PL-18-1080Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pei
•m it
Permit NO. °PL-4-18-1080
Permit Type: Plumbing - Residential
'ork Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 6/1312018Expiration: 12/10/2018
Parcel Number
Applicant
474 NE 95 Street
Miami Shores, FL 33138-
1132060140440
Block: Lot:
ANNE & NESTOR MORALES
Owner Information
Address
Phone
Cell
ANNE & NESTOR MORALES
474 NE 95 Street
MIAMI SHORES FL 33138-
(305)283-7233 (305)733-6534
Contractor(s) Phone CeII Phone
REGOSA ENGINEERING SERVICES It (786)262-2964 (786)344-8720
Valuation:
Total Sq Feet:
$ 2,500.00
0
Type of Work: NEW SHOWER , KITCHEN SINK VANITY ,
Type of Piping:
Additional Info: NEW SHOWER , KITCHEN SINK VANITY ,
Bond Return,:
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.80
$2.25
$2.00
$0.60
$150.00
$3.00
$2.40
$162.05
Pay Date Pay Type
Invoice # PL-4-18-67281
04/25/2018 Credit Card
06/13/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 112.05
$ 112.05 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Final
Underground
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 contractor to do the work stated.
June 13, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
Building Department Copy
June 13, 2018
1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
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
018
FBC 201 Sth
Master Permit No. Ik C t a —SOS
Sub Permit No. i LYFI 10g0
El ROOFING ❑ REVISION
1PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS:
4 N5 75- sT
City: Miami Shores County:
Miami Dade
❑ EXTENSION ❑RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
zip:3 3/ 3 e
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type:
Address:
Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): AA) A% (\�} V'�'t N tiles-f5,2 t-lU�•��� phone#:
41 q AI
City: J`I 1 - i (itC\J/Q _C State: Zip: 3 3 ( 3 i'
Tenant/Lessee Name: ,, Phone#:
N.3i-1� �� C j 1oi /,AiNl L, c0 /1
CONTRACTOR: Company Name: Re C 0 S -6V j yleexi S C. Phone#: 7 v (p 0/- 6 )- a-ct 6
Address: / J 7 0 0 e li�}-ut e i/ l N
City: Ill/WG. wc4 State: P' ( Zip: 331 /C
Qualifier Name: (- L JS `Pb1- O (/ t, 2i Phone#: l8 (� a-t9 )16 v
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2 "SD 6)
Email:
33-C y
Type of Work: ❑ Addition ❑ Alteration
Description of Work:
:,,Specify color of color thru. tile:
Square/Linear Footage of Work:
❑ New ❑ Repair/Replace
n Demolition
.,fir c/i/ 'H 5/4'k 1/29/5w-
etL3tM-0i1'SitS v t
Al�illl
.Gf � atri2 �itMu� �•�tit��
VIOS ),ry.lx �+t,tix.t 5c
Submittal Fee $ .CI Permit Fee $ filli ' !3' 1 ''1' CCF $ri' `47,,.,.• CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
as
(Revised02/24/2014)
TOTAL FEE NOW DUE $
V i !r
Bon�ding'Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
ti •_E
Mortgage Lendetr'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. ti
- "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 issuee absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
, Z•.
Signatur �',
Lac
OWNER or AGENT
oregoing instrument was acknowledged before me this
day of , 20
by
jl.✓N1-=C1V;dN i/UES on pe g�Sily nownto�n/(
� I ( (44' ' ?ne or who has produced
Signature
CONTRACTOR
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
******************************
� l
The foregoing instrument was acknowledged before me this
day of 'sr,-. (j ' 20 by
CL 0 5-r k td g Go7K,ho is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
LUCY'ZUZULO-M
Notary Public - NAV Modda
Commission i1 FF 232675
My Comm. Expires Aug 20 201Y
as
MIGUEL DE PAZ
Notary Public - State of Florida
•�•, - = Commission 11 GG 135943
:,04 e: My Comm. Expires Aug 20, 2021
'AOFr7Bonded through National Notary Assn.
APPROVED BY K ( 'f X /a Plans Examiner Zoning
Structural Review
Clerk
(Revised02/24/2014)