PL-16-2421Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Perri* NO. PL -8-16-2421
Permit Type: Plumbing - Residential
Work Classification: Pool - Private
Permit Status: APPROVED
Issue Date: 12/28/2016 Expiration: 06/26/2017
Parcel Number
Applicant
1000 NE 96 Street
Miami Shores, FL
1132060143560
Block: Lot:
DAVID KING
Owner Information
Address
Phone
CeII
DAVID KING
1000 NE 96 Street
MIAMI SHORES FL 33138-
(617)755-6875
Contractor(s) Phone CeII Phone
RIGHT CHOICE POOLS & SPA INC (954)345-7277
Valuation:
Total Sq Feet:
$ 4,000.00
450
Type of Work: CONNECTION PLUMBING, AND HEATER TO
Type of Piping: CONNECTION PLUMBING, AND HEATER TO
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
$2.40
$3.38
$3.38
$0.80
$225.00
$9.00
$3.20
$247.16
Pay Date Pay Type
Invoice # PL -8-16-61158
08/31/2016 Check #: 4472 $ 50.00 $ 197.16
12/28/2016 Check* 4736 $ 197.16 $ 0.00
Amt Paid Amt Due
Available Inspections:
Inspection Type:
Main Drain
Final
Rough
Review Plumbing
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 28, 2016
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
December 28, 2016 1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
dPLUMBING ❑ MECHANICAL
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
RF:CF,TVED
BY.
AUG 31 2016
Imo'
((,,F��BC 20 !! II /�
Master Permit No. ( ) c P t - 2..`1 Zb
Sub Permit No. Irik. -1(0 - 2 (-(7
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
JOB ADDRESS: 1000 NE 96 STREET
DRAWINGS
City: Miami Shores
County: Miami Dade
Zip:
NO X
Folio/Parcel#: 1 1-3206-014-3560 Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): DAVID KING & CYNTHIA HERBST
Address:1000 NE 96 STRRET
BFE:
FFE:
Phone#: 617-755-6875
City: MIAMI SHORES
State: FL zip: 33138
Tenant/Lessee Name:
Email:
Phone#:
CONTRACTOR: Company Name: RIGHT CHOICE POOLS & SPAS,INC.
Address: 3855 NW 124 AVE
Phone#: 954-345-7277
City: CORAL SPRINGS State: FL
Qualifier Name: CHRIS BARRASS
State Certification or Registration #: CPC1458305
DESIGNER:
Architect/Engineer: 4of " Qj\ J `-Fel `�► j'
Address: i)1 S •� . rabIQ 1.CiA.P
Value of Work for this Permit: $ ' 000
Type of Work: ❑ Addition ❑ Alteration
33065
Phone#: 954-261-9013
Certificate of Competency #1 KO -a5 —
nnII Phone#:
City: +� i State: ML.. Zip: 3? I %°i
Square/Linear Footage of Work:
❑■ New ❑ Repair/Replace ❑ Demolition
Description of Work: CQ\(1Q (* -D1 h;n Ci cc
Specify color of color thru tile: 13‘ u2
Submittal Fee $ Permit Fee $ (( G
Scanning Fee $ Radon Fee $ 3 • 3 O
Technology Fee $ 3 2 Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF$ Z •`A O
DBPR $ 3 . 3 c'
. $cD
4
CO/CC $
Notary $ -Or
Double Fee $
Bond $
TOTAL FEE NOW DUE $
cl q • R (o
I 1
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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
I day of , 20 I , by
bQ (2 i'\ kj n9 , who is personally known to
me or who has produced L i 0 -A .a.2 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
_,�; m,5 NANCY CALTABIANO
:._ ,•, ..,- MY COMMISSION 1 FF 956746
.�� : EXPIRES: February 2.2020
. Bonded Thru Notary Public Underwriters
11
1
Signature
CON TOR
The foregoing instrument was acknowledged before me this
day of k), t
i \r - (F5rilMA<SS, ,whoisp
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Lisa Hyman
Notary Public - State of Florida
Commission#FF 930671
Expires 10/26/2019
************************************************************************************************************
APPROVED BY
(Revised02/24/2014)
16 - if, Plans Examiner Zoning
Structural Review
Clerk