PL-15-3210Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. PL -12-15-3210
Permit Type: Plumbing - Residential
Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 1/2112016 Expiration: 07/19/2016
Parcel Number
Applicant
82 NW 98 Street
Miami Shores, FL 33150-
1131010330230
Block: Lot:
NYCE DANIEL
Owner Information
Address
Phone
Cell
NYCE DANIEL
82 NW 98 Street
MIAMI SHORES FL 33150-
(786)517-7915
82 NW 98 Street
MIAMI SHORES FL 33150-
Contractor(s)
PRACTICALITY INC
Phone
(786)972-5602
Cell Phone
Valuation:
Total Sq Feet:
$ 2,500.00
0
Type of Work: PLUMBING WORK FOR GARAGE CONVERSION
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
$1.80
$4.50
$4.50
$0.60
$300.00
$3.00
$2.40
$316.80
Pay Date Pay Type
Invoice # PL -12-15-58197
01/21/2016 Credit Card
Amt Paid Amt Due
$ 316.80 $ 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 a, irate an. •. all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named . ; . -.44r r to�.. e� k slat
„i �' January 21, 2016
Date
Authorized Signature: Owner / Applicant /
Building Department Copy
January 21, 2016 1
E Is -3z09.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-250233 Permit Number: PL -12-15-3210
Scheduled Inspection Date: March 01, 2016
Inspector: Hernandez, Rafael
Owner: DANIEL, NYCE
Job Address: 82 NW 98 Street
Miami Shores, FL 33150 -
Project: <NONE>
Contractor: PRACTICALITY INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number (786)517-7915
Parcel Number 1131010330230
Phone: (786)972-5602
Building Department Comments
PLUMBING WORK FOR GARAGE CONVERSION
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
\A(t'
February 29, 2016
For Inspections please call: (305)762-4949
Page 7 of 22
GC- CGC1508386 Rooting- CCC1326760 Electrical-EC13004092 Plumbing-CFC1428324
Engineering-PE61745 Mechanical CMC 1250145 Home inspector HI5270
IIRACTICALITY CONTRACT
www.PracticalityConstruction.com
Date: Dec 10, 2015
State of Florida
County of Broward
Before me this day personally appeared \"L'6 S L (14/ti who, being duly sworn, deposes and says:
That he will be the only person working on the project located at:
Sworn to (or affi
d subscribed before me this /Qday of
sTL
20 fr-by
Personally Known
OR
Typ
rode,
en 1 Ica 1.
MYRTELLE PERRAULT
MY COMMISSION #FF035074
of.'.l'.:.i bleation P>XOU:l J„ly 10. 2017
(407) 398-0153 FloridaN• arySeroice.c, n
Prin Ty.,' or Stamp Nam ' of Notary
Miami Shores Viiiage
Building Department
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 gay ofj e �,�,,, c�� , 20 /S
By ?.J y
who is personally known to me or has produced
ntification.
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
PLUMBING ❑ MECHANICAL
JOB ADDRESS:
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
Master Permit No.
Sub Permit No.
❑ ROOFING • REVISION
❑ PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
FZ N� - j7Z
FBC 20
Tie IS -321J9
is-3a(U
❑ EXTENSION ENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: (QS(r/p7Load: Construction Type: Flood Zone: BFE: FFE:
e /
OWNER: Name (Fee Simple Titleholder): r -I y L (_ %g iv / ` Phone#:2 e,6 .... ,..5---/ ?/ r
Address: 3 2 /V 6-U 9 g 53 /V
City: Hi. T h2 / S h 0.4- & S State: L Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: /0i- ?G4/ C ? /, ZC y i N e Phone#:
Address: %Q2,//-4,..) 'ice * (J e r)41 0 /
City: C.6cokik/ cX-eAla<f State: 03-Z._ �p zip: 5'36,--a'Qualifier Name: AJ eS Zug] A Phone#:?sf 3, ? 80/9
State Certification or Registration #:(4.c../929 3,2 fCertificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Square/Linear Footage of Work:
Value of Work for this Permit: $
Type of Work: ❑ Addition Alteration ❑ New
Description of Work:
C;/(� &t. ! .4 2it CA ae/ioff
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
❑ Repair/Replace ❑ Demolition
e.A1ed 710
Tib C Lb $'it* - t(Z.nn
-
4..
Permit Fee $. !`Y CCF $ CO/CC $
Radon Fee $ DBPR $ Notary $
Training/Education Fee $ Double Fee $
Bond $
TOTAL FEE NOW DUE $3( 6 - 610
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.
i
Signature i Signature
OWNER or AGENT
CONTRACTOR
The forego' g instrument was kn ledged before me this The foregoing instrument was acknowledged before me this
,� ay of , 20 , by 2,L___ day of Q , 20 / J , by
t '( e --e- 0 2 Gt. I e--/ , who is personally known to Y✓GS L'1y i 4 , who is personally known to
me or who has produced as me or who has produced as
tifi ati an o did—t�apke n oat identification and who did take an oath.
TA
LI -- _ \I, 3 NOTARY PUBLIC:
NO
Sign:�� • � Sign:
Print: !��.: "� (tdtY@1Fbrida Print:
♦ � , . ane ��GGG,,``"`ti��:�io ce
Seal: Seal:
0 ISSION #FF035074
OF rti4",.•' EXPIRES July 10. 2017
07)
(4 398-0153 FloridallotaryService.com
************************************************************************************************************
APPROVED BY � 1z3"5 Plans Examiner _ Zoning
Structural Review
(Revised02/24/2014)
Clerk
115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000
VALID OCTOBER 1, 2015 THROUGH SEPTEMBER 30, 2016
DBA: Receipt #:P Li MBING/LWN SPRNKL/CONT.
Business Name: PRACTICALITY INC Business Type:
Owner Name: YVES LUBIN
Business Location: 4921 NW 48 AVENUE
COCONUT CREEK
Business Phone: 954-369-8014
Rooms
Seats
Employees
1
Business Opened:12/30/2010
State/County/Cert/Reg:CFC142 8324
Exemption Code:
Machines Professionals
For Vending Business Only
•
Vendin4 T
Tax Amount
Transfer Fee
NSF Fee
Penalty
Prior Years
Collection Cost
Total Paid
27.00
0.00
0.00
0.00
0.00
0.00
27.00
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS BECOMES A TAX RECEIPT
WHEN VALIDATED
Mailing Address:
PRACTICALITY INC
4921 NW 48 AVENUE
COCONUT CREEK, FL 33073
This tax is levied for the privilege of doing business within Broward County and is
non -regulatory in nature. You must meet all County and/or Municipality planning
and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt does not indicate that the business is legal or that
it is in compliance with State or local laws and regulations.
2015 - 2016
Receipt #04C-14-00001917
Paid 09/08/2015 27.00