PL-16-130 (2) 4
Permit Nth. ISL-1-16-130
Miami Shores Village —not I
■ Permit Type:Plumbing-Residential
�. 10050 N.E.2nd Avenue NW Work Classification:New
r h Miami Shores,FL 33138-0000 PED n
Phone: (305)795-2204
Permit Status:APPROVED
�ORI'�A
Issue Date: 1/28/2016 Expiration: 07/26/2016
Project Address Parcel Number Applicant
11004 NW 2 Avenue 1121360020240
Miami Shores, FL 33168- Block: Lot: LSP HOMES LLC
Owner Information Address Phone Cell
LSP HOMES LLC 455 NE 210 Circle Terrace (305)527-3643
MIAMI FL 33179-
455 NE 210 Circle Terrace
MIAMI FL 33179-
Contractor(s) Phone Cell Phone
Valuation: $ 12,200.00
KDF CONSTRUCTION INC (305)244-8781
Total Sq Feet: 00
Type of Work:NEW CONSTRUCTION SINGLE FAMILY HOME Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Return: Final
Classification:Residential Scanning: 1 Water RainReviewmbing
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Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $7.60
DBPR Fee Invoice# PL-1-16-58362
$6.41 09/26/2015 Credit Card $50.00 $413.62
DCA Fee $6.41
Education Surcharge $2.60 01/28/2016 Credit Card $413.62 $0.00
Permit FiF $427.00
Scannin Fee $3.00
Technollg Fee $10.40
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Total: $463.62
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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"ttiereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting,th'is permit I ssume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRI AL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
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OWNERS AFF' IT: Ice9thtall the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construc a zoning. Fu e,I authorize the above-named contractor to do the work stated.
If January 28, 2016
Ahori ed Si ture:Owner / Applicant / Contractor / Agent Date
Buil fiig Department Copy
January 28, 2016 1
-� Miami Shores Village CEIVED
Building Department JAN 15 2016
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305)795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305)762-4949
FBC 20/ZI-&&�,
BUILDING Master Permit No.P_Z._—71
PERMIT APPLICATION Sub Permit No.P L 1/h w--L3
F-]BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /1000 �W Zl4dL-
City: Miami Shores County: Miami Dade Zip: 33/ L 'f
Folio/Parcel#: 11 - 2-134 _VU Z"U ZyO Is the Building Historically Designated:Yes NO
Occupancy Type: Load: ICoctrnstr�uction Type: / Flood Zone: BFE: FFE:
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OWNER: Name(Fee Simple Titleholder): Jr y 4,P S C Phone#: 3(11^s2 7 Sar Y 3
Address: y�S� xG Z10 aIC/ ,�/
City: 1" yk4 y State: 1"L Zip: 33/ 7
Tenant/Lessee Name: / Phone#:
Email:
CONTRACTOR:Company Name: Phone#:
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Address:
City: s,s, .�...�-..e.2 State: �L— Zip: 3Y7 V4
Qualifier Name: Phone#:
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State Certification or Registration#: [� /cC J�2 �I.3 S Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ /a7 Ped. Oz) Square/Linear Footage of Work: Zcf�{s9"-
Type of Work: ❑ Addition ❑ Alteration / I] New F-1 Repair/Replace ❑ Demolition
Description of Work: N�'–K� �e--i s 1,v� 7(koL_ S'�Sri r�
Specify color of color thru tile:
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Submittal Fee$ Qj` Permit Fee$ 2 CCF$ �//.60 CO/CC$_
Scanning Fee$ ' Radon Fee$ DBPR$ Notary$
Technology Fee$�� . 'l� Training/Education Fee$ vim �6 Double Fee$
Structural Reviews$ Bond$ Xf
TOTAL FEE NOW DUE$ 7663 •G 2"
(Revised02/24/2014)
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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 ELECTRICAL WORK,PLUMBING, SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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
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�twas
er o Agent Contractor
The foregoing instruume acknowledged before me this a The foregoing instrument was acknowledged before me this�
day of�S�t,20 P5,by day of fir,20��,by 44,r f 141, /r �G��r'
who is personally known to me or who has prod' ed�_ who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:Sig .'
Sign:
Print: A M 1 Q- n i r1—S Print:
My Commission Expires: JAMIE JENKINS My Commission Expires: JAMIE JENKINS
MY COMMISSION#FF009945 MY COMMISSION#FF009945
EXPIRES:April 21,2017 EXPIRES:April 21,2017
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)