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PL-18-201 P ' Permft No. PL-1-18-201 Miami Shores Village Permit,Type:Plumbing-Residential 10050 N.E.2nd Avenue NW p-� it wnrir.Ctassifleatidn.l4ddi#ionlAl#ea�aa#ior71 Miami Shores,FL 33138-000i;je,r Pet'frtit Status.<APPROVED Phone: (305)795-2204 FCORiDA Issue nate:316/2018 FExpiration: 09/0212018 Project Address Parcel Number Applicant 107 NW 96 Street 1131010250090 Miami Shores, FL Block: Lot: ELLA ALLEN Owner Information Address Phone Cell ELLA ALLEN 107 NW 96 ST MIAMI SHORES FL 33150-1714 Contractor(s) Phone Cell Phone Valuation: $'1,250.00 ISLAND PLUMBING CO (305)361-2929 - � Total Sq Feet: 0 Type of Work:KITCHEN PLUMBING AS PER PLAN Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out , Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Underground l Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-1-18-66240 DBPR Fee $2.00 DCA Fee $2.00 03/06/2018 Check#: 1738 $ 116.20 $0.00 Education Surcharge $0.40 Permit Fee $100.00 Scanning Fee _ $9.00 Technology Fee $1.60 Total: $116.20 1 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. OWNE FI V : I 'fy that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constr ctio i g uth rmore,I authorize the above-named contractor to do the work stated. March 06, 2018 (Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy March 06,2018 1 r. Miami Shores Village RECEIVED Building Department JAN 2018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305)795-2204 Fax:(305)756-8972 .11 INSPECTION LINE PHONE NUMBER:(305)762-4949 �•}� FBC 201*7 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit NO.TLI S - 2a 1 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL i]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS . ❑ CHANGE OF 0 CANCELLATION ❑SHOP CONTRACTOR �DRAWINGS JOB ADDRESS: I d City: Miami Shores County: Miami Dade Zip:33160 Folio/Parcel#: 11—N 0 07. w 1 fl Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): olTiitlleholder): E'er' Phone#.3� 1 Address: I P 7 1 V V ` CP ai- City: b1Q.Q� State: F:L, Zip:33f,529 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: �� .� U� y�9�0✓G �- Phone#: J�� (0/ 9 29. Address:,` 50-; ;� GP0v� Svc 227 ll City: A� y Qls-c4Vt,r state: Zip: 331)0� pp Qualifier Name: Z�a-S &99 GO Phone#: State Certification or Registration#:. 4/�- .0 /i Certificate of Competency#: # DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ l�ic1�' Square/linear Footage of Work: Type of Work: ❑ Addition [Yf Al eration ❑ New ❑ Repair/Replace ❑ Demolition _ Description of Work: "'- } ... ....- •-- `Y--.:e Specify color.,o ,color thru tile: Submittal Fee$ Permit Fee$ ©V• 00 CCF$ CO/CC$' Scanning Fee$ Radon Fee$0 „ 07 DBPR$ Q 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 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." E 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 fubject to attachment. Also,a certified copy of the recorded notice of commencement mustbepost4a`t'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. l r Signature f7&r a,-4&Zy Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The.foregoing instrument was acknowledged before me this day of - 20 , by �� day'of ✓ 20 0 by who is personally known to (i1/1 111� ���IVI`1 who is prsonally known to me or who has produced L cs�'•-Zao-Ome or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: OUTS B SE ` " Sign MY COMMISSION#GG 103959 r Print: i; ` �= Print: 4A M 1130 r %F r tiBonded 7hru Notary Public Underwriters ::' ,° Seal: F� " �� Seal MY COMMISSION#FF1o5592 EXPIRES March 24,2018 Ia07)398-Ot53 Floridallotaryservice.com t ************************************************************************************************************ APPROVED BY \\3�`\� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)