PL-15-1514Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Peet NO. PL-6-1 5-1514
Permit Type: Plumbing - Residential
Work Classification: Addition/Alteration
Pennit'Status: APPROVED
Issue Date: 7/20/2015
Expiration: 01 /16/2016
Parcel Number
Applicant
1017 NE 95 Street
Miami Shores, FL
1132060143580
Block: Lot:
MIAMI PROPERTY SOLUTIONS I
Owner Information
Address
Phone
Cell
MIAMI PROPERTY SOLUTIONS LLC
142 NW 100 Street
MIAMI SHORES FL 33150-
(305)807-4045
190 NE 111 Street
MIAMI SHORES FL 33161-
Contractor(s)
PSG PLUMBING SERVICES, INC
Phone
(305)796-7304
Cell Phone
Valuation:
Total Sq Feet:
$ 2,500.00
00
Type of Work: RE LOCATE KITCHEN REMOVE AND REPLAC
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Amount
$1.80
$3.38
$3.38
$0.60
$225.00
$9.00
$2.40
Total: $245.56
Pay Date Pay Type
Invoice # PL-6-15-56034
06/19/2015 Check #: 6804 $ 50.00 $ 195.56
07/20/2015 Check #: 6814 $ 195.56 $ 0.00
Amt Paid Amt Due
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 all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor
de;v
/ Agent
July 20, 2015
Date
Building Department Copy
July 20, 2015
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
FBC 20t0
BUILDING Master Permit No. CC'- t - .931
PERMIT APPLICATION Sub Permit No.12Z.16---/S/ 9
El BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 1111 RENEWAL
PLUMBING ❑ MECHANICAL El PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /0/ ? /7 1 5 s-(
City:
Miami Shores County: Miami Dade Zip:
Folio/Parcel#: ' I -- �J 20(c 0 64 ^ 3 6 8 0 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load:
Construction Type: V- Flood Zone: X BFE: FFE:
OWNER: Name (Fee Simple Titleholder): k P3 I I j V r i2S (,l. C
Address:440 2 A
City: 1.4[444( Ito
State:
Phone#: 1D5 - 400- 4. 32
Zip: 35 6 Qj
Tenant/Lessee Name: Phone#: _
Email:
CONTRACTOR: Company Name: PS 7/04164\1 Se vtrG G -f Phone#:7Se6" 3/ � rga sS
Address: 3 g5%..2AR- J•!u) (% S'S 1 pp
City: opA-LK etil State: ?for"c A Zip: 330.5'(-/
Qualifier Name: Peett,c2 S. (7e) S .�}-A-) Phone#:
State Certification or Registration #: /4(2 A)-. 7 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ p�
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑/ Alteration ❑ New ItI Repair/Replace ❑ Demolition
Description of Work: KL �-p�a �� ��' � -_) /1 a
Specify color of color thru tile: , ins)
Submittal Fee $ Permit Fee $ , 22-5- Xr' CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ q1 6 •
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 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 einspection fee will be charged.
Signature
OWNER or AGENT
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
/ 7 day Qof�Jv ✓LC , 20 / 5- , by r ` day of ✓ v - e , 20 l S , by
L, i it# # //•e( , who is ersonally known to ,.j't,o G'�t �., � , who is personally known
Axle or who has produced 774r4>,-1/4-i-L as me or who has produced �� • as
identification and who did tak an oath. identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED BY
o+"' Poi,. Notary Public State of Florida
' Maxine Y Go^tNi
31i o` My Commission.Fc: 639239
'tp� c a Expires 09/30/2016
* ****** *********** *** k***
NOTARY PUBLIC:
Sign:
Print:
Seal:
************************************************************
Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)