PL-16-3215Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. PL -11-16-3215
Permit Type: Plumbing - Residential
Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 1219/2016
Expiration: 06/07/2017
Parcel Number
Applicant
541 NE 105 Street
Miami Shores, FL
1122310140260
Block: Lot:
TARIK & CATHERINE GUETARN
Owner Information
Address
Phone
CeII
TARIK & CATHERINE GUETARNI
541 NE 105 Street
MIAMI SHORES FL 33138-
(404)395-7245
541 NE 105 Street
MIAMI SHORES FL 33138-
Contractor(s)
ISLAND PLUMBING CO
Phone
(305)361-2929
CeII Phone
Valuation:
Total Sq Feet:
$ 6,000.00
0
Type of Work: NEW KITCHEN CABINETS INSTALL NEW PL
Type of Piping:
Additional Info: NEW KITCHEN CABINETS INSTALL NEW PL
Bond Return :
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$3.60
$2.69
$2.69
$1.20
$180.00
$9.00
$4.80
$203.98
Pay Date Pay Type
Invoice # PL -11-16-62176
12/09/2016 Check #: 01094
11/28/2016 Credit Card
Amt Paid Amt Due
$ 153.98 $ 50.00
$ 50.00 $ 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 accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated.
December 09, 2016
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
December 09, 2016 1
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC
*PLUMBING ❑ MECHANICAL
JOB ADDRESS: 541 NE 105 ST
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 2011
Master Permit No. Ac_ (- 3 Z 1Z
Sub Permit No. P 1 i (CJ -s 2 1 -5-
ROOFING
ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑ PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#:11-2231-014-0260
Occupancy Type: RES Load:
Is the Building Historically Designated: Yes
NO X
Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): TARIK GUETARNI CATHERINE GUETARNI
Address: 541 NE 105 ST
Phone#: 404-395-7245
City: MIAMI SHORESState: FL
Tenant/Lessee Name: N/A
Email: tguetarni@aol.com
Zip: 33138-2044
Phone#:
CONTRACTOR: Company Name:
Address: 3-243 - 02/8
City:
Qualifier Name: t' 3 Se( OV / . 1-7Ar)
State Certification or Registration #: c1- S t R 6 •
5/10 no( ?fvrnd>r��
Phone#: 306-. 36/-a/z-
6/ S rt, State: P
DESIGNER: Architect/Engineer:
Address: 9231 SW 12 STCity: MIAMI State: FL Zip: 33174
OSCAR POSADA ARCHITECT
Zip: 3311-1 `)•
Phone#: 3-15S- 333 _ 67 83 -
Certificate of Competency #:
Phone#: 305-554-1195
Value of Work for this Permit: $
6/ oar) Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑■ Alteration
❑ New
❑ Repair/Replace ❑ Demolition
Description of Work: NEW KITCHEN CABINET, INSTAL NEW PLUMBING FIXTURES SAME LOCATION
1ST FLOOR BATHROOM, KEEP SHOWER AND TOILET & SINK AT NEW LOCATION
2ND FLOOR BAT.HROOM FIXTURES SAME LOCATION
Specify color of color thru�tile: j ' r_ - ..:,•',,
Submittal Fee $ 1Lc,. J.I. Permit Fee $ • f��% CCF $ t "Ri i ++ c.1.1_, CO/CC $ .
Scanning Fee $ Radon Fee $ DBPR $ 1 — A ^.4 Notary .$_.,._.- `--
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ Q�
TOTAL FEE NOW DUE$ 15� '
(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 and a reinspection fee will be charged.
Signature af��"��^i�--1i?�ati'_''
OWNER or AGENT
The foregoing instrument was acknowledged before me this
11'* day of �1v-v - 3 . , 20 1 �' , by
l,p."�I\ec enc 5 �Je(,p,4 �, who is personally known to
me or who has produced (36S -13? -$1-630-0 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
**********
1401 aaa-015a
APPROVED BY
(Revised02/24/2014)
GeOROINA SALVATORE
MY COMMISSION # FF911149
* "r/tIbq S *August f 2019*
Senna
*
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
a -D` day of !"' 1/4)04SeS , by
I _ 2r...oulG
o is personally know to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Plans Examiner
Structural Review
• ," rye y Public State of Florida
�Notary Catherine Petit
ir My Commission FF 957875
Expires 02/07/2020
*
Zoning
Clerk