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PLC-18-846I the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating authorize the above -named contractor to do the work stated. ignature: Owner / Applicant / Contractor / Agent Building Department Copy Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit NO. PLC-4-18-846 Permit Type: Plumbing Commercial Work Classification: Addition/Alteration Permit Status: APPROVED Issue Dates 5/8/2018 Expiration: 11/04/2018 Parcel Number Applicant 755 NE 91 Street Number: 2-F Miami Shores, FL 1132060440220 Block: Lot: BRUCE BENDER CURT DYER Owner Information Address Phone Cell BRUCE BENDER CURT DYER 5900 ALTON Road MIAMI BEACH FL 33140-2025 5900 ALTON Road MIAMI BEACH FL 33140-2025 Contractor(s) NN SMART SERVICES CORP Phone (786)346-1715 Cell Phone Valuation: Total Sq Feet: $ 150.00 0 Type of Work: REPLACE SINK Type of Piping: Additional Info: REPLACE SINK Classification: Commercial Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Invoice # PLC-4-18-67005 05/08/2018 Cash 04/02/2018 Credit Card Amt Paid Amt Due $ 58.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Final Water Main Lavatory 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 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 construction and zo May 08, 2018 Date May 08, 2018 1 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 RECEIVE APR 0 27016 C( 1-1 FBC . BUILDING Master Permit No.C-C -cSLS PERMIT APPLICATION Sub Permit No. P \C ( LILO ❑BUILDING E ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL LUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 3 (3 i Folio/Parcel#: l I -3t9-06 - 0 ic'-O D ao Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: /��+ FFE: OWNER: Name (Fee Simple Titleholder): £(/ / JLDy v Phone#: 30 "! 7�0©0J3 Address: 0Ott 90 -MY) ` /� City: A/ ¢ f � State: '-- Zip: 33 / tiw Tenant/Lessee Name: Phone#: Email: CONTRACTOR:nCompany Name: .rR:Z-Z P (0yr tov Inc_ Phone#: (7)55c- - r / % Address: ! L2-5 cJ 35 s ()n l + . p . City: (4t&Ctj1,V1 _ + State: �- Qualifier Name: .Tasid Ma eu zip: s501 �5& eft— Phone#:: (7(a) 7w % �-C t State Certification or Registration #: — I Li 2_9 2..Ds . Certificate of -Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 1O • 00 Square/Linear Footag ,of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace n Demolition ` Description of Work: �p 1 at.� 2(, �? bn+K••.,., lea=,.,,,-'-. -- ^..... �,,,vna.,, ... H t"'S(3:k+f �('t v•y fbivi'3:.Y I; t t •G1 ,��y�, a us c +DUX E _ wtti I '�.1 Y ilrrrr r yR7 e.� •6 f la " '�• i Specify color of color, thru the 1> rr 0 r Sa l�-r4rC`crtl rtt. -7 , an i0'1 Submittal Fee$—" —4:::e"'4.o#^ew.w..,itFee1$/tpo • i l'i f'i F . 3 i. CCF $ DBPR $ 2 • P Notary $ Scanning Fee $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE$ •6o Radon Fee $ , GC7 (Revised02/24/2014) Bonding Company's Name (if applicable) • Bonding Company's Address City State Zip Mortgage Lender's Nanie (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." 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. Signatur� OWNER or AGENT The foregoing instrument was acknowledged before me this 2.__ day of Apr,20 / , by CV /a— Dy , who is personally known to me or who has produced j oO — )Do —6 3 Z / as identification and who did take an oath. NOTARY PUBLIC: Sig Print: / Q Seal: S. GLADYS OBAND, o/ Commission N FF 917i, S� in Commission ExPi' ;* '` MY lembet 10. 201 APPROVED BY SignatureX The foregoing instrument was acknowledged before me this 2- day of /r� , 20 , by 3 AS( �a-CA , whos personally known to , me or who has produced `(//°9 ' V 8—Js identification and who did take an oath. NOTARY PUBLIC: Sig Print: Seal: Plans Examiner Nam issio DYS OBANDO s commission B FF 917046 U com '• ommission Expires *Pt -l.;' mbet 10, 2019 Zoning Structural Review Clerk (Revised02/24/2014)