BPP-17-2482Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. BPIF-10-17-2482
rm 1
Permit,Type. Pools/Whirlpools/Hot Tubs
Issue Da te:11 / 13/2017
Work Classification: "Repair
Permit Status: APPROVED
Expiration: 05/12/2018
Parcel Number
Applicant
1685 NE 104 Street
Miami Shores, FL
1122320320210
Block: Lot:
SEYMOUR NASH
Owner Information
Address
Phone
CeII
SEYMOUR NASH
1685 NE 104 ST
MIAMI FL 33138-2667
Contractor(s)
JAY CONSTRUCTION COMPANY
Phone CeII Phone
(305)610-6688
•
Valuation:
Total Sq Feet:
$ 15,000.00
400
Approved: In Review
Comments:
Date Approved:: In Review
Date Denied: 4144/0p
Type of Work: Swimming Pool Occupancy:
Additional Info: INSTALL NEW BRICK PAVER{ and Return :
Classification: Residential anning: 3
Fees Due
CCF
CCF
DBPR Fee
DBPR Fee
DCA Fee
DCA Fee
Education Surcharge
Education Surcharge
Permit Fee
Permit Fee
Scanning Fee'
Scanning Fee
Technology Fee
Technology Fee
Total:
Amount
$0.00
$9.00
$2.00
$0.00
$2.00
$0.00
$3.00
$0.00
$100.00
$0.00
$0.00
$9.00
$0.00
$12.00
$137.00
Available Inspections:
Inspection Type:
Final
Foundation
view Planning
tin Building
Pay Date
Invoice #
10/17/2017
11/13/2017
Pay Type
DS-10-17-65386
Credit Card
Credit Card
Amt Paid Amt Due
$ 50.00 $ 87.00
$ 87.00 $ 0.00
ilding
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, myagent, 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 aorize the above -named contractor to do the work stated.
Authorized Signature: Owner / \ ppli ant /
/ Agent
November 13, 2017
Date
Building Department Copy
November 13, 2017 1
BUILDING
PERMIT APPLICATION
ILDING ❑ ELECTRIC
❑ PLUMBING
JOB ADDRESS:
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
❑ ROOFING
RECEIVED
OCT 1 7 2017
c-t4 Q1--(
FBC
Master Permit Nag 11-9 Z0 2- •
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
-1 /
/ i1/� /7,S e (
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade
Zip:
Folio/Parcel#: 1 / ' 223,2- 0 3 2 - OQ.l () Is the Building Historically Designated: Yes
Occupancy Type: Load:
OWNER: Name (Fee Simple Titleholder
Address: 16 /ve 11a
City: /"1/‘.' 6/17)-c 1
Construction Type: Flood Zone:J' 71 BFE:
Sta
NO ✓
FFE:
36S =6/v - 4,6d-1)
14/
,.iL ♦♦♦ Z
Tenant/Lessee Nam :
Email: KA't c'' '- (•.414
CONTRACTOR: Company Name: ja..4L 1V-1/c/6.
Address:
City:
Qualifier Name: �J
°"
c
to32-I E. ` ou I
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address:
State:
/C4 f7
Phone#:
Phone#:
Phone#:
viti96j r Certificate of Competency #:
Phone#:
Zip: 3 3/ rCi
/^ City:
Value of Work for this Permit: $ (ODO fiG *Linear Footage of Work:
„Type of Work:- ..❑-Addition ❑ Alteration ❑ New
State: Zip:
Repair/Replace • '❑ Demolition
Description.of Worki A/le.J
34161-4)
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee $
Structural Reviews $
CO/CC $
Notary $
Training/Education Fee $ Double Fee $
Bond $
TOTAL FEE NOW DUE$ 8' ' \
CCF $
DBPR $
(Revised02/24/2014)
•
•.
V r!Z T
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: Aso '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 postenotice, 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
O�� , 20 ` R ' , by
c l `� .,� moo 1 Nasb�sopersonallllyknown to
-� me or who has produced 1 , LXi1 1 d"`- as
identification and who did take an oath.
NOTARY PU : IC:
Sig
Print:
Seal:
,,�f1,�'I'r:-"t•• MAHARAI K. GONZALEZ
• • MY COMMISSION # GG 044602
EXPIRES: November 2, 2020
******************************
APPROVED BY
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
14_ day of a* , 20 by
a M ei se; is ersonally known to
me or who has produced '� t k as
,identification and who did take an oath.
Fes,
NOTARY PUBLIC:
Sig
Print:
Seal:
:"•" 'y?c'; M MAHARAI K. GONZALEZ
• .% Y COMMISSION # GG 044602
• so Fo.•,r . 'ovembdr2,2020
"Bonded Thru Notary Public Underwriters
**** *******************************************************************
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)