PL-17-733 Permit N0. PL-3'-1 7-733
' t Permit TyPe:Plumbing-Residential
Miami Shores Village
1oo*nw.E.2nd Avenue NE Work Classification:Pool -Private
Miami Shores, FLoa1o8-ooun P'erllil
Pennit Status:APPROVED
Phone: (305)795-2204
art
issue Date:4/2612017 Expiration: 10/22/201 7
Project Address Parcel Number Applicant
650 NE 97 Street 1132060171640
Miami Shores, FL 33138- Block: Lot: SYLVIA FLORES
Owner Information Address Phone Cell
SYLVIA FLORES 650 NE 97 Street
MIAMI SHORES FL 33138-
650NE97Stree
MIAMI SHORES FL33i3B'
Contractor(s) Phone Cell Phone Valuation: $ 1,000.00MASTER CRAFTSMAN POOLS INC (305)746-2849
Total Sq Feet: 0
Type of Work:POOL PIPING
Available|
Type of Piping: Inspection Type:
Additional Info:POOL PIPING Main Drain
Bond Return Final
Classification:Residential Scanning: 1 Rough
Review Plumbing
Fees Due Amount Pay Date Pay Type Arnt Paid Amt Due
CCF $0.60 Invoice# PL-3-17-63356
DCA Fee $3.38
Education Surcharge $0.20
Permit Fee $225.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $236.36 1
,
In munamoumion of the issuance to me of this nwnnh. | agree 10 perform the work covered hereunder in compliance with on ordinances and regulations
pertaining thereto and instrict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit | assume responsibility for all work done by either myself, my agent, aonmmo. or employes. | understand that separate prnnim are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS, DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: | certify that all the foregoing information is accurate and that all work will be uunr in compliance with on opnooamo |owe regulating
construction and zoning. rmxennoe. iauthorize the above-named contractor muothe work stated.
April 25, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building
Department� ��
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PC
i
Miami Shores VillageC� .- ;-,
Building Department MAR 1 62017
10050 N.E.2nd Avenue,Miami Shores, Florida 33138
I Tel:(305)795-2204 Fax:(305)756-8972 L"— -—
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20iq
BUILDING Master Permit No. U e ` --� -233
PERMIT APPLICATION Sub Permit No. 91 F�'���
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
MPLUMBING ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
(�I CONTRACTOR DRAWINGS
JOB ADDRESS: (�� 0bL '����
City: Miami Shores County: Miami Dade zip:
Folio/Parcel#: Is the Building Historically Designated:Yes 2NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE:' FIFE:
OWNER: Name(Fee Simple Titleholder : � S Phone#: 7,96 2-
Address: �^^�`� �r, S� ST
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: " `�'l. &4?13 yl AA4-` T fl��� Phone#: 7
Address: �C'\�'qJ� SW
City: VVw4'iu- lState:
_ Q Zip:
Qualifier Name: __j �s�- J • - Phone#:
State Certification or Registration#: C�oL 0 5 .2 3 d Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 4666Y Square/Linear Footage of Work:
Type of Work: ❑ Additiy /❑ Alfie ation ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: � �c / lQ
N
YYJ.'Jry Cp.y`:� � r•:H _ .`YNJ k'+it {{Y `
J �� - t111�.1.
Specify color tof color thru,tyle'�: ! noL. ASS
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tAwt^`�C:�e
Submittal Fee$ Permit Fee$7^� CCF$
Scanning Fee$ Radon Fee$ DBPR$ WulydAit�fi`+SAY °fN tary$?
Technology Fee.$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 03G
(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
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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
�-
— J71- �"l r
—day of AA 20 / / by day of 20 /' by
qmp Z.-55h;A& who is personally known to &-r who is personally known to
me or who has produced PL �L as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign: l ott, G 1�&,'e, —
Print: O Print: U
r
Seal: Seal: 1;?, WCOMMiSS:CN#FF 995780
Zettie Jones � Wins:y Pub
• ��' Banded Tfru Nct3ry Pubik llrvle
COMMISSION!PFY09I)81 «••
ONNOTARY.COM
num, .
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)