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PL-15-2184Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. PL-8-15 2184 Permit Type: Plumbing - Residential Work Classification: Pool - Private Permit Status: APPROVED Issue Date: 91/812018 Expiration: 03/16/2016 Parcel Number Applicant 1050 NE 107 Street Miami Shores, FL 33161-7374 Owner Information GABRIEL MARTIN KUSKUNOV 1122320280520 Block: Lot: Address 1050 NE 107 Street MIAMI SHORES FL 33161-7374 r Phone GABRIEL MARTIN KUSKUNOV ell 1050 NE 107 Street MIAMI SHORES FL 33161-7374 of Contractor(s) SUNSET POOL AND SPA Phone (305)804-1068 CeII Phone Type of Work: MAKE ALL PLUMBING FOR THE POOL Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 3 COCELLED Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20p r i 1$3781 4 a $3.38 $0.40 $225.00 $9.00 $1.60 $243.96 Pay Date Invoice # 08/25/2015 09/18/2015 Pay Type Amt Paid Amt Due PL-8-15-56863 Check #: 2787 5q.0Q,$ 193.96 Ch �{9, �• $.193.96 ;'$ 0.00 Available Inspections: Inspection Type: Main Drain Final Rough Review Plumbing 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 ntractor to do the work stated. September 18, 2015 Authorized Signature: Owner / Applicant / Con actor / Agent Date Building Department Copy September 18, 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 RECEIVED AUG 25 2015 BY: _ Idi FBC 20 Q BUILDING Master Permit No. 6T - 15- Z( O PERMIT APPLICATION Sub Permit No. IS-- 2,1 g Lf BUILDING ❑ ELECTRIC '• . i! o PC E L 1'1 REVISION ❑EXTENSION RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 106 N E J 01 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: i\- 222 ©Z$ - 0 SZb Is the Building Historically Designated: Yes NO Occupancy Type: 5 R. Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Lr i e( NI pit ,Z <V S Kl,) 40 V Ph e#: � Address: 1 0S� . M e. 11 ST-ANC c 44EID City: tC+1 SOY-e State: /04 + (Lk Zip: `mil+ '' lS Tenant/Lessee Name: Email Bake ' rv+ . CO m CONTRACTOR: Company Name: SlYt4 -iPif:ya\ Pc)\ Address: S�' - Phone#: City: ‘\,1\'• O\ Vvs State: -ri Cl { i AA Zip: 33 (% S Qualifier Name: 8Y eve- I\ . (--,NTx.)12.? Phone#: State Certification or Registration #: CPC `" o 0 c6,C Certificate of Competency #: DESIGNER: Architect/Engineer: A t41 8tk i 0C-G N-eA C7 s- Phone#: 30 S--.2(01- 017.4 Address: 1 skU 5 S U4 • Zy- St S kl i -e, l i t City: rikiciM 1 State: 1• Zip: Value of Work for this Permit: $ 1 , S O O > 0 6 Square/Linear, Footage of Work: ? i~ . Type of Work: ❑ Addition El Alteration �7k " ,,,, t 1! (❑ .Repair/Replace ❑ Demolition f Description of Work: rY1(,kQ e(u , n►� U e +in e,eZtt. i Specifycolorof colorthru tile: e,sl. Submittal Fee $ Permit Fee $ i22 S. ' CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ ( Q 3'1G (Revised02/24/2014) Bonding Company's'Name (if applicable) hl,` Bonding Company's Address City State s. , Zip Mortgage Lender's Name (if applicable) e s Mortgage Lender's Address'- City ._ y r eaY• ' .State :k Zip a e. • ., an irt,.f r. 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 perfoilmed 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 iegood 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. I the absence of such posted n ice, the inspection will not b • • •roved and a reinspection fee will be charged. Signature - Signature WNER or AGENT The foregoing instrument . s acknowledged before me this / 14 day of t •. ,20 tS ,by M1 • who is personally known to me or who has produced d.- er \\e-evxce as. identification and who did take an oath. . NOTARY PUBLIC: Sign: Print: Seal: 3i' pRr�a�' �•O 6C�' CARY M. RODRIGUEZ APPROVED BY Ida • • 1. My Comm. Expires Aug 18, 2015 9,v Commission # EE 106632 "' ,�'••` Bonded Through National Notary Assn. CONTRACTOR The foregoing instr qr ent-was acknowledged before day of Tyre- ' , 20 ii �74cz Y 1 who ispersonally known to by me or who has produced as identification and who did take an oath. NOTARY PUBLIC: t•-7�'�� , Plans Examiner • >ti T ;, CARY M. RODRIGUEZ i e`t% Notary Public - State of Florida .2 My Comm. Expires Aug 18, 2015 S;P;,, : Commission # EE 106632 °F "``''� Bonded Through National Notary Assn. Zoning (Revised02/24/2014) Structural Review Clerk