PL-18-1448Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Perrr
it
Permit NO. PL-5-18-1' 448
Pennit Type: Plumbing - Residential
Work Classification: Gas
Permit Status: APPROVED
Issue Date: 615/2018
Expiration: 12/02/2018
Parcel Number
Applicant
9901 NE 13 Avenue
Miami Shores, FL
1132050090480
Block: Lot:
CAROL INVEST USA INC
Owner Information
Address
Phone
Cell
CAROL INVEST USA INC
990 BISCAYNE Boulevard
MIAMI FL 33132-
t
990 BISCAYNE Boulevard
MIAMI FL 33132-
Contractor(s)
SUBURBAN PROPANE LP
Phone
(305)635-4427
Cell Phone
Valuation:
Total Sq Feet:
$ 1,400.00
70
Type of Work: INSTALL 1/2 GAS LINE FROM EXISTING
Type of Piping:
Additional Info: INSTALL 1/2 GAS LINE FROM EXISTING
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.00
$0.00
$0.00
$0.00
$75.00
$3.00
$0.00
$78.00
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-5-18-67711
05/25/2018 Credit Card $ 50.00 $ 28.00
06/05/2018 Credit Card $ 28.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Press Test
Review Plumbing
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 information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futh e, I authorize the above -named contractor to do the work stated.
June 05, 2018
Author
ture: (Swner / Applicant / Contractor / Agent
Date
Buil Department Copy
June 05, 2018
1
BUILDING
PERMIT APPLICATION
I
BUILDING ELECTRIC
(PLUMBING ❑ MECHANICAL
JOB ADDRESS: 9901 NE 13 Ave.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
n ROOFING
n PUBLIC WORKS
Master Permit No.
Sub Permit No.
RECEIVED
MAY 252018
C4(
S�
FBC 20 _,yQ-4
19 8-\U S
n REVISION Q EXTENSION ❑ RENEWAL
Li CHANGE OF n CANCELLATION (l SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County: Miami Dade
zip: 33138
Folio/Parcel#: 11-3205-009-0480 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Carol Invest, USA
Address: 990 Biscayne Blvd. Suite 801
City: Miami State: Florida
Tenant/Lessee Name: N/A
Phone#:
Phone#:
zip: 33132
Email:
CONTRACTOR: Company Name: Suburban Gas
Address: 3800 NW 59th St.
Phone#: (305) 635-4427
City: Miami State: Florida
Qualifier Name: Alex Brito
State Certification or Registration #: 01196
zip: 33142
Phone#: (305) 635-4427
Certificate of Competency #:
DESIGNER: Architect/Engineer: Victor BruCe
Address: PO Box 530019
Value of Work for this Permit: $ 1400.00
Type of Work: ❑ Addition n Alteration
Phone#: (305) 310-5030
City: Miami Shores State:Fl. Zip:33138
Square/Linear Footage of Work: 70 OF
n New ❑ Repair/Replace
(l Demolition
Description of Work: Install 1/2" gas line from existing propane tank to new ventless fireplace
-ra -cp IGc p I C - _.7001
Specify color of eoldethr""litite: `-''*°`''"'"',`
ti4`'
Submittal Fee $ ': rrt•S'r ram. ,Permit Fee'$ ,x e�✓
rv'.,Qk a 914at
Scanning Fee $ »_ . .,, .4 .,Radon Fee $ :..-�.
Technology Fee S _ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
DBPR $ .Notary $.
Double Fee $
Bond $
TOTAL FEE NOW DUE $ '" GO
(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
ZiIn.
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,
F P.NACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC
OWNER'` AFFIDAVIT: ? 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 r WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NC ICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2.500, 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 reinspectionfee will be charged. •a.:
Marco Bruzzi ( Carol Ilpvest USA)
Siggnature
OWNER or AGENT
The foregoing instrument was acknowledged before tyre this
Signature
Alex Brito
CONTRACTOR
//'►(� Theforegoingw ioregoing instrument as acknowledged before me this
_._aI , day of RpY 1 1 , 20 ,IS V l
by O "ay ,f . 20 . . by
Marco Bruzzi who is oars rally i nCL^Jil':O AVe •4 RJ . , who is • rsonally known t
me or who has produced as me or who has produced as
identification and who did take an oath,
identification and who did take an oath.
NOTARY PUBLIC:
Seal: _ ro°a., LUCIA G ISASI
ail � MY COMMISSION #FF182628
",:",:?oF d'' EXPIRES December 10, 2018
.... 4. .. * & 4.4971 4 015= *MOrkiaNbtBl eiSfi e tionY i . ': *.. ::': X >:: * ... i
S h IA"
NOTARY PUBLIC: 0
Sign: e 7%
:grin;: -12 ► 0. '\tee
Seal:
APPROVED BY
Plans Examiner
Structural Review
• Koala Alvarez
State of Florida
C ,�7My Commission G0121853 �r
I•. cy s 41.0710512021 *t!,
Zoning
Clerk
?Revise d02/2 /2Oi4)