PL-17-2845Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit n/a. PL-1.1-17-2845
Permit Type: Plumbing - Residential
tozk Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 2/27/2018
Expiration: 08/26/2018
Parcel Number
Applicant
1064 NE 97 Street
Miami Shores, FL 33138-
1132050170200
Block: Lot:
MARIE ROBSON
Owner Information
Address
Phone
Cell
MARIE ROBSON
1064 NE 97 ST
MIAMI SHORES FL 33138-2556
Contractor(s) Phone
SEA COAST CONSTRUCTION GROUP (786)385-2139
CeII Phone
Valuation:
$ 4,000.00
Total Sq Feet: 251
Type of Work: REPLACE EXISTING PLUMBING FIXTURES
Type of Piping:
Additional Info: REPLACE EXISTING PLUMBING FIXTURES
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$2.40
$2.25
$2.00
$0.80
$150.00
$3.00
$3.20
$163.65
Pay Date Pay Type
Invoice # PL-11-17-65797
02/27/2018 Credit Card
11/30/2017 Credit Card
Amt Paid Amt Due
$ 113.65 $ 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 AFFID
construction an
certify that all the fore in infor
thermore, I authorize he bove
Auth4yfzed Signature: wner
accufate and that all work will be done in compliance with all applicable laws regulating
ctor to do the work stated.
/ applicant / Contractor
February 27, 2018
Date
Building Department Copy
February 27, 2018 1
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
❑ ROOFING
❑ PUBLIC WORKS
JOB ADDRESS: LV{P I NE 97 Sr'
City: Miami Shores County:
'I ( s7lONS
(A`IL )40N1CRUC
CEIL k-ELE1!
NOV 3 0 2017
S h
�FBC 201
Master Permit No. I2--( l� '"7 P)IZD
Sub Permit No. P l \ -2guts
❑ REVISION ❑ EXTENSION RENEWAL
CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Dade Zip:
Folio/Parcel#: (1 32°5 - Or./ ' 02 oa
Occupancy Type: Load:
OWNER: Name (Fee Simple Titleholder):
Address:
Is the Building Historically Designated: Yes NO
Construction Type: Flood Zone:
MA I 13.
tom NE '-7S
BFE: FFE:
Phone#: 1 g(v 2S3 2't 4
City: M i 4'4 1 c�(— V L S State: FL- Zip:3313g
Tenant/Lessee Name: Phone#:
Email: 4oN(1 QUL-. 1-1 7 Ta i\(t='T'
CONTRACTOR: Compan Name: 6./CL OOO ( ksf rue1; 0Ai grout hone#: (7t6, -jg5- Zt3 i
Address: I2ILI Re.(&)Ra ��v,atl1t pO_JJKS+rc-t-c.--ior►Soci<.ot-CC vn
City: Ocr�p c`�ra_k State: `ov-Z �-t Zip: 3J 9 3
Qualifier Name:7-t/o (�i i'e(Z Phone#: 6 —3 Fry 2 3 j
State Certification or egistration #: �yF 0—) Z k 3 8 a Certificate of Compete��
Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 12 ti0 • Square/Linear Footage of Work: 25 I
Type of Work: ❑ Addition ❑ Alteration ElNew ❑ Repair/Replace ❑ Demolition
Description of Work: RC P pLt CC E34Isri /J pbv il gi N 6. f (x 11J e
2 f T I -t 2c o f .r ( K i rcit I J SA- -i e
LACAitI oni + r1 E, ( 'o C-iLIST/NG W4-/Ns
Specify color of color thru°tile:
. Submittal Fee $ Permit Fee $ 15 0 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
IS .e'S
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
•City t ; '`+ State Zip
,Mortgage Lender's Name (if applicable)
a /1 '
Mortgage Lender's Address
.• _ ..
City ' I 1 =+ State Zip
e: 1 '
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 $25b0, 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 tl4e 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 willot e approved and a reins ctionill be charged. } 1
Signature
The foregoing instrument was acknowledged before me this
day of Nox- gM- ,20t1 ,by
ONiQ.jt. 5)rn11M , who isers4M17-Mot3to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
o #FF 954760 , '
•;„ A '0;—noed ih0
//4C' , STAT` 0v �e��'
***********************************.***********************************
The foregoing instrument was acknowledged before me this
OF day of 40vewrt t'( , 20 , by
�lX�robCca (r vZ , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
APPROVED BY
Sign: tcc el'
Print:
Seal:
K / /2—/' ! Plans Examiner
Structural Review
ly
c,,�M4
Y NotaryPublic State of Florida
1' Lazaro Garcia
My Commission GG 138382
M Expires 08/27/2021
**
Zoning
Clerk
(Revised02/24/2014)