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PL-18-2266(0)Ru.. frES IN 40 WV' Location Address Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: P1-848-2266 Permit I VAR Number: 627495 PermitType: Plumbing - Residential Work Classification: Addition/Alteration Permit Status: Approved Ise crate:10/16/2018 Expiration: 04/08/2019 Parcel Number Project 285 NE 103 ST, Miami Shores, FL 33138-2430 1121360130440 <NONE> Contacts r KENNETH & DEENY LORBER 285 NE 103 ST, MIAMI SHORES, FL 33138 Owner R&I PLUMBING SERVICES CORP RENE GUZMAN 7898 NW 174 TER, MIAMI, FL 33015 Business: 3058236911 Contractor Description: TUB TO SHOWER REMODEL OF GUEST BATHROOM REMOVE AND REPLACE 1 TOILET 1 SINK Fees Amount CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee $ 2.40 $3.75 $2.50 $0.80 $250.00 $3.00 $3.20 Total: $265.65 Building partment Copy KENNETH & DEENY LORBER 285 NE 103 ST, MIAMI SHORES, FL 33138 Applicant Valuation: $ 3,100.00 Total Sq Feet: 80.00 Inspection Requests: 305-762-4949 Payments Total Fees Credit Card Credit Card Amount Due: Date Paid Amt Paid $265.65 08/23/2018 $50.00 10/16/2018 $215.65 $0.00 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date October 16, 2018 Page 2 of 4 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC [PLUMBING ❑ MECHANICAL Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 RECEIVED AUG 2 3 2018 FBC 20i ' Master Permit No. P.-C-1 8 2 CAS/ Sub Permit No. P I ' ZZC000 ❑ ROOFING ❑ REVISION ❑PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: -25 Ne 103 Sire ❑ EXTENSION ❑ RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores Zip: Folio/Parcel#: 11 2-31 to' 013. f7`¢'Li0 Is the Building Historically Designated: Yes County: Miami Dade Occupancy Type: Load: Construction Type: Flood Zone: OWNER: Name (Fee Simple Titleholder): ran gbficr9 Lov 1 ✓ Address: 28S NE. 1 O3 5$r& City: A'►a r r t 6tft tW?.S State: Tenant/Lessee Name: Phone#: Email: 137 NO BFE: FFE: Phone#:• CONTRACTOR: Company Name: PIDR4 Address: 73c)g AJ4) / 74 7 Ali city: Yv/A / State: y: r Qualifier Name: G-e-tia, (-)V 411 a.•J Zip: ;33 13h Phone#: d�S 5-Z/ j Zip: 3 l Phone#: [J - d25 '6—2 /% State Certification or Registration #: Certificate of Competency #: (311 41)0 7 z-% DESIGNER: Architect/Engineer: Phone#: Address: City: State: ip: Square/Linear Footage of Work: go ❑ Repair/Re lace ❑ Demolition Value of Work for this Permit: $ 3f ( t. Type of Work: ❑ Addition ❑ Al ration ❑ N Description of Work: l OL , �% ( Q (�9 j1 F et_c _ Ci 4-0111t— 1 c J Specify color of color thru tile: Submittal Fee $ Permit Fee $ c?50 • CCF $ CO/CC $ Scanning Fee $ Radon Fee $ - ---(:) DBPR $ . Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ • TOTAL FEE NOW DUE $ 2 i - (Q (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 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 . - notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attach -nt. o, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs en (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be appr, ved and a reins • ion fee will be charged. Signature Aid,m, • The foregoing instrument was acknowledged before me this vv �— day of klOil.4 �- , 20 D , by t�crw'wf- ik/1 1_ov r el , who is personally known to Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this j 4 day of R'WL S-l- , 20 I $ , by ZA'-4 , who is personally known to me or who has produced a, or, �� as me or who has produced TX_ On' -tt (L as identification and who did take an oath. NOTARY PUBLIC: identification and who did take an oath. NOTARY PUBLIC: Sign: Sign: Print: T. VA Z Print: SV 3 c-P7 �u u, Seal: a°�Y P��,, Sljyaja T. Vasquez Seal: `o pA7 14 Suyapa T. Vasquez e a Commission # FF942611 s?° �., Commission # FF942611 Expires: December 9, 2019 - A. - Expires: December 9 2019 **********44 r�:***411W $4,1h111 94 ************************ *‘***.Bor C0141iAaron ary************* APPROVED BY te/3/49 Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk 7/1-fol SIN Terme Mome. FL 3 Pholy Nto) 422-5357 Ociabrir4 21)1* iuse of FiritA mq-4 _Korna- I& 41•40060to *at ap l7Pme4 -2#11cfattOttria Before tor ***day perfa logatl. Thso he CM 4g WO be the 4,my person working. on the prorg.3 located at; Sesaars, 3313, x who, being duly ;worn. C000selur Sortobie worn to tor affirmed? and what:I-01W beforeInc dm VS day of Cli(31K. 20 by Pcnonally known Oft Produced Identification Tyne Identiricalum Produced N-A. L