PL-16-3092 Permit NO. PLA 1-16-3092
5NR'US L�� Miami Shores Village t Permit Type:Plumbing-Residential
10050 N.E.2nd Avenue NWWork Classification:Addition/Alteration
Miami Shores,FL 33138-0000 '
a gas Phone: (305)795-2204 Permit Status:APPROVED
FCORiDf''
Issue Hate:212112017 Expiration: 08/20/2017
Project Address Parcel Number Applicant
102 NW 93 Street 1131010330900
Miami Shores, FL 33150- Block: Lot: JONI HARRIS
Owner Information Address Phone Cell
JONI HARRIS 102 NW 93 ST
MIAMI FL 33150-2235
Contractor(s) Phone Cell Phone
Valuation: $ 15,000.00
MG PLUMBING&SPRINKLER SERVI( (305)525-9236 Total Sq Feet: 60
Type of Work: RENOVATE GUEST BATH AND ROOM.NEW C Available Inspections:
Type of Piping:
Inspection Type:
Additional Info:
Top Out
Bond Return: Final
Classification: Residential Scanning: 1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $9.00
Invoice# PL-11-16-62038
DBPR Fee $6.75 02/21/2017 Credit Card $490.50 $0.00
DCA Fee $6.75
Education Surcharge $3.00
Permit Fee $450.00
Scanning Fee $3.00
Technology Fee $12.00
Total: $490.50
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 Ldzoning.
I certify that all t foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructioFuthermore 't or* t bove-named contractor to do the work stated.
February 21, 2017
horized ' nature:Owner / plicant ontractor / Agent Date
Bui ing Departme Copy
February 21, 2017 1
Miami Shores Village %A Q. i
Building Department ���
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 _
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20(C./
BUILDING Master Permit No-EL I(- 3d(Q
i
PERMIT APPLICATION Sub Permit N
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
VOILUM ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:] CANCELLATION ❑ SHOP
`` 1� ,,� CONTRACTOR DRAWINGS
JOB ADDRESS: I fl N �`0 S��el—
City: Miami Shores County: Miami Dade Zip: 33 f
,,qW
Folio/Parcel#: It _3 io) -b33-129Da Is the Building Historically Designated:Yes NO
Occupancy Type: S�F Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER: Name(Fee Simple Titleholder): �l/ROa�' �6 4AD_aL c_ Phone#:
Address: DC7 Z_ �l V4• -1-5
City: Wk S l''Q� State: Zip:
Tenant/Lessee Name: Phone#:
Email: s
CONTRACTOR:Company Name: �C7 (31 'ca
�/.�c t�14CR f�Zyr 1 one#:
Address: iL 4.5 ill!? �a3 S✓r'
City: 6 !S IState: Zip:
Qualifier NamPhone#: Zej_-i"1--5�%23�
State Certification or Registration#: Cf d5Z,9 Zy Certificate of Competency#:
DESIGNER:Architect/Engineer: ( P� Phone#: 3!:--�-33w-GLUJ
Address: Z - 1'z cam City: W State: ;:"( Zi
Value of Work for this Permit:$ 1 ae:s C)• — quare/Linear Footage of Work: 1c� f—
Type of Work: ❑ Addition E1 Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:' O t)
� OD
Specify color of color thru tile:
Submittal Fee$ ' Permit Fee$ �b CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ �"l
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address _
City State A Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to Iobtain 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 YOUAENDER 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"'"
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of� _� 20 14 by _day of/VO L&Z jj A,e 20 L�g , by
�d who is personally known to J who is personally known to
me me or who has produced t fl tSbm4—LL
idemtifKatiorr and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
AL
••.•;p�'„ga�,' SIE AE LF
Sign: Sign:
Print: Print: i-M res ct
T"PWN.•.,' %° Bonded Through National Notary Assn.
Seal: * * MY COMMISSION t FF 167000 Seal:
EXPIRES:January 24,2019
.Med Ttn Budget Notary Servkes
APPROVED BY -Z�� / Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)