MC-16-1872 (2) 3f
e*sO1i':as iii Miami Shores Village Pt3rmk7 ype.` VIMM
10050 N.E.2nd Avenue NE
... �n.� W C"�S� It �ti61t1�•
Miami Shores,FL 33138-0000it
PROVED
.;
y- A Phone: (305)795-2204 3 i,
E, f20B Expiration: 112/ 017
IN
Project Address Parcel Number Applicant
520 NE 102 Street 1132060171060 LYNN FRANZOSA
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
LYNN FRANZOSA 520 NE 102 ST
MIAMI SHORES FL 33138-2455
Contractor(s) Phone Cell Phone Valuaption- $ 500.00
SANSONE CORPORATION 954-428-8919
Total Sq Feet: 120
Tons: Available Inspections:
Additional Info:INSTALL 2 EXHAUST FANS. Inspection Type:
Classification:Residential Final
Approved:In Review Rough Duct
Comments: Date Approved::In Review Review Mechanical
Date Denied: Type of Work: Review Mechanical
Scanning:1 Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# MC-7-16-60457
DBPR Fee $2.25 07/06/2016 Credit Card $50.00 $109.10
DCA Fee $2.25
Education Surcharge $0.20 08/16/2016 Credit Card $ 109.10 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compli nce with all ordinances and regulations
pertaining thereto and in strict nfo ity with the plans,dr Ings,statements or specifications submitted to the prop r authorities of Miami Shores Village. In
accepting this permit I ass,One respo sibility for all wor done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRIC , LUMBIN ,MECHANIC ,WINDOWS,DOORS,ROOFING and SWIMMING POOL wo .
OWNERS AFF" T: I rtify that all the f going information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and` ring. the ore,I a orize the above-named contractor to do the work stated.
August 16, 2016
Authors ed at - wner / Applicant / Contractor / Agent Date
Building epartment Copy
August 16,2016 1
Miami ®res Village -
. Building en J L.062016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 III ,
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION UNE PHONE NUMBER:(305)762-4949
FC 20 c4S—rl—E
BUILDING Master Permit N .-
PER IT APPLICATION sub Permit NOc) - 1
❑BUILDING ❑ ELECTRIC ❑ ROOFING ® REVISION ❑EXTENSION ®RENEWAL
❑PLUMBING 0 MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 520 NE 102nd Street
City: Miami Shores County: Miami Dade Zip:
Folio/Pareel#: 11-3206-017-1060 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: 8FE: FFE:
OWNER:Name(Fee Simple Titleholder):John & Lynn Franzosa Phone#:
Address: 520 NE 102nd Street
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Phone#: 305.525.1427
Email:
CONTRACTOR:Company Name: Sansone Corporation Phone#: 954.410.4695
Address: 590 Goolsby Blvd.
City: Deerfield Beach state: FL __Zip: 33328
Qualifier Name: Scott Sansone 8 Phone#: 954.428.8919
State Certification or Registration#: CAI (- P L- '1 1b Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip,
Value of Work for this Permit:$ �� Square/Linear Footage of Work: 1 2— '0
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replac� ❑ Demolition
Description of Work: S 7, c
.Specify color of color thru tile. r 4�
Submittal Fee$ CZ Permit Fee$. CCF$ Q - EDO CO/CC$_
Scanning Fee$ 0�) Radon Fee$, c2• �'� DBPR$ cPS Notary$
Technology Fee$ 0• U® Training/Education Fee$ �-� Double Fee$
Structural Reviews$ Bo d$
TOTAL FEE NOVI DUE$ I �� • I J
(Revised02/24/2014)
I
a
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 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.
At;���
Signata Signature
OWN AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of r 20 / .by 7 dayof V1
20 by
(A S who is personally known to �e- T[ Ct- kA Co ho is personally known to
me or who has prodded as me or who has produced as
identification and who did take an oath. Identification and who did take an oath.
NOTARY PU (C: (VOTARY PUB
1"Lo' —--(J
Sign: � Sign: /
Print: CC v��` C�� Print:
1�aY vuai.�
LAURAFAMCT
aa
Seal. MEXPMES'Xamhis,* MY COMMISSION 0 FF 1 21 Seal: �pgY pUg` RRAFARLI
2019 '. ,° MyCOMMISSION#FF 188027� ' EXPIRES:March 16,2019
"5� �B �rygervtc�
APPROVED BY 1PI1kaminer Zoning
Structural Review Clerk
(Revised02/24/2014)