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PL-17-2055Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. PL-8-17- 055 Pennit Type: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 8/23/2017 Expiration: 02/19/2018 Parcel Number Applicant 426 GRAND CONCOURSE Miami Shores, FL 1132060170070 Block: Lot: HERIBERTO CRUZ Owner Information Address Phone Cell HERIBERTO CRUZ 1000 NE 96 Street MIAMI SHORES FL 33138- 1000 NE 96 Street MIAMI SHORES FL 33138- Contractor(s) LASSETER PLUMBING CO INC Phone Cell Phone (305)525-5075 (305)893-7180 Valuation: Total Sq Feet: $ 1,500.00 0 Type of Work: RE -PIPE EXISTING WASTE AND WATER FO Type of Piping: Additional Info: RE -PIPE EXISTING WASTE AND WATER FO Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Amount $1.20 $2.25 $2.25 $0.40 $5.00 $150.00 $3.00 $1.60 Total: $165.70 Pay Date Pay Type Invoice # PL-8-17-64866 08/15/2017 Credit Card 08/23/2017 Credit Card Amt Paid Amt Due $ 50.00 $ 115.70 $ 115.70 $ 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 . FID VIT: I certify that all4he foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construc "on a d-oning. Futhermore, I,authoyize jhe above -named con#ractor to do the work stated. zed ignature:Owner / j/Applintractor / Agent August 23, 2017 Date Buildi g Department Copy August 23, 2017 1 q3\ri'4C BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC )?pLUMBING ❑ MECHANICAL 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. ❑ ROOFING ❑ REVISION ❑ PUBLIC WORKS ❑ CHANGE OF (� / , _ a /� ,&, CONTRACTOR L JOB ADDRESS: � C. - - `�n 6 1.tiS"cQ, City: Miami Shores County: Miami Dade Zip: 33 I : g Folio/Parcel#: 1- 3 4--0 0010 Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: OWNER: Name (Fee Simple Titleholder): Address: 'If 46.2 City: r)11.,-.-fz,' S Tenant/Lessee Name: 14c=�(g e c.72 041 r) 1 BFE: FFE: RECEIVED AUG 1 �1pp Ca FBC 20 1-1 P 1 1 =1- 2055 ❑ EXTENSION RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS Phone#:3E4_5 as State: I✓L. Zip: 33 ) 3t Email: l> I as�. c:T CONTRACTOR: Company Name: Lis% s piomxg,491 Address: p g34 S tE t �9 City: rzi-h t v ` % kW `ly. . Qualifier Name: State Certification or Registration #: GAL. ©d.4. 1(p`�% DESIGNER: Architect/Engineer: Address: Phone#: Phone#: 305.89 3 -'Peso Zip: 3g ie f - • Phone#:3f6 "52 / Certificate of Competency #: Phone#: Value of Work for this Permit: $ .i• City: State: Zip: Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration n New ❑ Repair/Replace ❑ Demolition Description of Work R r F-A 12 =N eck9 t:_ f :r' _ € t'c.P i22e s ' ` `.iV . %' +vt-1= Specify color of color thruatile:�_- Submittal Fee $ Permit Fee $ lre0 CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ S - Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ j� TOTAL FEE NOW DUE $ ! I b , 4 6 (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 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 1 COMMENCEMENT MAY 1 1 ra. RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO Y1OUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." r } 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 n_be approveli and a reinspection fee will be charged. RN"‘h Ic Signatu Signature • ,aati t , DOWNER or AGEN ' ti CONTRACTOR• The foregoing instrument was acknowledged befo : is The foregoing instrumentwas acknowledged before me this day of `� 20 1 by i day of S , 20 F , by ribev-f0 Ex me or who has produced .r-.4 as identification and who did take an oath. N • TARY PUBLIC: mravrie Print: Seal: , who is personally known to U0hh (j P1 , who is personally known to me or who has produced —PA 1 as identification and who did take an oath. NOTARY PUBLIC: Seal: _ . t ** + MAHARAI K. GONZALEZ ' •, MY COMMISSIf1N # r;G 044602 z,` EXPIRES: November 2, 20206. kodi.� • Bonded Thru Notary Public Underwriters ssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssss APPROVED BY Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014)