PL-17-2712 f
Permit-No. PL-11-17-2712
R s Miami Shores Village Permit Type:Plumbing-Residential
�• 10050 N.E.2nd Avenue NE
Work Classification:Add ition/Alteratidn
Miami Shores,FL 33138-0000 Permilt
Permit Status:APPR6VE
Epi,H6 Phone: (305)795-2204
F�ORLDA ration: 07/15/2018p�
Ex i
Issue Date: 1/1612618
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Project Address Parcel Number Applicant
440 NE 91 Street 1132060190050
JEFFREY COOPER
Miami Shores,'FL Block: Lot:
Owner Information Address Phone Cell
STEPHANIE LOPEZ GOMEZ 440 NE 91 Street
MIAMI SHORES FL 33138-
440 NE 91 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $9,000.00
VEPCCO CONSTRUCTION &MANAGE (954)980-5786 Total Sq Feet: 0
Type of Work: INSTALL NEW PLUMBING AND NEW WATER Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
Top Out
Bond Return: Final
Classification:Residential Scanning: 1 Review Plumbing
Underground
4
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $5.40 Invoice# PL-11-17-65657
DBPR Fee $4.50 11/15/2017 Check#:2653 $50.00 $274.90
DCA Fee $3.00
Education Surcharge $1.80 01/16/2018 Credit Card $274.90 $0.00
Permit Fee $300.00
Scanning Fee $3.00
Technology Fee $7.20
Total: $324.90
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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 c thatII t for going information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin In rm , I hori a the above-named contractor to do the work stated.
January 16, 2018
AuthTenatureolowner / Applicant / Contractor / Agent Date
Build partment Copy
January 16, 2018 1
inn
Miami Shores Village � `'
N 7V 1 $ 2617
Building Department BY:
01
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 '
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 r tS
BUILDING Master Permit No.-a�I-7 4 -23
PERMIT APPLICATION Sub Permit No.2-1-4 ?�;) 12
F-1 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION F-1EXTENSION [:]RENEWAL
E-1/PLUMBING ❑ MECHANICAL [-]PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 44�O
City: Miami Shores County: Miami Dade zip: '�\a;o
Folio/Parcel#: \\ ,32ro6-O\f1 -c=o5o Is the Building Historically Designated:Yes NO V1
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): 7:� c_4zjgTq_Z Phone#:(
Address: 4-k-0 K-_ K 5`c
City: NAA A eCk State: _F 1 Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: V CG] ccA. r� jkk Phone#:��5
Address: \1 k.
City: pL_agCState: 'r-L- Zip: 33325
Qualifier Name: QcaS3VL 'v#EE7A_ Phone#:(�fSa��l�2 �£�6
State Certification or Registration#: 4::C - 42c\2e2_ Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: 1 City: State: Zip:
3 .
Value of Work for this
tyh �
is Permit:$ ;�Bcve lJ Square/Linear Footage of Work:
Type of Work: 1J Addition E?f Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: \ALL 1 �C-t,,, pu�►��\,�G �o ►� ,� �,�,A.-��, �..�►��
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ �?00 / CCF$ _ CO/CC$
Scanning Fee$ Radon Fee$ 3• Q DBPR$ Notary$ •-
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ Z-44-• 10
(Revised02/24/2014)
7.
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
i
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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.....
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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
t 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.
a !�
Signature _ Signature
OWNER or AGENT CONTRA TOR
The foregoing instrument was acknowledged'before me this The foregoing Instument was acknowledged before me this
J day of 0CT013ETZ 20 'l- by "b day of c.'—''<o2,-g� 20 1'1. by
OE;rF'2E`% CC 'tOwho is personally known to r2cAvv5p-& who is personally known to
me or who has produced as me or who has produced���j, �5 L�GB= as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
Seal: „y p�Stb d seal: Ricardo Dominguez
Commission # FF958686
My Conw4uiw GG 10°� ?yTQ�a Expires:February 8,2020
Bonded thru Aaron Notary
APPROVED BY & 194 Plans Examiner Zoning
I w[ - ./ I—
Structural Review Clerk
(Revised02/24/2014)
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