PL-18-871Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. PL-4-18-871
p t
Permit Type: Plumbing - Residential
Work Classification: Addition/Alteration
Pennrit Status: APPROVED
Parcel Number
Expiration: 10/06/2018
Applicant
825 NE 97 Street
Miami Shores, FL 33138-
1132060142600
Block: Lot:
DIANNE & MARC STEAD
Owner Information
Address
Phone
Cell
DIANNE & MARC STEAD
825 NE 97 Street
MIAMI SHORES FL 33138-2527
Contractor(s) Phone Cell Phone
REGOSA ENGINEERING. SERVICES (786)262-2964 (786)344-8720
Valuation:
Total Sq Feet:
$ 1,200.00
0
Type of Work: NEW TOILET VANITY SHOWER VALVE
Type of Piping:
Additional Info: NEW TOILET VANITY SHOWER VALVE
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.25
$2.00
$0.40
$150.00
$3.00
$1.60
$160.45
Pay Date Pay Type
Invoice # PL-4-18-67034
04/09/2018 Credit Card
04/04/2018 Credit Card
Amt Paid Amt Due
$ 110.45 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Final
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 certify that all the foregoing information is accurate and that a
construction and zoning. Futhermore, I authorize the above -named contractor to do the
o��ill be done in compliance with all applicable laws regulating
i + y�i
Authorized Signature: Owner / Applicant / Contractor
April 09, 2018
Date
Building Department Copy
April 09, 2018 1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION
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
Master Permit No.
Sub Permit No.
®PLUMBING ❑MECHANICAL El PUBLIC WORKS ❑CHANGE OF
CONTRACTOR
JOB ADDRESS: va„( Ai' C+ l 7 S
City: Miami Shores County:
Folio/Parcel#: / /3 a o 6 0/'/,z 4. o b
Occupancy Type: Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): MAIL C
Address: Ai- Ai- C• 97 ,Pr.
City: /'h /A/P, / SWo,Qc f
Tenant/Lessee Name:
Email:
State:
RED �4r{
APR 0 4 Z018
FBC zor�
taC, 18-2-00�
❑ EXTENSION 1 ❑ RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
Miami Dade Zip: 5,7/Jo
Is the Building Historically Designated: Yes NO 2<
piAaie
Flood Zone:
ST Ai
BFE: FFE:
Phone#:(30T) 7 •7 - / ooZ 5/
/JT��I1) Cc ectG'our, ,
Zip: 33/ J $
Phone#: /v%
CONTRACTOR: Company N1 ame: ?E(�S/l E/4GII>rEETZ/, ?awe ES, Phone#: 7 �V%' 795
Address: / Soo fie ,yE gst$
City: /f%»/4/ State: FL
Qualifier Name: GV STA,VO' , tie
Phone#:
Zip:33/6L
State Certification or Registration #: Certificate of Competency #: '.
DESIGNER: Architect/Engineer: `' ` Phone#:
Address:
City: State:
Value of Work fot'this,Permit: $ / 200
Type of Work: cc ,1Addition ❑ Alteration
Descriptron'of Work: '` E'u/7To,Z .r
4-`
Zip:
Square/Linear Footage of Work:
® New ❑ Repair/Replace ❑ Demolition
V 9/4/ 7'1 syo te/E _. //,i yb--
all :f:�. - .� .
•
`vl 1 v'0,l'i`-0...7#
I.,- —
olor of ?Colo
Specifycr thru tile:
Submittal Fee $ Permit Fee $ /5 ^
Scanning Fee $ Radon Fee $ �1 -CA DBPR $ ' as Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ (�c
TOTAL FEE NOW DUE $ (I O • ` c�
CCF $ CO/CC $
Y;
(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 r 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 a3
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.
1.
"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 broch e ill be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commence ent ust be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the •bsenc: of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
/ `' M'
Signature �'''c'
OWNER orA•ENT
The foregoing instrument wfeacknowledged before me this
..7f day of , 20 i/ , by
who is personally known to
me or who has produced as
identification and who'did take an oath.
NOTARY PUBLIC:
Sign:
Print:^ -
Seal:
*
OLORIA COTO
* Commission # GG 104094
Expires July 12, 2021
4`ORl40 &MOThruBudget Miry 811111 K
Signature
Th- fo egoing instrumen
day of
was ackno , e•
LIRA/
e this
iV ,by
sonally known t
me or who has produced as
identification and who did take an oath.
,I�I,Ianwan/.
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Sign: F --i: 0
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Print: (mod/. �/�4 : "DOF
•
Seal: y'•.Ir PUB.V\GScx,,.
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NOTARY PUBLIC:
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APPROVED BY
Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)