PL-17-2250Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. PL-9-17-2250
Permit Type: Plumbing - Residential
WorkClassitication: Pool - Private
Perrn t Status: APPROVED
Issue Date: 10/23/2017
Expiration: 04/21/2018
Parcel Number
Applicant
290 NE 101 Street
Miami Shores, FL 33138-2423
1132060134590
Block: Lot:
STEVEN T DOBIE
Owner Information
Address
Phone
Cell
STEVEN T DOBIE
290 NE 101 Street
MIAMI SHORES FL 33138-
(512)569-3370
290 NE 101 Street
MIAMI SHORES FL 33138-
Contractor(s)
ROSMEL POOLS INC
Phone CeII Phone
(305)592-7900
Valuation:
$ 2,000.00
Total Sq Feet: 788
Type of Work: NEW POOL & DECK ROUGH AND HOOK UP
Type of Piping:
Additional Info: NEW POOL & DECK ROUGH AND HOOK UP
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$3.38
$2.25
$0.40
$225.00
$3.00
$1.60
$236.83
Pay Date Pay Type
Invoice # PL-9-17-65098
10/23/2017 Check #: 3600
Amt Paid Amt Due
$ 236.83 $ 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.
OWNER FFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construct i and z. ', Futhermore.,`authorize the above -named contractor to do the work stated.
Li WQu-t�
Authorized Signature: Owner / plicant / Contractor / Agent
October 23, 2017
Date
Building Department Copy
October 23, 2017 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
Master Permit No.
RECEIVED
SEP 19 2017
FBC 201�
7P p R- 22-U4-
Sub Permit No. P —
2250
❑ ROOFING ❑ REVISION
▪ PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: c O I I • L . LOI
City: Miami Shores
County:
Miami Dade
❑ EXTENSION RENEWAL
❑ CANCELLATION SHOP
DRAWINGS
Zip: W*5) 62
Folio/Parcel#: () 'a4t9(4;2—oi—Lieio Is the Building Historically Designated: Yes
Occupancy Type: Load:
Constr
ction Type: Flood Zone:
BFE:
NO
FFE:
OWNER: Name (Fee Simple Titleholder):---_< iN/7i e Phone#: S-17 —S-64 _ j
Address: 2 /) A /0/
City: M(OM / S)YA&5
Tenant/Lessee Nam
Email:
CONTRACTOR: Company Name:ai �'' IS --at . Phone#:30 xfOo
State: Zip: S �v
Phone#:
5 eke
Address: gWO VPi= CVh• Jt"• L (O 3
C,o�hc7—
City: rat , . State: 1[r. Zip: 33(7�
Qualifier Name: �) [creek) ' %'%G( 1Ir. - • Phone#:
State Certification or Registration #: C " jL 3f 11 Certificate of Competency #: '
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: r Zip:
Value of Work for this Permit: $ eii. fc Square/Linear Footage of Work: -o Cl
Type of Work: ❑ Addition f 1 Alteration E New
Description of Work:
`Ro( ic'_. Coo
❑ Rpair/
place ❑ Demolition
14.
Specify color of color thru tile: ,.
•
Submittal Fee $- a. a r $
Permit Fee $ : ,2 5 CCF CO/CC $
Scanning Fee $' • Radon Fee $ • 25
Technology Fee $ Training/Education Fee $
Structural Reviews $
DBPR $ .Notary $ •, ...• ,
Double Fee $
Bond $
TOTAL FEE NOW DUE $ ,,3 / . (3(k*
(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 • 1W 1 ` ? i ' State Zip
—Y t i ;.
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 thatallwork 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: F* YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YF 4 OUR NOTICE OF COMMENCEMENT."
.
j
Notice to Applicant: As a condition to the issuance of a building permit with an estimatedvalueexceeding $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 ays after the building permit is issued. In the absence of such posted notice, the
inspection will not be appro d and a reinsp n fee will be charged.
Signature
. OWNER or AGENT
The foregoing instrument was acknowledged beforemethis
day of 'U 1y , 20 17 , by
Tiobie , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: c,,16
Seal:
**********
•••• •lE r S,,
•
,.... =4.7, DORIS ANAYS MMTINEZ
Notary Public - State of Florida
•
• : ..• Commission # GG 072917
3 *'MAyEilAVh. *ptl #l*1M*2 3Pt*
Bonded through National Notary Asp.
APPROVED BY
fe•
r`i F
Signatur
� _,• i x CONWACTOR
:, r
The foregoing instrument was acknowledged - before me this
a1 I dayof- }s�V11( r ,20 20 /17 by
(gull (�tJG , who is personally known to
me or who has produced as
identification and who did take an oath.
)
NOTARY PUBLIC:
• /\
Sign:
iPta‘q Marthr,L
, PNY4. ;;•; DORIS A NAYS MA RTINEZ
Notary Public - State of Florida
Commission # GG 072917
4 +'° :, o°oMy Comm. Expires Feb 14, 2021
**************************''%#? * 4**.yaNtrt4tKr tftNISIE a}NKar n**�
Plans Examiner Zoning
Print:
Seal:
• An a
***********
Structural Review Clerk
(Revised02/24/2014)