DS-16-720 a F s f #
t4 Miami Shores Village t of►T y LM, ew
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000 EA,E
Phone: (305)795-2204
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`�R` � , ' ,3/ � , • Expiration: 09/21/2016
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Project Address Parcel Number Applicant
1201 NE 101 Street 1132060171470
Miami Shores, FL 33138-2608 Block: Lot: MICHAEL JOSPEH NUNZIATA
Owner Information Address Phone Cell
=MICHAEL JOSPEH NUNZIATA 1201 NE 101 Street (352)682-8303
MIAMI SHORES FL 33138-
1201 NE 101 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,800.00
SLOAN CONSULTING INC (954)972-3202
._.. ...... __...._,. . ,..._..._. _,______. __...,__ _.._.,_.__... .. .. Total Sq Feet: 520
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:REPLACE DRIVEWAY Additional Info:REPLACE DRIVEWAY Review Building
Bond Return: Classification:Residential Review Planning
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Contractors Bond $500.00
CCF $�60 Invoice# DS-3-16-59072
DBPR Fee $2.00 03/25/2016 Check#:8238 $92.80 $550.00
DCA Fee $2.00 03/21/2016 Check#:8234 $500.00 $50.00
Education Surcharge $0.60 03/21/2016 Check#:8235 $50.00 $0.00
Permit Fee $125.00 Bond#:3022
Scanning Fee $9.00
Technology Fee $2.40
Total: $642.80
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 accurst d hat all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named contrac r o the vit6ttltc stated.
March 25, 2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
March 25,2016 1
Miami Shores Village RECEIVE
I
Building Department MA 21 -2016
10050 N.E.2nd Avenue,Miami Shores, Florida 33138 4BY:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(30S)762-4949 l t
FBC 20
BUILDING Master Permit No. KC,
PERMIT APPLICATION Sub Permit No.D -3 (0 _ -7�9t)
❑BUILDING F-1 ELECTRIC ❑ ROOFING r-� REVISION ❑ EXTENSION RENEWAL
❑PLUMBING F-] MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF El CANCELLATION ❑ SHOP
A, CONTRACTOR DRAWINGS
JOB ADDRESS: �Z® � N C� IN S
City_: Miami Shores Countv: Miami Dade zip: 33 I � s
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type:4DL* AILoad: Construction Type: NtlAt t6'- Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 1r16c � UA 7%A� Phone#:
Address: i Z DI AIE 40'; s t
City: wvtwi S I14yp5 State: Ir-L Zip: 3
Tenant/Lessee Name: Iy/A Phone#:
Email:
CIA SSlulc
CONTRACTOR:Company Name: 110CAU 6k1ACr 4!'2!z) KA 9---19---1 eio110101!Ahnl Phone#: 9 11'0,03 Z.a/b "
^I 1 � 6040ctk
Address: gLt/1(0 A41{aA`�iL 9���,/ 2
City: AkQy4a4e- State: 1'L Zip:
Qualifier Name: 9 Pyi P SC k lWd I42 P F Phone#: 1 �- 9l aZ , 3 Zo Z ® lee)
State Certification or Registration#: C&6 ,5 7S� �Z�9 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: � Z Olt �11 A Ave'' U w,t I I City: Coy oo"t �VOC�z state: 1 L Zip: 33033
Value of Work for this Permit:$ 11 Square/Linear Footage of Work: 5 2 0 --5-r
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: lnlin(,L W
Specify color
ofcolorthru tile:
Submittal Fee$ -JCk� Permit Fee$ P�,^�. CCF$ CO/CC$ 10
Scanning Fee$ �. � Radon Fee$ "W DBPR$ 4) "w Notary$ 2
Technology Fee$ 0 U Training/Education Fee$ O'Go Double Fee$ 9
W
Structural Reviews$ Bond$_� � �y�Q
TOTAL FEE NOW DUE$ G O
(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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the f=re
n (7) days after the building permit is issued. In the absence of such posted notice, the
inspectiopection fee will be charged.
SignatSignature
NER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
7 dayo'f 1�9 r�0 .( 20 I'l�' by r a day of ar-C-L 20 ) LP ,by
�p
&( o$l ��✓� uT�� ,who is personally who is personally kno�ern to
mgor who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY P IC:
Sign
Sign:
Print: 2/�'1G�SGt i� l!�'RL i� Print:
Seal: Lindsay M Rayner Seal: , ERIKAETCHISON
MY COMMISSION#FF 074271
COMMISSION tFF922054 1c, *` EXPIRES:March 17,2018
EXPIRES: September 27,2019 => P No Public Underwriters
Bonded Thru Notary
��nnna
7Ti";—t*1—*, PIans
APPROVED BY Examiner rc� Zoning
Structural Review Clerk
(RevisecIO2/24/2014)
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