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PL-17-381Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Pe •mit Permit NO. PL -2-17-381 Permit Type: Plumbing - Residential Work Classification: Pool - Private Pennit Status: APPROVED Parcel Number Expiration: 09/04/2017 Applicant 241 NW 92 Street Miami Shores, FL 1131010331180 Block: Lot: PERFECT HEAT LLC Owner Information Address Phone Cell PERFECT HEAT LLC 241 NW 92 Street MIAMI SHORES FL (305)608-4672 241 NW 92 Street MIAMI SHORES FL Contractor(s) RENO'S PLUMBING & POOL INC Phone (561)368-3308 Cell Phone Valuation: Total Sq Feet: $ 1,000.00 0 Type of Work: PLUMBING FOR NEW POOL CONSTRUCTION Type of Piping: Additional Info: PLUMBING FOR NEW POOL CONSTRUCTION Bond Return : Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scarining Fee Technology Fee Total: Amount $0.60 $3.38 $3.38 $0.20 $225.00 $9.00 $0.80 $242.36 Pay Date Pay Type Invoice # PL -2-17-62938 03/08/2017 Check #: 3502 $ 192.36 $ 50.00 02/14/2017 Check #: 3500 $ 50.00 $ 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. honzed Signature: Owner / Applicant / Contractor / Agent Building Department Copy March 08, 2017 Date March 08, 2017 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION UNE PHONE NUMBER: (305) 762-4949 RECP FEB 1 4 2017 s-� FBC 20 (L -t BUILDING Master Permit No.1- - 38 PERMIT APPLICATION Sub Permit No.P 1 1.-4 73451 ElBUILDING ELECTRIC D ROOFING ❑ REVISION El EXTENSION RENEWAL ]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: .. -I 1 ►ti3 CON 1\6 r4:, e -k— City: Miami Shores County: Miami Dade Zip: # I S� Folio/Parcel#: k1 `3\ 0 I 0.--2-: l k.% 0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: .FFE: OWNER: Name (Fee Simple Titleholder):PerteC-k- 1oct+ U -L. — J c\-sXc .2 tO Phone#: Address: 4s 0 s. Sh0(12. D r1C.X, ItC-4L( City: Kv%VL QecdState: FC-- Zip: 53 1`11 Tenant/Lessee Name: Phone#: i Email: CONTRACTOR: Company Name: .e_r\O rS p1u NV*Arn j Pdo1 -ir\f✓ Phone#: i Address: '�1i5a 1 a 1 Arai a 1 j V. -6V.-6- City: -eA rcLi �p State: Zip: 3'3t -1v4 Qualifier Name: .`C Y'�\(arkd \S -G\- c Phone#: State Certification or Registration #: C PC—PS Q / wa Certificate of Competency #: DESIGNER: Architect/Engineer: Ara Ftc. Crvci.itfTy P-n9inei rs 111x. Phone#:5(I k-{' (7 67 Address: a call I (i cl k(5i�2 n rive . �! City: &act Red c" State: FL Zip: "."\-tD.ar Value of Work for this Permit: $ 11t cx.c 2 Square/Linear Footage of Work: Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: NWMJ \)aQk 1S1/4 -(c s.Q.QY) Specify color of color thru tile: Submittal Fee $ Permit Fee $ 1.,- f' CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ ' ` Z . 3±0 (Revised02/24/2014) I Bopding 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 thenoticeof 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 Mk 13o - OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this .2Clytday t�off () j fIi ?Jt° i , 20 i6 by De day of t Y'\ L DeX , 20 tCo by A44T(aI �J i vb , who is personally known to \00A0 \& \ . Signature VaJ2a, CONTRACTOR , who is personally known to me or who has produced F£ D rtc. t3 t..- i 2 as me or who has produced FL,bYve (.m2211BP as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: identification and who did take an oath. KYLE C HAMBRmi" NOTARY PUBLIC: MY COMMISSION* GG066511 XioXo ; EXPIRES January 26, 2021 ao-tb i-r.Cc Sign: L Print: Seal: KYLE C HAMBRICK MY COMMISSION* GG066511 XPIRES January 26, 2021 It mla r tCLc I ************************************************************************************************************ APPROVED BY (Revised02/24/2014) Plans Examiner Structural Review Zoning Clerk 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 lie 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: J State of Florida County of Miami -Dade Owner 1((-) The foregoing was acknowledge before me this --U day of By - c bzvG T'ehrcot,20t7 . who is personally known to me or has produced n CteMS`k as identification. Notary: SEAL: YANADY PRIETO MY COMMISSION # FF214031 EXPIRES: Bonded 7hwMarch 25, 2019 NotaryU Public ndenvnters