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PL-15-1156 156 Miami Shores Village ?nei1 10050 N.E.2nd Avenue NE 3 vrkC1aaa� AtldittolrtltAlt�ii` tion, Miami Shores,FL 33138-0000 Phone: (305)795-2204 Perm' (apt , iRPl t VEi3 ; 2Q1 Ex ration: 02/20/2016 � p Project Address Parcel Number Applicant 1285 NE 95 Street 1132060144020 Miami Shores, FL Block: Lot: ROBERT AND NANCY FREHLINt Owner Information Address Phone Cell ROBERT AND NANCY FREHLING 421 E SAN MARINO Drive MIAMI BEACH FL 33139- 421 E SAN MARINO Drive MIAMI BEACH FL 33139- Contractor(s) Phone Cell Phone Valuation: $ 450.00 GRAY DOLPHIN POOLS&CONSTRU( (305)207-0606 Total Sq Feet: 0 Type of Work:PLUMBING FOR POOL Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning: 1 Review Plumbing Underground Fees Due Am]00 Pay Date Pay Type Amt Paid Amt Due CCF Invoice# PL-5-15-55580 DBPR Fee 08/24/2015 Credit Card $236.36 $0.00 DCA Fee Education Surcharge Permit Fee $ Scanning Fee Technology Fee Total: $23 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 cpytV that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning ore,I authorize the above-named contractor to do the work stated. August 24, 2015 Authorized Sign to :O ner / Applicant / Contractor / Agent Date Building D pa ent Copy August 24,2015 1 FIRR5 Miami Shores Village I MAY 155 Building Department �BY:_9= 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 BUILDING Master Permit No. S —� PERMIT APPLICATION Sub Permit No. Q m 0�ip ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1285 NE 95 STREET Com: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-014-4020 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Robert & Nancy Frehling Phone#: Address:1292 NE 95 STREET City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: is CONTRACTOR:Company Name: Gray Dolphin Pools & Construction, Inc Phone#: 305-207-0606 Address: 16225 SW 117 AVE UNIT#D14 City: MIAMI State: FL Zip: 33177 Qualifier Name: Raonel Lopez Phone#: State Certification or Registration#: CPC1457551 Certificate of Competency#: DESIGNER:Architect/Engineer: Oppeniteim Architecture & Design Phone#: 305-576-8404 Address:245 NE 37 ST SUITE #102 �/ City: MIAMI State: FL Zip: 33137 Value of Work for this Permit:$ T Gt � Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Lp W Specify color of color thru tile: j el Submittal Fee$ Permit Fee$ Z 7,5 K-y 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) . W 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 wi ered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of comme ust be pa ted at the job site for the first insp tion which occurs seven (7) days after the building permit &. In en a of such osted notice, the inspection will no;K7ection fee will be charged. d � Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this regoing instrument was ackn Red before me this day of 4 20 l ,by day of 20 by ,OW—k ark (U VAIN .who is personally known to who is personally known 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: i Sign: Sign: Print GL Print: < 4Y a� qv � �; EE855016 Seal: Seal: d' "9r�li�A Iv1 SP�I�TOVdIA l N� °J vc nb 29.,2016 (Pft1vI1SSl0N 9 EE855016 29,2016 *>k�**x�x�**a**�*****+*e�*�er�***�x*****�x��***x�*x�**�x*****x��*******+►�****��x*�**��`�***+r<�x�e****�**a�w**��********�>k�*� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)