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PL-17-1537 WE- E entia7° Miami Shores Village rl " 10050 N.E.2nd Avenue NE WQ�I;lassif�c r bn ldditiol Witarata an Miami Shores,FL 33138-0000 �� €� � RVEd' s lite Phone: (305)795-2204 SI2tt7 Expiration: 12/1 /2017 Project Address Parcel Number Applicant 275 NE 94 Street 1132060133830 JOSE AMADOR Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell JOSE AMADOR 275 NE 94 Street (305)484-6527 MIAMI SHORES FL 33138- 275 NE 94 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 700.00 MILLENNIUM PLUMBING LLC (561)674-7727 _... Total Sq Feet: 0 Type of Work:INSTALL FLUE PIPE FOR GAS WATER Available Inspections: Type of Piping: Inspection Type: Additional Info:INSTALL FLUE PIPE FOR GAS WATER Top Out Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# PL-6-17-64268 DBPR Fee $2.00 06/08/2017 Credit Card $50.00 $64.60 DCA Fee $2.00 Education Surcharge $0.20 06/21/2017 Credit Card $64.60 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 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 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. Futhermo =thrize above-named contractor to do the work stated.G� June 21, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy June 21,2017 1 Miami Shores a RECEIVE Villa L) g Building Department A 6806 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 5� FBC 201`1 BUILDING Master Permit No. LF F-A —&O-S PERMIT APPLICATION sub Permit No. (2 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ;4PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP n I CONTRACTOR DRAWINGS p�/, JOB ADDRESS: S "I`Y �4 's City: Miami Shores County: Miami Dade Zip: -3136 Folio/Parcel#: l 1-3 Z®-� Q Q 31J;3 o Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Y Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):� MO YA .414AX4 Phone#: Address: l: City: C State: Zip: ( 3 Tenant/Lessee Name: Phone#: Email: "�I`�gl 44' CONTRACTOR:Company Name: !.[.�Ji1siU�� L Phone .� r Address.///--? City: State: �� Zip: Qualifier Name: v �e Phone# State Certification or Registr tion#: �/ � y' � Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ ��@ l Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee$ Permit Fee$ 16® CCF;$ CO/CC$ Scanning Fee$ Radon Fee$ DBPRC$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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 nd a reinspection fee will be charged. s1 � Signature Signatu orNER 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 Sj� 2 1 by "_ ©,SF �1/ITAm i personally knowo who is er �knZown o me or who has produced as me or who ha produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTAR�LP IC: Sign: Gz Sig l Print: �� ( L V/� / �.� �t//CJ Print: A Seal: s��•w, Seal: " ThalsaiB Sta�eotRorMs V 0 SlLVAIR DAC ,,�;., DasWa . , Commission N FF i> �pf CiO0810B8 OOuI MY Commission f•,;;res APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)