PL-17-1683Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. PL -6-17-1683
Permit Type: Plumbing - Residential
Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 8/14/2017
Expiration: 02/10/2018
Parcel Number
Applicant
53 NE 102 Street
Miami Shores, FL 33138-
1132060131660
Block: Lot:
LYDIA AMADOR
Owner Information
Address
Phone
Cell
LYDIA AMADOR
53 NE 102 Street
MIAMI SHORES FL 33138-2322
Contractor(s)
ROSMEL POOLS INC
Phone
(305)592-7900
Cell Phone
Valuation:
Total Sq Feet:
$ 2,000.00
0
Type of Work: NEW POOL AND DECK
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$3.38
$3.38
$0.40
$225.00
$3.00
$1.60
$237.96
Pay Date Pay Type
Invoice # PL -6-17-64430
07/06/2017 Check #: 14643
08/14/2017 Check #: 14582
Amt Paid Amt Due
$ 50.00 $ 187.96
$ 187.96 $ 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
constru
edify at II thgoing
Futh - ore, I
Auth
formation is accurate and that all work will be done in compliance with all applicable laws regulating
amed contractor to do the work stated.
zed Signatur='Swn= /
Applicant / Contractor / Agent
Build'ng Department Copy
August 14, 2017
Date
August 14, 2017 1
(it) 74GC x,�vo��✓
(3) 37X
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
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: 53 t4.Z• toa s1.
REC°\1 ED
JO2821
S4-11
FBC 20H
Master Permit No. % — j (O'2
Sub Permit No.P'Lai '-' l
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County:
Miami Dade Zip: £3 { 31?
Folio/Parcel#: I.1-3Xio-CA Itela0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction Type:New Pbol Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Ljdic,1 Mark, 4 *1L C1 r Phone#:306- 2O1-105.25
Address: 53 nl.E• 1 G11
City: MICAM i SaOr e.S
State: Zip: 3313$
Tenant/Lessee Name: 1114 Phone#:
Email:
CONTRACTOR: Compa•ny Name: Qcsr el Pcols
Address: 'I300 A.(,V. 5 s4 • SVi
W/01.
Nl%
Io
Phone#: 3O5- -'7/03
City: %fY.4t State:
Qualifier Name: (k. I I.0 C) . L.e)Vci 'fir' .
.
State Certification or Registration #:Cv. 145Wi l l ` . Certificate of Competency #: .
DESIGNER: Architect/Engineer:' TC Gnat r rS, 1Ix.. Phone#- 5-.2 ./ -63-// •
Address: 1915 5•W , .2d %... :Alk, lit City: Ala iYl s State: fl. Zip: 33155
Zip: 33/ 7.2 -
Phone#: 303 -
Value of Work for this Permit: $ e?iCC°, CO
Type of Work: ❑ Addition ❑ Alteration
Description of Work: Ale lV Pm i '. .
Square/Linear Footage of Work:
New ❑ Repair/Replace
❑ Demolition
•
a h'1]a
Specify color of.colorsthru tile:. _.„,i
Ax
-
Submittal Fee $ /� Permit Fee $ 58.
Scanning Fee $ Radon Fee $
Technology Fee $ i ' V) 0 Training/Education Fee
Structural Reviews $
(Revised02/24/2014)
1 If
DBPR $ Notary $
Double Fee $
Bond $ _ i „
TOTAL FEE NOW DUE $ S ,
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 PROPERLY: IrYOU 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 subjectto attachment. Also, a certified copy of the'recorded notice of commencement musf 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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of M'u,t_
(,,OA Marv' k , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
, 20 11 , by
Sign:
Print:
Seal:
pVic 7 rida
rmmission 4}1397
omen. Expires1 4, 2021
dthrough National Notary Assn.
****************************************
APPROVED BY
(Revised02/24/2014)
Signature
•
CONTR TOR /
The foregoing instrument was acknowledged before me this
day, of MA•1 , 20
WaI•fr k (.,rrlvG Tr. , who is personally known to
me or who has produced
identification and who did take an oath.
17 ,by
NOTARY PUB
I
Sign:
Print:
Seal:
as
•�' • ; Commission N GG 072917
� < :i My Comm. Expires Feb 14, 2021
os F:
Bended through National Notary Assn.
***************************************************************
Plans Examiner
Zoning
Structural Review Clerk