PLC-17-2568Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Pe
mit
Permit NO. PLC -10-17-2568
Permit Type: Plumbing - Commercial
Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 11/7/2017 Expiration: 05/06/2018
Parcel Number
Applicant
9537 NE 2 Avenue
Miami Shores, FL 33138-
1132060133910
Block: Lot:
DVS LLC
Owner Information
Address
Phone
Cell
DVS LLC
9400 NE 2 Avenue
MIAMI FL 33138-
(305)756-3711
Contractor(s) Phone
FIAT PLUMBING & GENERAL CONTR, (305)446-6366
CeII Phone
Valuation:
Total Sq Feet:
$ 20,000.00
0
Type of Work: NEW WORK TO BE DONE AS PER PLAN NEW
Type of Piping:
Additional Info: NEW WORK TO BE DONE AS PER PLAN NEW
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$12.00
$9.00
$6.00
$4.00
$600.00
$3.00
$16.00
$650.00
Pay Date Pay Type
Invoice # PLC -10-17-65486
11/07/2017 Credit Card
10/30/2017 Credit Card
Amt Paid Amt Due
$ 600.00 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Re Pipe
Main Drain
Heater
Water Service
Final
Water Main
Lavatory
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 AFFID
construction
T: I certify that all the foregoing info ation is accurate and that all work will be done in compliance with all applicable laws regulating
ng. Futh rmore, I - . ize the a • e -named contractor to do the work stated.
utho ized Signat wner / / pplicant /
Building Department Copy
/ Agent
November 07, 2017
Date
November 07, 2017
1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION
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
RECEIVED
OCT 302017
FBC 20 R -i
Master Permit No. CC /7- 3?6.
1 C ) —ZSCo8
Sub Permit No.
,PLUMBING ❑ MECHANICAL []PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: 9 S-37
❑ EXTENSION ❑ RENEWAL
❑ CANCELLATION
❑ SHOP
DRAWINGS
City: Miami Shores
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
County: Miami Dade
Zip: 3'3 /-3e
OWNER: Name (Fee Simple Titleholder): u
Address: q 6/0 0 A) . ..2/41)&__
City: l. -'t t` A -i" -i 1 State: Zip: 3 3 / 31?
Tenant/Lessee Name: Phone#:
Email:
Phone#: 3 or 7 37 /1
CONTRACTOR: Company Name: P7/21-7— .l {, j1 )A) a
Address: `7 ?- -7 6 (-4._.) 3 is 4-1)
/---17(__ Zip: 3 3 13 3
City: Pi l‘ %�-/�- / Sta�t/e�
Qualifier Name: -J CD /L- (z A /4/ 4-7" Phone#: .3 O S-.3 Do L, S 3 4
State Certification or Registration #: C F7C C,' S 9" 7 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Phone#: 3 d T f 636
Value of Work for this Permit: $ x 2-0, 000 .exp
Type of Work: ❑ Addition ❑ Alteration
Square/Linear Footage of Work:
❑ New 0 Repair/Replace
Description of Work: % t4.R.w w00
❑ Demolition
tbC, it ects P LCWN •
Specify color of color thru tile: /
Submittal Fee $ Permit Fee $ �" �' CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 6 - a DBPR $< - GNotary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ Com - GO
(Rovi': dfl7hdbrildl
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
,�1J day of f (rdD ,20 /7 ,by
/2f1 1- cr-n 4t 1 , who is personally known to
f
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
MY COMMISSION M FF953536
EXPIRES January 25.2020
140/) 39A-0' S3 FloridMleteySewrce aur
Signature �b --�-✓
CONTRACTOR
The foregoing instrument was acknowledged before me this
' day of Cr.C,20 77 ,by
3046 € A-• 4.1 4T , who is personally known to
me or who has produced 6 Z.—
identification
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
... a :. orida
. . Jessica C Nasib
- My Commission FF 140139
Expires 07/09/2018
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APPROVED BY
1Ravicer1117 /9ahn1 al
11-4-19 Plans Examiner
Zoning
Structural Review Clerk