The URL can be used to link to this page

PL-15-574Project Address Miami Shores Village 10050 N.E. 2nd Avenue N Miami Shores, FL 33138-0000 Phone: (305)795-2204 Pe mit Permit NO. PL -3-15-574 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED fatale Date: 811712015 Expiration: 02/13/2016 Parcel Number Applicant 9290 N BAYSHORE Drive Miami Shores, FL 33138- 1132050270240 Block: Lot: RICKI LONDON Owner Information Address Phone CeII RICKI LONDON 9290 N BAYSHORE Drive MIAMI SHORES FL 33138-2949 9290 N BAYSHORE Drive MIAMI SHORES FL 33138-2949 Contractor(s) Phone AA MASTERS MECHANICAL AIR MOV (305)559-7004 Cell Phone Valuation: Total Sq Feet: $ 8,100.00 00 Type of Work: NEW PLUMBING SYSTEM NEW BATHROOMS A Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $5.40 $4.50 $4.50 $1.80 $300.00 $9.00 $7.20 $332.40 Pay Date Pay Type Amt Paid Amt Due Invoice # PL -3-15-54812 08/17/2015 Check #: 429 $ 332.40 $ 0.00 Available Inspections: Inspection Type: Top Out Final Review Plumbing Underground 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 '• ccurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-na ed c.� tractor to do the work stated. Authorized Signature: Owner / Applicant / Co t act• / Agent Building Department Copy August 17, 2015 Date August 17, 2015 1 0 4 BUILDING PERMIT APPLICATION UILDING ❑ ELECTRIC PLUMBING Miami Shores Village 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 2010 Master Permit No.[ l,, 20 Sub Permit No. L ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP %�r� CONTRACTOR DRAWINGS C� JOB AnnrPFcc• c C u �L 04q, 0/ City: Miami Shores County: Miami Dade Zip: 3�1-8 Folio/Parcel#: (("--5 S' �-1 J Is the Building Historically Designated: Yes NO 11- Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name (Fee Simple Titleholder): �L t I \_,,;11,&w\_,,;11,&w Phone#: �� q41,-+ Address:'3 1le� \%-ti City: %-tIIntNt1 Tenant/Lessee Name: Phone#: Email: !t^i_( .t Li1 G din P)JUY\QnC ProCLS . (D A4 State: Zip: 5 fin- ill k... ah Ol/�� f 'it --e".16. CONTRACTOR: Company Name: e:/ /U"c �l Pt S R / Phone#: '7e6 `- �,w 3 Address: / V / s UJ f C! d ��/��4 City: P_ / j /� State: •1' --- Zip: S i'',6 Qualifier Name: 7�,(-� (( rr-/'/[.c.... Phone#: State Certification or Registration #: f. / :/-6 1 6 ci Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address:((�� City: State: Zip: Value of Work for this Permit: $ B (0 t Square/Linear Footage of Work: Type of Work: ❑ Addition�j` I Alteration Z1 New /� ❑ Repair/Replace.,, / Description of Work: tv l.) f t1NMI% i grtIN I IV f g �� ra fr 1S iGN r (v ❑ Demolition Specify color of color awl( tile! iv 4e` Submittal Fee $Permit'Feei$1 a -��' XY CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ _. Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ nn / / TOTAL FEE NOW DUE s3 3, '7 Aasr (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 ail applicable laws regulating construction and zoning. moi, 1�., ti I . , 4/ "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." • j Notice to Applicant: As a condition to the issuance of a building permit with an estimated value 'exceeding $2.0, the applicant must promise in good faith that a copy of the notice of commencement rid construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notic .f commencement must be postedat the job site for the first inspection which occurs seven (7) days after the building permit 's issed. In th ',.sence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. I _ --- 1 ", i l ��•l�l 11 11' i �l J ) .I 1� •t Signatu e_ 1)\)sk 4 OWNER or AGENT The foregoing instrument was acknowledged before me this 2-1 day of •DSC— , 20 IL{ , by 9,1c4e-1 1_ r -j Oti , who is personally known to me or who has produced t� 1'1D as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: 00111111111/1/41/4 �\en1S 13/06/2016 OTARY PUBLIC �•• UrnmiSs ofl # 'r l •.EE113059... Q ��' " /1/TF OF F 10�\��• APPROVED BY ��3-fes 'iS (Revised02/24/2014) Signature CONTRACTOR The