PL-16-1098Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. PL -4-16-1098
Permit Type: Plumbing - Residential
Work Classification: Pool - Private
Permit Status: APPROVED
Issue Date: 7128/2016
Expiration: 01/24/2017
Parcel Number
Applicant
33 NE 93 Street
Miami Shores, FL 33138-
1132060130380
Block: Lot:
JOHN ZELINSKI
Owner Information
Address
Phone
CeII
JOHN ZELINSKI
33 NE 93 Street
MIAMI SHORES FL 33132-t
(786)515-5716
33 NE 93 Street
MIAMI SHORES FL 33132-
Contractor(s) Phone CeII Phone
GATOR POOLS AND SPA CONSTRUC (305)222-2220
Valuation:
Total Sq Feet:
$ 1,500.00
0
Type of Work: POOL PIPING
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 -4-16-59515
04/22/2016 Credit Card
07/28/2016 Credit Card ,
Amt Paid Amt Due
$ 50.00 $ 187.96
$ 187.96 $ 0.00
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 rt at all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named contract o do stated.
Authorized Signature: Owner / Applicant / Contracto / A. -nt
Building Department Copy
July 28, 2016
Date
July 28, 2016
1
BUILDING-
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINCPHONE NUMBER: (305) 762-4949
FBC 20 (-1
�
Master Permit Noy' Y ( f
Sub Permit No.'7L I G-1098
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS' ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
33 de q3 fist
City: Miami Shores County: Miami Dade Zip: .33/3 e
Folio/Parcel#: '/- 5Z04 - 0(3 O38,10 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
i
r
OWNER: Name (Fee Simple Titleholder):.,! J011f7 %hrz41 , Phone#:
Address: 33 NE 93,-,1 (-7 /� /
Cityi fi j(�rjq % �'/ Oil!5 State: f- / Zip: ? 3 /3 e
Tenant/Lessee Name: Phone#:
Email: 1
CONTRACTOR: Company Name: ft2 /Oil 00 /S G)/71� G Phone#:
Address: /3267 5 f w 74,67 !
S r
City: ,t �'0%Zip:n/ State: i % 7� -?ti
Qualifier Name:/t wz 1 (14r;(44/�Yy)c
State Certification or Registration #: 6..10 Ng;9-261 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
1
Value of Work for this Permit: $ // 100 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ® New ❑ Repair/Replace ❑ Demolition
Phone#:
Description of Work: /00/11;t2/7),
Specify color of color thru tile:
Submittal Fee $ 13) CZPermit Fee $ .,,z ��. CCF $ 1. - CO/CC $ P
Scanning Fee $ - CA Radon Fee $ 2 ' 3C::5DBPR $ 3' Notary $ T"
ol
Technology -Fee $ GO Training/Education Fee $ 0 - cf 0 Double Fee $
Structural Reviews $_ P Bond $ 1 0
TOTAL FEE NOW DUE $ 9 v 9'10
(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
1
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 laves 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 andconstructionlien 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
WNER or AGENT
I
The foregoing instrument was cknowledged before me this
day of IrL t , 20 _ 4,, by
jQ kik ae CI vt- k1 , who is personally known to
me or who has produced Q tY dp('2 e 1 / as
identification and who did take an oath..
NOTARY PUBLIC:
Sign:
Print:
Seal:
.RIANY OJEDA
MY COMMISSION A FF 983289
EXPIRES: February 22, 2020
Bonded'Rw Notary Public Undawdtera
**
' o
Signature
NTRACTOR
The foregoing instrument was acknowledged before me this
,A`Z,2, day of
Apy7 ( , 0 , , by
/VI /�1 V� 0.0.1-14AhhlG-r who is personally known to
me. or who has produced C (,0557.5211 -22D4s
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: ''� e + ARNNYOJEDA
y� MEXPICOREMMISS
S:FebuaryION t F22F 9 83289
;2020
400p ,,.000 Bonded Nay Public U
B
rs
.
_yK
****************************************************************
APPROVED BY
Plans Examiner
Structural Review
4 F
(Revised02/24/2014)
Zoning
Clerk