PL-16-335Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. PL-2-16-335
Permit Type: Plumbing - Residential
Work Classification: Gas
Permit Status: APPROVED
Issue Date: 2/9/2016
Expiration: 08/07/2016
1201 NE 94 Street
Miami Shores, FL 33138-
Parcel Number
1132050100010
Block: Lot:
Applicant
BERNARD LEE
Owner Information
Address
Phone
CeII
BERNARD LEE
1201 NE 94 Street
MIAMI SHORES FL 33138-
(954)673-6513
1201 NE 94 Street
MIAMI SHORES FL 33138-
Contractor(s)
Phone
Cell Phone
PAU PLUMBING CONTRACTOR INC (305)934-2894
Valuation:
Total Sq Feet:
$ 3,400.00
0
Type of Work: INSTALL NEW GAS PIPING TO CONNECT R
Type of Piping:
Additional Info:
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
$2.00
$2.00
$0.80
$119.00
$3.00
$3.20
$132.40
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-2-16-58604
02/09/2016 Check #: 210 $ 82.40 $ 50.00
02/05/2016 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Press Test
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 erti • - foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhe or- horize the above -named contractor to do the work stated.
February 09, 2016
Authorized Signa Owner / Applicant / Contractor / Agent ate
Building Department Copy
February 09, 2016 1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
PLUMBING ❑ MECHANICAL
JOB ADDRESS:
(Zo
Alf `3 4T4
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
FBC 20
Master Permit No. -/5— /6 04
Sub Permit No. 33L)
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
S G I
City: Miami Shores County: Miami Dade sZitr
Folio/Parcel#: Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone: BFE:
OWNER: Name (Fee Simple Titleholder): t E'- I24 0 —0' ' S
Address: 126/ 7 4 / S T
33/�
NO
FFE:
Phone#: N b - c12- " ) �7
City:VVI.: �� S
Tenant/Lessee Name:
State: Fes.
Email: bTL LL 6 6 6'4nl • ( vv
? l l
Phone#: / �(� ' s( 1 ) I 1
CONTRACTOR: Company Name: OW cm., 42t/r Ar-roc_ kri.-e, Phone#: Qu t af3q41
Address: 710 6) c t2v 1 3
City: M.D.t-ei4 hha State: rz Zip: 3 f'/'14
Qualifier Name: Royi II C13 Soto Phone#: Y2C9 31agc.-C
State Certification or Registration #: CrCHl.2 6%9 /0 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 3f400 °a Square/Linear Footage of Work:
Type of Work:
Description of Work:
❑ Addition 11<lteration ❑ New
gape —�4.N) -Wide (Qs.( We- )' p c "40-9.
❑ Repair/Replace ❑ Demolition
QQ 24 iQ-1 k /' , 2
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ /[ f CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ fz. 4.
(Revised02/24/2014)
Bonding Company's Name (if applicable)
v :..t.i
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: 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 not be approved and a reinspection fee will be charged. , -
Signature
CONTRACTOR
The foregoing instrument was_ acknowledged before���me this The foregoing instrument was acknowledged before me this
I EC& , 20 I 1 0ow-- , by OS day of 'tG3 k) P' , 20 (C by
',I. �� �`-- h1 is personally known to '-ZS` N Pk‘-�X) CQST , who is personally known to
^
me or who has produced 7 102-1V -- as me or who has produced i ' 1 T2(J 4. ( fir`/S as
identification and who did take an oath.
5 day of
identification and who did take an oath.
NOTARY PUBLIC: \ �a1111rlrrrr� ,
ire
Sign: 03i06120
Print:
Seal:
********************
APPROVED BY
Comrnias on #
`.,EE113059.•cQ 1
, OF \0,
"//111111111\��'
NOTARY PUB},
Sign:
Print:
C:
Seal: d i6010 °114, Notary Public State of Florida
Sindia Alvarez
Q� My Commission FF 156750
of le Expires 09/03/2018
***************************************************************************************
Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)