PL-18-31 Permit No. P"L-1-18-31
Dees
Miami Shores Village � PermftType:Plumbing-.Residential
10050 N.E.2nd Avenue NE Work Classification:Addition/Alteration
Miami Shores,FL 33138-0000 Parm
PetmitStatus:APPROVED
Phone: (305)795-2204
FLORIDA
issue,Date:1112/201g Expiration: 07/11/2018
Project Address Parcel Number Applicant
113 NE 105 Street 1121360050100
ANNIKA ASHTON ERIC HERNAh
Miami Shores, FL 33138-2032 Block: Lot:
Owner Information Address Phone Cell
ANNIKA ASHTON ERIC HERNANDEZ 113 NE 105 Street (954)554-0418
MIAMI SHORES FL 33138-2032
Contractor(s) Phone Cell Phone Valuation: $'1,100.00
ARMANDO PENA (786)255-5474 Total Sq Feet: 0
Type of Work:RELOCATE WATER HEATER AND WASHER AN Available Inspections:
Type of Piping: Inspection Type: a
Additional Info:RELOCATE WATER HEATER AND WASHER AN Top Out
Bond Return: Final
Classification:Residential Scanning: 1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# PL-1-18-66050
DBPR Fee $2.00
DCA Fee $2.00 01/04/2018 Credit Card $50.00 $60.20
Education Surcharge $0.40 01/12/2018 Check#: 1097 $60.20 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $110.20
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.
I
OWNERS FIjAV ce ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructio ao ng. Fut er 7A,
I authorize the above-named contractor to do the work stated.
January 12, 2018
Au orized igrZt er / Applicant / Contractor / Agent Date
Building Department 'Copy
January 12, 2018 1
Miami Shores Village RECEIVED
Building Department JAN 04 2018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Q
Tel:(305)795-2204 Fax:(305)756-8972 ` �(
INSPECTION LINE PHONE NUMBER:(305)762-4949 &41 �' \
FQBC 2014
BUILDING Master Permit No. t-1- – L44-2-
PERMIT APPLICATION Sub Permit No. P``1 }I AJ L
[--]BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
M A_ /o s-54-
City: Miami Shores
/ County: Miami Dade Zip:
Folio/Parcel#:_r f / Zj(� ��� �/��7 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): &_LLrft2C-i e- [A aniri ke\ Phone#: kk
Address: � If 0 *' I
City: IM i a m"I 4(od'e'i State: Zip: 3 7 (3
Tenant/Less'e'e Name'.,.� Phone#:
,�:IFI
CONTRACTOR:Company Name: .``. ��- - Phone#:
Address: 912- b ��/ i f s S T
City: State: E10 k"'J ! �
+ !� Zip•
Qualifier Name: — K Phone#:
i State Certification or Registration#: C.FC 6Certificate of Competency#:
DESIGNER:Architect/Engineer: C -Lo S 14oos, Phone#:
Address: City: State: Zip:
0.x.
`Value of Work for this Permit:$� ��Qy Square/Linear Footage of Work:
Type of Work: `❑ Additions n ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: la,:e(nCcvltz— GAM Lr L
Specify color of color thru tile:
'Submittal Fee$ Permit Fee$ (/
t �CCF,$ CO/CC$
Scanning Fee$ Radon Fee$ Z �� DBPR$ 2. .6 Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$�
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City t i 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 nsie p(, e, ob site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absent n„pos e2 Me,
inspection will not be approved and a reinspection fee will be charged. NotF 'D� Z
y Pu611c-` to of
0 ,;hYfi�"omm.Expires Apr 7,:201.,
' ondthrough!„ .onal Notary^.
Signature Signature
... ' '
OWNER or AGENT ! CONTRACTOR
r
The foregoing instrument was acknowledged before
me this The foregoing instrument was acknowledged before me this
day of 20 i A by day of VOL 20 417—J by
I�&A A who is personally known to J1?Aq&?2e9 PE/t1 who is personally known to
rrfetir w'ho has produced as me or who has produced FL A•L. as
identification and who d to �;a0,-. '1” '" "" ntification and who rd
B OENA�`RUZ ` `sOpeN46no�ylp�W
r, 111„
N TARY PUBLIC: 4 ,\° hotary';bhc St_Ie TARY PUBLIC: t#fZ a{4ff'Saiidx3 ww dr—°.�•
J Jor` Commias�ol; Fr 2G,��43 o £hS.Ol j #UO[SS(Wtj F'SAT t:G
2oiil�o: .Y Comm. Expires Apr' 201'. : ;r!t0,�io oye1S o!t <'.Aje`o,y.
„Bonded through A3;,nnal Notary A; 1 ZO f
_ I Ig „ ^
Print: ° ,os"= ''9., D Print:
.ii,., t 4i otar P
)M Y Public-Stato of Fioridac
Seal: :r�1�a ;C_mmission#FF 204543': Seal:
GoMm.E,,:pires Ap!T,
�� On through t:; at Notes
APPROVED BY �'Q Plans Examiner Zoning
Structural Review' Clerk
(Revised02/24/2014) i
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