PL-17-2114Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
445 NE 94 Street
Miami Shores, FL
Owner Information
Darren Ockert
Parcel Number
1132060140520
Block: Lot:
Address
445 NE 94th Street
Miami Shores FL 33138
Contractor(s)
R L D'ADDIO PLUMBING CO INC
Phone
(561)722-0355
CeII Phone
Phone
Expiration: 02/28/2018
Applicant
Darren Ockert
917 573-9022
Cell
Type of Work: NEW SEPTIC SYSTEM AS PER MASTER PER
Type of Piping:
Additional Info: NEW SEPTIC SYSTEM AS PER MASTER PER
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
DBPR Fee
DCA Fee
Permit Fee
Scanning Fee
Total:
Amount
$0.00
$0.00
$50.00
$0.00
$50.00
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL -8-17-64945
08/21/2017 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
HRS Approval
Final
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 "ertify-that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoninguth or thorizeetthe above-named contractor to do the work stated.
Authorized Sign tGre: Owner / Applicant / Contractor / Agent
September 01, 2017
Building Department Copy
Date
September 01, 2017 1
-peraOnq Miami Shores Village
L i Building Department
BUILDING
PERMIT APPLICATION
BUILDING
PLUMBING
JOB ADDRESS:
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑ ELECTRIC ❑ ROOFING
Master Permit No.
REVISION
Sub Permit No.
❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
4-4 - NEj-
RECEIVE
AUG 21 1017
FBC 20 kLA
CO Iggcl
PI 19- -2IRA
EXTENSION
RENEWAL
❑ CANCELLATION n SHOP
DRAWINGS
City: Miami Shores County:
Folio/Parcel#:
Occupancy Type: Load: Construction Type:
Miami Dade
Zip: 53 t SS?
Is the Building Historically Designated: Yes NO
Flood Zone:
BFE: FFE:
OWNER:Name(FeeSimpleTitleholder): f,2Vk Phone#: 0((� -53-3-c?O 22
Address: 4 it- S N+c ct�}—
City: (VI cc✓ -k. State: E - 1
Tenant/Lessee Name:
Email: C7t 0 rx d t�E . cowl
CONTRACTOR: Company Name:'—"R • l • �'I�I Ji 0 "--(1.)(h.-.)i1� t NQ Phone#: S-61 '7
Address:
Zip:
Phone#:
946 11-L6;.;
City: W TI h f7 -/ /c
C / State: p C . Zi : J 3 rr,�0S
Qualifier Name: *C �Y� �j� i Phone#: 77 5'S
State Certification or Registration #: CYC__ ns --23_26 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City:
Value of Work for this Permit: $
State: Zip:
on wIcksVga Square/Linear Footage of Work:
(3+2f1%;+ %Kath
Type of Work: ❑ Addition ❑ Alteration n New
❑ Repair/Replace
n Demolition
Description of Work:
i�ec,J scp'}i,c sclsf.t2,Vt tiS p€J rtn,cLS#Qt( pg/r,,.:�,
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ T
6
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 .he 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
-P\U c , 20
L1 day of
, by
J Y oc-V'lel`wrho is personally knownpto
me or who has produced 41 ` l C.x � r y� as
identification and who did take an oath.
NO RY PUBLIC:
Sig
Print:
Seal:
o EXPIRES: November 2, 2020
Fo �,oP� Bonded Thru Notary Public Underwriters
Signatur
CONTRACTOR
The foregoing instrument was acknowledged before me this
`//�,,�day of ✓IUs 20 /7 , by
hiCIT/T�c>Yi'I S j , who is personally known to
�f
me or who has produced 00ai 4CLAI as
identification and who did take an oath.
NOTARY PUBLIC:
Sign•
Print:
Seal:
****************************************************************
APPROVED BY
(Revised02/24/2014)
•
.,? a tidr;
(407) 398-0153 FloridallotaryService.corn
*ARV***e**ilr*******,F* **-***** ,Ir*************
NIURKA QUESADA
MY COMMISSION *FF187751
EXPIRES January 7, 2019
Plans Examiner Zoning
Structural Review Clerk