PLC-17-549 Permit NO. PLC-3-17-549
OREs , Miami Shores Village Aft t Permit Type:Plumbing-Commercial
10050 N.E.2nd Avenue `Pur Work Classification:Addition/Alteration
Miami Shores,FL 33138-0000 Permit Status:APPROVED
lo Phone: (305)795-2204
IV Issue Date: 3115/2017 Expiration: 09/11/2017
Project Address Parcel Number Applicant
Street 1132060132480
Miami Shores, FL Block: Lot: MIAMI SHORES VILLAGE
Owner Information Address Phone Cell
MIAMI SHORES VILLAGE
Contractor(s) Phone Cell Phone Valuation: $ 900.00
RCR PLUMBING SERVICES, INC. (305)336-1646 (305)336-1646
Total Sq Feet: 40
Type of Work:INSTALLATION OF FUEL LINES FROM THE Available Inspections:
Type of Piping: Inspection Type:
Additional Info: INSTALLATION OF FUEL LINES FROM THE Top Out
Classification:Commercial Re Pipe
Scanning:3 Main Drain
Heater
Water Service
Water Main
Lavatory
Final
Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# PLC-3-17-63133
DBPR Fee $2.25
DCA Fee $2.25 03/02/2017 Credit Card $50.00 $115.10
Education Surcharge $0.20 03/15/2017 Money Order $ 115.10 $0.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $165.10
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 ce5o that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and Ker r authorize the above-named contractor to do the work stated.
March 15, 2017
AuIzed Signature: r / Applicant / Contractor / Agent ate
Building Department Copy
March 15,2017 1
1 >-w
Miami Shores Village i
�cRIVED
Building Department MAR 2 2017
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 S-�l
FBC 201LI
BUILDING ,,;` Master Permit No. PW-2-16-323
PERMIT APPLICATION ��` Sub Permit No.Pt r F) 'S�
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
❑■ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 135 NE 97th Street
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: 1132060132480 Is the Building Historically Designated:Yes NO X
Occupancy Type: N/A Load: N/A Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Village Of Miami Shores Phone#:305-795-4857
Address: 10050 NE 2nd Ave
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Tom Benton (Village Manager) Phone#:305-795-4857
Email: bentont@miamishoresvillage.com
CONTRACTOR:Company Name: RCR Plumbing Services Phone#: 305-336-1646
Address: 8835 SW 107th Avenue, Suite 169
City: Miami State: FL Zip: 33176
Qualifier Name: Ramon Rodriguez Phone#: 305-336-1646
State Certification or Registration#: CFC1429270 Certificate of Competency#:
DESIGNER:Architect/Engineer: CPH, Inc. Phone#: 305-274-4805
Address: 1992 SW 1st Street City: Miami State: FL Zip: 33135
Value of Work for this Permit:$�*9 00 '7 jjgj j Square/Linear Footage of Work: 40 LF
Type of Work: ❑ Addition ❑ Alteration ❑■ New ❑ Repair/Replace ❑ Demolition
Description of work: Installation of fuel lines from the on-site 1000 gallon above ground storage tank to the
day tank and generator
Specify color of color thru tile: t G
Submittal Fee$ Permit Fee$ 1 0 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ r
(Revised02/24/2014) I I C ICD
Bonding Company's Name(if applicable) N/A
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 sw2b osted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature / Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 by day of !A A(LC LA20 by
A ,
=9Y x rwho is ersonally kno n to 0 4uC
Bt1r o has produced as aiworwho has produced 3� as
i0e�tifi tion and who did take an oath. identification and who did take an oath.
PUBLIC: NOTARYPUB
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APPROVED BY — Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)