PL-17-2147Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pe
Parcel Number
Permit NO. PL-8-17-2147
Permit Type: Plumbing - Residential
Work Classcation: Drainfield
Permit Status: APPROVED
: 8/24/2017
Expiration: 02/20/2018
Applicant
444 NE 93 Street
Miami Shores, FL 33138-
1132060140200
' Block: Lot:
SETH & LYNETTE LONG
Owner Information
Address
Phone
Cell
SETH & LYNETTE LONG
650 W Avenue
MIAMI BEACH FL 33139-
(305)325-6976
650 W Avenue
MIAMI BEACH FL 33139-
Contractor(s) Phone Cell Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Valuation:
Total Sq Feet:
$ 10,000.00
400
Type of Work: NEW SEPTIC TANK & DRAINFIELD.
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$6.00
$4.50
$4.50
$2.00
$300.00
$9.00
$8.00
$334.00
Pay Date Pay Type
Invoice # PL-8-17-64983
08/24/2017 Check #: 328
Amt Paid Amt Due
$ 334.00 $ 0.00
Available Inspections:
Inspection Type:
WF25 Approval
Ftinal ilt ►i+w�
Revie0 Pliijnbing �►
D
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 i strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this p it assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for E _I? AL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS
constructio
itify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
Futhermore, I authorize the above -named contractor to do the work stated.
Aut prized Signature: Owner / Applicant / Contractor / Agent
August 24, 2017
Date
Building Department Copy
August 24, 2017 1
Value of Work for this Permit: $ VC3(rD3D
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work: Renewal of permit ?Liu .--- ad `ti
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 24
FBC 201uk
BUILDING Master Permit No. P1-J 1 2 � 9 i
PERMIT APPLICATION Sub Permit No.-2- 7 1—`
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION •RENEWAL
El PLUMBING ❑ MECHANICAL El PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOBAD�REss: 444 NE 93 Street
City: Miami Shores County: Miami Dade Zip: 3?I 3''
Folio/Parcel#:11-3206-014-0200 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: PBFE: FFE:
OWNER: Name (Fee Simple Titleholder): Seth Long i Phoneg4 41 s �.
Address:444 NE 93 Street '411 e1 4'4..t/ / t
City: Miami Shores State: FL Zip: 33138 ` L
Tenant/Lessee Name: NA
Email:
Phone#:
CONTRACTOR: Company Name: Mr. C's Plumbing & Septic
Address: 19932 NW 2 Avenue
Phone#: 305-651-7859
City: Miami State: FL Zip: 33169
Qualifier Name: Kemble Ettrick
Phone#:
State Certification or Registration #: SR061536 Certificate of Competency #:
DESIGNER: Architect/Engineer: NA
�i t t
Address: City: ( tState Zip:
Square/Linear Footage of Work: 0
Phone#:
❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
- 34-0o
Bonding Company's Name (if applicable) NA
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) NA
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.
Signatur
OWNER or AGENT
Signature
CONTRACTOR
The foregoqing instrume , was acknowledged before me this The foregoing instrument was acknowledged before me this
7y day of • l , 1j� V , 20 17 , by / 74 //day of s , 20 /7 , by
3c.4 L 1--CV ' , who is personally known to ��IIM�JCG e /� ,who is personally known to
me or who has produced 5
identification and who did take an oath.
NOTARY PUBLIC:
Sign:,
Print:
Seal:
j)e ri^ s - d
;•s"" DONALD MARTIN
MY COMMISSION # GG102743
*ilifia ********R****aY** *s ******
APPROVED BY
Fp/p-
as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
a.��d t�
Kl<...
OHAI f� a
********************
Plans Examiner
DONALD MARTIN
„3:.*:***1 MY COMMISSION # GG102743
...;!*0,05.s.z7 EXPIRES May 09, 2021
r
*******
Zoning
(Revised02)24/2014)
Structural Review Clerk