
Contractor(s) Phone Cell Phone
Valuation: $ 2,500.00
KIS CONSTRUCTION SERVICES LLC (786)975-5750
Total Sq Feet: 88
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Drywall
Date Denied:
Miscellaneous
Type of Construction:TILES ON GARAGE,DRIVEWAY. Occupancy: Window Door Attachment
Stories: Exterior: Tie Beam
Front Setback: Rear Setback: Final
Left Setback: Right Setback: Framing
Bedrooms: Bathrooms: Insulation
Plans Submitted:
Certificate Status: Truss Insp
Certificate Date: Additional Info: Final PE Certification
Bond Retum: Classification:Residential ColumnsFoundation
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Window and Door Buck
CCF $1.80 Fill Cells Columns
DBPR Fee $2.00 Invoice# RC-9-15-57020 Wire Lathe
DCA Fee $2.00 09/24/2015 Credit Card $ 117.80 $0.00 Review Electrical
Education Surcharge $0.60 Review Building
Permit Fee $100.00 Review Plumbing
Scanning Fee $9.00 Declaration of Use
Technology Fee $2.40 F.Termite Letter
Total: $117.80 F.Elevation Certificate
Review Planning
Review Mechanical
Review Electrical
Review Structural
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 rict conf ity ith the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I a Lime res onsib ity for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRIC PLUMB( G,M CHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFF( IT: I certify a all a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an z nin uthe I horize the above-n ed contractor to do the work stated.
September 24,2015
Authoriz Sign ture. / Applicant / Contractor / Agent Date
Buildin artment Copy
September 24,2015 1
Miami Shores Village SEP 2015
Building Department ov
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 �T*
INSPECTION LINE PHONE NUMBER:(305)762-4949 l
FBC20 �
BUILDING NG Master Permit No.,�
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
�® ,q CONTRACTOR DRAWINGS
JOB ADDRESS: /47 �y 1��
City: Miami Shores ..`� County: Miami Dade Zip: 3 138
Folio/Parcel#: �/21- 003 055® Is the Building Historically Designated:Yes NO x
Occupancy Type: Load: Construction Type: Flood Zone: _ BFE: FFE:
f�
e�Ci g a J,11A&
OWNER:Name(Fee Simple Titleholder): C i 6r , Ions J_j C Phone#: '796 4–�XS5
Addres�s{:� io'irp 96,Zo s2V A
`
City: i' b 4 ill 1 State: F/,,)A I o A Zip: 5 3 13.3
Tenant/Lessee Name: Phone#:
Email: /
CONTRACTOR:Company Name: �C� l��� 'IZ�� 5 11VK 5Phone#1:79()95�t �
Address: q K0 5W C I `
City: 61/A IMI State: I f OYI QA Zip: 33 072
Qualifier Name: 9 0!j A 5em1'� Phone#: Z& 91® 45
State Certification or Registration#: C 5 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alte7Uoa
New ep it/Replace ❑ Demolition
escription of Work: ��C'� F IT
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ i! '��°�— CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ 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 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 c ifted copy of the recorded notice of commencement must be posted at the job site
for the first inspection which oc s seven (7) ys a r the building permit is issued. In the absence of such posted notice, the
inspection will not be ap ave a reinsp n fee ill be charged.
Signature Signature
ER rAGENT CONTRACTOR
The foregoJ* strument was acknowledged before me this The foregoing instrument was acknowledged before me this
3 daily of os 20 1�— by A0 day of A5Ki0 ` 20 l':�- by
�fffiQ P�r�ciaeis personally known to a� �+ct -�( l;wI�S"is personally known
�i or who has produced as who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign
Print: Print:
Seal: Seal: ,;,,,, ;
MYIN HE WMEZ HERNANDEZ
MY COMMISSION#EE221249 •; := MY COWISBION#EE 221249
EXPIRES:December 1,2016 -,� ., o: EXPIRES:December 1,2016
Bonded Thru Notary Pubtic U %1 ,,SSP Bonded T1uu Notary Public Undaueftem
r
APPROVED BY �4 c ✓ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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