PL-16-3199 pwnjt
wo
.s Rte$c, Miami Shores Village � �!)€ P(� )' aF�ess�dl�ritial \
10050 N.E.2nd Avenue NE
a I/i%tktittil Psi Private
Miami Shores,FL 33138-0000 � �
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Phone: (305)795-2204 . - � •-•-,
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''Issue,t tek 1112312,0,1 v Expiration: 05/22/2017
Project Address Parcel Number Applicant
889 NE 97 Street 1132060142650
Miami Shores, FL 33138- Block: Lot: EDORADO 8 CATHERINE RIBE7 ,
Owner Information Address Phone Cell
EDORADO&CATHERINE RIBETTI 889 NE 97 Street (305)609-7323 (786)612-9664
MIAMI SHORES FL 33138-
.
889 NE 97 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 900.00
AQUARAMA POOL INC (305)934-4226
. . _... _..._. _ . . . .:.. . __. ..,. Total Sq Feet: 0
Type of Work:POOL PIPING Available Inspections:
Type of Piping: Inspection Type:
Additional Info:POOL PIPING Main Drain
Bond Return: Final
Classification:Residential Scanning: 1 Rough
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60 Invoice# PL-11-16-62156
DBPR Fee $3.38 11/23/2016 Check#:2965 $236.36 $0.00
DCA Fee $3.38
Education Surcharge $0.20
Permit Fee $225.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $236.36
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING MMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is a to that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named tr t o do the work stated.
November 23,2016
Authorized Signature:Owner / Applican / Agent Date
Building Department Copy
November 23,2016 1
Miami Shores Village '
Building Department 2 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ,
Tel:(305)795-2204 Fax:(305)756-8972 7BY'' -
INSPECTION LINE PHONE NUMBER:(305)762-4949 Com.—M
FBC ZO1
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. L- 1 �6z3I61 °r
F-IBUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type:SV—.V— Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Phone#�? -44ZZ4e
Address: -! ta a..:::
City: State: F7.4-1 Zip:
Tenant/Lessee Name: Phone#:
Email: RA�eLvyx4RIn
ti
CONTRACTOR:Company Name: Nl oti/ Phone �?-'I A2269
Address: � -� !�� iCl V"1
City: State: Zip: 342
Qualifier Name: t ' Phone#:
State Certification or Registration#: I:J C JL4 (0 7�g!) Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ew EJRepair/Replace ❑ Demolition
Description of Work: PG
RUL Fiv f 06
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
t A
Bonding Company's Name(if applicable)
Bonding Company's Address
City State ip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a p it to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance.- a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdicti 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 approve and a reinspection fee will be charged.
Signature Signature
L--�( OWNER or AGENT CONTRACTOR
T e foregoing instruments ac owled ed before me this T e ore oing instrumVIP7
acknowledged before me this
day of g 20 by day of 20� ,by
personally known to who ic. to
me or 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 PUBLIC:
IVIS SANCH EZ
�o MY COMMISSION#FF158432 ;:if ®w..'` IVIS SANC EZ
Sign: F ,: XPIRES Sep ber 9,2018 Sign: w CSM IgSION#FF1584 ?,
Print: Print: 144
5�edh
Seal: Seal:
i
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)