PL-17-2561Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. PL.-10-17-2561
PennitType: Plumbing - Residential
Work Classification: AdditionlAlteration
Permit Status: APPROVED
Issue Date: 10/31/2017
Expiration: 04/29/2018
Parcel Number
Applicant
501 NE 92 Street
Miami Shores, FL 33138-
1132060141120
Block: Lot:
LIZA ROSE CIRALDO
Owner Information
Address
Phone
Cell
•LIZA ROSE CIRALDO
501 NE 92 Street
MIAMI SHORES FL 33138-
(917)744-1879
501 NE 92 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
THE NEW MIAMI SHORES PLUMBING (305)751-2446 (786)553-5424
Valuation:
Total Sq Feet:
$ 11,856.00
0
Type of Work: ALL PLUMBING WORK, GROUND, ROUGH IN
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$7.20
$6.23
$4.15
$2.40
$414.96
$3.00
$9.60
$447.54
Pay Date Pay Type
Invoice # PL-10-17-65477
10/31/2017 Check #: 1792
10/27/2017 Check #: 001786
Amt Paid Amt Due
$ 397.54 $ 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: .1 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. FuSbefmore, I authorize the above -named contractor to do the work stated.
Auth• izd Signat a:Owner / Applicant /
Contractor / Agent
October 31, 2017
Date
Building Deiartment Copy
October 31, 2017( 1
Miami Shores Village
/n. 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
BUILDING
PERMIT APPLICATION
OfCT272017
`144
FBC 20 NLr
Master Permit No. RL 1 1-[2 -7
Sub Permit No ?L (4 ' ZSG
❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑ RENEWAL
PLUMBING ❑ MECHANICAL 0 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP'
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: .
Sal M l.) wd areet
Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): . J _4 C (2'I W(/ Phone#:
Address: 0 r I) L. 7 L 5 f
City: )1A " / SO . State: ft-- Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: AN AA+ 5 PL)(J,trIt,E? Phone#: 305 ' 7S I 4/Y4
Address: qcx) AlW /Uu " 5 et
City: / 1., A V'
Qualifier Name:
State: 'FL
Zip: . 16'2
Phone#:20S" 1-St c26+616
State Certification or Registration #: C.L. 0 (72_ Certificate of Competency #:
DESIGNER: Architect/Engineer: 141 4- Y kJ. LPL— Phone#:
Address: / City: State: Zip:
Value of Work for this Permit: $ 1 J I CSC//, 642 ✓ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration l i New ❑ Repair/Replace f 1 Demolition
Description of Work: • iyu, e0t o14 .8/ A 1.4)71 K /
.r,'< t.A.m l'a cW % rat.)01 /A,
^,.4'9._ -
Spec: fycolorLof color tfiru tile: ;'.
Submittal Fee $+'�# i L/j s Permit Fee $ 1 1 y CCF $ CO/CC $
Scanning Fee $� Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ , Double Fee $
Structural Reviews $ , Bond $
TOTAL FEE IOW DUE $
(Revised02/24/2014)
r -
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 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 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.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 7c "� , 20 / - , by 2j-kl day of 16419-1—C , 20 I') , by
6�st SafeCif tc�o, who is personally known to it /I2 /eA , who is personally known to
me or who has produced as me or who has produced ,FL -
identification and who did take an oath.
Signature
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
•
,
!al
• .' • iFERNANDE
MY COMMISSION # FF993291
-o7`• EXPIRES May 17, 2020
(40I) 398-0153 noodalloterySerki com
APPROVED BY
CONTRACTOR
The foregoing instrument was acknowledged before me this
NOTARY PUBLIC:
Sign:
Print:
Seal:
Plans Examiner
Structural Review
KENNETH E KOTAIIK
''i: MY COMMISSION X FF952553
••,.. r•• EXPIRES Jan ,y 20, 2020
kAtmmolae****��S`e% tot** *** *******
as
Zoning
Clerk
(Revised02/24/2014)