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PL-18-1266Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. PL-5-18-1266 Permit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue ©ate: 5/29/2018 Expiration: 11/25/2018 Parcel Number Applicant 92 NW 93 Street Miami Shores, FL 1131010170010 Block: Lot: Filip Adamowicz Owner Information Address Contractor(s) Phone Cell Phone THE NEW MIAMI SHORES PLUMBING (305)751-2446 (786)553-5424 Cell Valuation: Total Sq Feet: $ 5,000.00 0 Type of Work: HOT & COLD WATER RE -PIPE Type of Piping: Additional Info: HOT & WATER RE -PIPE Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Penalty Fee Permit Fee Scanning Fee Technology Fee Work without Permit Fee Total: Amount $3.00 $3.38 $2.25 $1.00 $100.00 $225.00 $3.00 $4.00 $225.00 $566.63 Pay Date Pay Type t Amt Paid Amt Due Invoice # PL-5-18-67515 05/14/2018 Credit Card $ 50.00 $ 516.63 05/29/2018 Credit Card f $ 516.63 $ 0.00 Available Inspections: Inspection Type: Top Out Final Review Plumbing Review Plumbing Underground 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 s ict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I a ,ime responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICA LUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni s I thermore, I authorize the above -named contractor to do the work stated. Authorized - • ure: Owner / Applicant / Contractor / Agent Building 1 D - rtment Copy May 29, 2018 .,QIJ j;e,ies May 29, 2018 Date 1 41°) BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC PLUMBING ❑ MECHANICAL JOB ADDRESS: at- /V w City: Miami Shores Folio/Parcel#: 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 BY: AY2018 I i FBC 201 1 Master Permit No. ? L 1O.-1 110h Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION El RENEWAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION 111 SHOP a3 RDD s County: II —(O( Q( -Do (D Occupancy Type: _ Load: Construction Type: CO NTRACTO R Miami Dade DRAWINGS Zip: 3 S I S^C) Is the Building Historically Designated: Yes NO•N Flood Zone:. BFE: FFE: OWNER: Name (Fee Simple Titleholder): p F I LII+�P ? V -XC. Phone#: Address: qLW q I` D O t City: AA I 1 H0rS Tenant/Lessee Name: State: FL—. Email: A-0 0\--M oc-o(c2— _ AAA- IC --(CO CONTRACTOR: Company Name: e,(A) (I0144' '\)Y PI uryibi Address: G O 1 ki,k4Q City: ~I f CL/V1. i State: iI I0 Ir) (A U. Qualifier Name: 'J{r\i\k 5 MCI�U Gj��lil State Certification or Registration #: cr .01 w % k. $r Phone#: 7724SFe(!J Zip: 3 3 1-O Phone#: 30S• 7 S I Z U y� Phone#: Certificate of Competency #: Zip: 33M DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 5 , 00C) o o • L1� Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration n New Ei Repair/Replace n Demolition Description of Work: Hof- (Ind Cold Leja- r- Pit,- Rpe • • t• < $a riiSpecify colorofcolorthru tile: , a t r..+: ; + as - i irff ; Submittal Fee - {` Permit Fee $ Scanning Fee $ Radon Fee $ a ;;-S DBPR A$ • Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ D� St, rµ Oral Reviews $ \Bond $ �• lao • Cio (Revised02/24/2014) TOTAL FEE NOW DUE $ C 3 Bonding Company's Name (if applicable) Bonding'Company's Address City State Zip Mortgage Lender's Name (if applicable) S •F42Go Mortgage Lender's Address PO S e I 033 City r):' S400.) 1J State /c Zip S©.30 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 ncement must be posted at the job site he absence of such posted notice, the whose property is subject to attachment. Also, a certified copy of the recorded notice of for the first inspection which occurs seven (7) days after the building permit is inspection will not be approved and a reinspection fee will be charged: Signature • t , OWNER or AGENT ► i 4 The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this r day of M A \/ , 20 \ 7 , by 7 day of �G , 20 id-- , by � ,j P ��A W +� is personally known to DeM XI IS PIGAA 1,i* , who is personally known to Signature . ued. In reti P 6 DAN CONTRACTOR me or who has produced as me or who has produced identification and who did take an oath. NOTARY PUBLIC: identification and who did take an oath. NOTARY PUo Sign: Print: Seal: ************************* APPROVED BY _pry ocik Notary Public State of Florida Dayana Perez ysc, / My Commission GG 139415 o� a Expires 08/29/2021 * Sign: Print: al: Air as ***************** 'Plans Examiner Notary Public State of Florida Dayana Perez c, , My Commission GG 139415 Exires 08/29/2 201 **** ****************** Zoning 4 (Revised02/24/2014) Structural Review Clerk Studor Vent Connect Into Septic Tank Septic Tank i� #: Miami Shores Village APPROVED BY ZONING DEPT BLDG DEPT • I DATE 714 SUBJECT 10 CC MPLIDNCE . fH ALL FEDERAL STATE ANv Cf.Ut' 'f riUL_S AND REGULATIONS VTR 106 • • • •• • • •••• •• • • • • • • •• •• • • • • • • • • • • •• • WC • ••• • • • • • • • • • • • • • •. • • • • • • • • • •• •• • • • • • •• • • • • • • • • •• • • •• • • • • •. • Philip Adamowicz 98 NW 93rd Street Miami Shores, FL. 33138 • • 4. Laundry we • Tub kis Shower wIc vtz Stack Two way el 0 Septic Tank •.•• • • • • •••• • • • •• • • • • • • • • • • • / • • . • • • •••• •• • • • • • • • • •••• • •• • • •• •• • • • • • • • • •• • •• • • • • • •• • • • •• • • • • • • • • • •• •