PL-17-2140 Parmit NO. PL-8-17-2140
�sNO1%s LMiami Shores Village mt Permit Type:Plumbing-Residential
10050 N.E.2nd Avenue NE Work Classification:Addition/Alteration
Miami Shores,FL 33138-0000 Per I
Permit Status:APPROVED(305)795 2204
FtoR1o�
issue Date:$13012017 Expiration: 02/26/2018
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Project Address Parcel Number Applicant
1075 NE 96 Street 1132060143690
Miami Shores, FL Block: Lot: NICOLAS TERZANI FRANZISKA
Owner Information Address Phone Cell
FCOL
AS TERZANI FRANZISKA HINZE 1075 NE 96 Street (786)246-8759
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
Valuation:, $ 11,900.00
WESTLAND PLUMBING CORP (305)863-6223 (786)236-0198
.w.— _. ... _w. __, .... w Total Sq Feet: 0
Type of Work:NEW BATHROOM,KITCHEN,AND LAUNDRY Available Inspections:
Type of Piping: Inspection Type:
Additional Info:NEW BATHROOM, KITCHEN,AND LAUNDRY Top Out
Bond Return: Final
Classification:Residential Scanning: 1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $7.20
Invoice# PL-8-17-64976
DBPR Fee $5.35
DCA Fee $5.35 08/30/2017 Check#: 18667 $344.90 $50.00
Education Surcharge $2.40 08/24/2017 Credit Card $50.00 $0.00
Notary Fee $5.00
Permit Fee $357.00
Scanning Fee $3.00
Technology Fee $9.60
Total: $394.90
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 certify that all the foregoing inVmati isccurate and th all worill be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the abo contractoF� ork stat
August 30, 2017
Authorized Signature:Owner / Applicant /(C�Otor / Ag Date
Building Department Copy
August 30, 2017 1
l
Miami Shores Village I
'
Building Department AUG 24 2017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: --
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201 sth
BUILDING Master Permit No. IAC 1-7- 113 69
PERMIT APPLICATION Sub Permit No. PL 11 — 2144
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ERE I NEWAL
1,00
LUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 967yl.S�.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: food Zone: BFE: FIFE:
OWNER:Name(Fee Simple Titleholder`):f'- ; � LIBPhone#: .?Lob L3'i'V a I.
i
Address: 1�5 WE C%qk St. %P
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name:�QV�t- i`� Com' -� --- t� YYf 1 IV)& 6QrA21 Phone#: —
Address: YY -
City: State:—Flb!'I DGl Zip: -�53 0 ( 0
Qualifier Name: C-0V-6 S t-� Phone#: 78b ` 36 01
State Certification or Registration#:` Vie(=`l; � 7 ly Certificate of Competency#:
DESIGNER:Architect/Engineer: - Phone#:
Address: l City: State: Zip:'
Value of Work for this Permit:$ Square/Linear Footage of Work:
r
Type of Work: ❑ Addition R Alteration ❑ New ❑ Repair/Replace ❑ Demolition
,
r i
�Description of Work: V3 r1-0 a r-LL. i Ot}'� otto D ,�-� W_Q 1 i ��
Specify color of color thru tile:'
Submittal Fee$ �� �V Permit Fee$ 1 CCF$ CO/CC$
r
Scanning Fee$ Radon Fee$ DBPR$ 5' 3 S Notary$ p
i
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
Mortgagetender'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. ", -t 1 " � I)
, - ) _'`,�
"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+ti LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR•NOTICE OF,COMMENCEMENT " � �-,
I J1�.'s< t4f- n9_,,....,.a 3
Notice to Applicant: As a condition to the issuance of a building permit with an'est►aii ted Gdlue%exceedihd,$25ob,,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 A NT CONTRACT R
1
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ��n 20 by 24i-h �day of 1 20 17 by
UC, who is ersonally known o r�0 1 Y non 0 who is personally known to
me or who has produced as me or who has produced Ir v'e ii 1 I'�QhS`Q as
identification and who did take an oath. identification and who did t e an oat .
i
NOTARY PUBLIC: NOTARY P
Sign: Sign: v
Print: Print:
;y.. .' = YANADYPRIEfO
Seal: ' ' EXPIRES March 2,2018 Seal: '.: :*€ M COPOMISSIONNFF214031
398-0153 Floridallotaryufvice.com ,�:•....:° PIKES:March 25,2019
(407)
i, Bonded Thru No
tory Public Umierwriten;
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APPROVED BY d /"1 V—I Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)