foregoln. Instru AA was acknowledged before me this `7 day of 1IJtaA1 % , 20 / by ir �( , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Plans Examiner TI1111/,C' Structural Review II/,III ►r► • JORGE ROSSEAU MY COMMISSION .s t'F t ;)O45 EXPIRE n<,;v n 3i3 (40 raa-crin F 3ti N_:': w..e.. *** ************** Zoning Clerk Miami Shores Village Building Departmen 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in 'the- case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami -Dade '\ The foregoing was acknowledge before me this 2M day of UQ , 20 / /. By g:CAZ Zee ,L it So ho i as identification. Notary: SEAL: ersonally known to m (407) 33341t or has produced st h. liffrirrl,d SEAU ll i l SSfON AFF119045 45 tirl-1 L sslapA 201t3 FlotMtKkttectrS .c.e cam Date: 03, /0. / S State of FtO(JJ A County of DOloik Mieiz /464/4 JiC I. 4tg Mo, -rl ‘ g,/6/,SOF/., A‘ S YSTEi c CDT, 5, 2 5_ g Mill Ann j L 3.99 Before me this day personally appeared TSc u 6aeA a who, being duly sworn, deposes and says: ,7z3_,< 044- 6h -t -r (ie'Lt11.0-/ /.4-LAAAvvio 4210 IV Sok yJ'lvor€c Dr. Al t'k. i £l,or-ti FL 33/ 38 Sworn to (or affirmed) and subscribed before me this 3Gsus f -pr ` JORGE RoSSE.AU I my COMMISSION AFT119a,15 ;F>> Mov n ;;Z:110 day of Mikeori . 20 IS, by Personal vsl ncva OR Produced Identification Type of Identification Produced , Pr i t, Type or Stamp Name of Notary y 1/ 1 BUILDING PERMIT APPLIC BUILDING ❑ ELECTRIC ❑ ROOFING LUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: `r�9c /Y Miami Shores Village 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 ❑ CHANGE OF CONTRACTOR r Permit No. FBC 20 / X ril -C i6 .2-0- b Permit No.'1S r591i ❑ EXTENSION ❑RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS s oe 3 0 City: Miami Shores County: Miami Dade Zip: 3 (30 Folio/Parcel#: Is the Building Historically Designated: Yes NO x Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �C` i to .41 ib04 Phone#: 722.374'/% 47246 N .41,5 /As/L.= Da City: N4 (4*. t S,4 State: FL- _Zip: ! g Address: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: 44- +MA is "ieuilbv,tifve ih2 MbYlh(r Phone#: 6704 —7C ' -1,13b Address: KO/ ciosi /05 72A2 %' SZS City: /1'1 t Ih41 State: F – Zip: ?J' ; (94 Qualifier Name: Fe/ ,C Oc ?as 6t, Phone#: wig -74 $- 933o State Certification or Registration #: C_ -f_/9 2 C/i 9 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: ,, c� City: State: Zip: Value of Work for this Permit: $gtate% !bp Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration nn__-- -- ❑ New n Repair/Replace ❑ Demolition Description of Work: PINS (�I Sraru /1& RovE UNC 64.61 IN0 CIAS 9 ritorta? Trak _ ir"v ovt 6444 ue I.A-rnYt40^4 Specify color of color thru tile: Submittal Fee $ Permit Fee $ /75 ;4."."/ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ Li (Revised02/24/2014) Bon- 'ng 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. 1 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 brochur will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commenc ent must be posted at the job site - for the first inspection which occurs seven (7) days after the building permit is ' j d. Ir absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signaturit WA ` OWNER or AGENT The foregoing instrument was acknowledged before me this 0 day of N O\JC,20 ,by Ci l 1 .. Ofd , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: C j r i cp Seal: ********** CHRISTINA FRIG() MY COMMISSION # FF229344 '5400,41.EXPIRES: May 11, 2019 *********** ******** Signatu CONTRACTOR The for:f. ing instrument was acknowledged before me this 301 day of h t) e_.,t-I Qit , 20 (>c , by cQ aQ�JS 602 -VI's •l,who is pe s�alOcnown to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: JORGE ROSSEAU 1Y COMMISION #FFI 19045 EXPIRES MAY 4, 2018 (407) 398-0 53 FloridallotaryService.com ******************************************************************* APPROVED BY (Revised02/24/2014) d''fls Examiner Structural Review Zoning Clerk