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PL-18-1010Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Permit NO. PL-4-18-1010 Permit Type: Plumbing - Residential Work Classification: Pool - Private Permit Status: APPROVED Issue Date: 8/2/2018 Expiration: 01/29/2019 Parcel Number Applicant 1148 NE 105 Street Miami Shores, FL 33138-2108 1122320280140 Block: Lot: STEPHANE FERNANDEZ Owner Information Address Phone Cell STEPHANE FERNANDEZ 1148 NE 105 Street MIAMI SHORES FL 33138- 1148 NE 105 Street MIAMI SHORES FL 33138- Contractor(s) POOLS BY G.E. CORP Phone Cell Phone (786)732-0614 (786)355-3382 Valuation: Total Sq Feet: $ 400.00 60 Type of Work: RELOCATE POOL EQUIPMENT TO SIDE OF Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Penalty Fee Permit Fee Scanning Fee Technology Fee Work without Permit Fee Total: Amount $0.60 $6.75 $4.50 $0.20 $100.00 $450.00 $3.00 $0.80 $450.00 $1,015.85 Pay Date Pay Type Invoice # PL-4-18-67193 08/02/2018 Check #: 466 04/17/2018 Credit Card 1_ Amt Paid Amt Due $ 965.85 $ 50.00 $ 50.00 $ 0.00 MI 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. OWNERS AFFIDAVI certify tha the forego construction and zo no. utherm•,' thorize Authoriz•d Signat e: Owner / information is accurate and that all work will be done in compliance with all applicable laws regulating bove-named contractor to the work stated. M'ue/ ,e ia.1 August 02, 2018 Applicant / Contractor / Agent Date Building Department Copy August 02, 2018 1 BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING REVISION �K.4 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 CETVED A`R172018 ( TM FBC20/ter Master Permit No. BPP 1€F ( W l Sub Permit No. L (e --10 L 0 ❑ EXTENSION ❑ RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: I ! 4 /V e i 05 S4 • City: Miami Shores County: Miami Dade ▪ CANCELLATION Zip: El SHOP DRAWINGS Folio/Parcel#: . Is the Building Historically Designated: Yes NO Occupancy Type: Load: fsdf Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee SimpleeTitleholder): % e- fettk a Address: ' t 17 ! e l o5 S'• ( City:: MICA, kAA i SLt%cW 0 3 State: •+L vtcte,z Phone#: :&77673'66 zip: 33 / Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: POOLS r• nit Address: (p5fl SO 2.3 ap- City: 4 ' A PA I State: Ft - Qualifier Name: '?�) C l(elNi'?(-- ► � ply i J � Phone#: State Certification or Registration #: C 114 5 O n / 5 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: Value of Work for this Permit: $ Phone#: l 355-33 ?2. Zip: 331557 -7035533 82 4 a �Q !Ji City: State: Zip: Square/Linear Footage of Work: f 0 L: P/ Type of Work: ❑ Addition ❑ Alteration n New Repair/Replace ri Demolition Description of Work: PLOCA-fT P©k- ecpti tii+ S e d f k o.)SC Ott :AU'/;l.'Y'iii.q Specify color of colo?thrutile: l=; r.cs: •Submittal Fee $ Permit Fee $' Scanning Fee $ Radon Fee $ CCF $ CO/CC $ DBPR $ • ; 5 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ I � • CO Structural Reviews $ Bond $ - (Revised02/24/2014) TOTAL FEE NOW DUE $ q-Gs B Ara ry Bonding Company's Address .t 72,,........ ,— XisV City; — --- --^ ` State Zip Mortgage Lender's Name (if applicable) E , - 4 . '++- _ 't Mortgage Lender's Address Bonding Company's Name (if applicable) 7 t City I 7 { State* . Zip ' + p t .t • mot'; of m 1 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 1t.. 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. 1K "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." •{, 4 f•r — 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. Sign'atu OWNER or AGENT Signature" ON�f ACTOR The -foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this , 20 ( by p ( day of l�eR-t 1 , 20 . 12 , by wn to (1 day of ApYLL ` i.) `'tittle qicrtardpho is personally known to me or who has produced 4 as me who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: . Print: Seal: AIDAPEGUERO * * MY COMMISSION 1 FF 165583 EXPIRES: October 5, 2018 . ', em rues' Bonded Thru Budget Notary Services 31 APPROVED BY identification and who did take ar oath. NOTARY PUBLIC: Sign' Print: Seal: • Plans Examiner �`;� * •(rr A8)A PEGUERO * MY COMMISSION 1 FF 165563 EXPIRES' October S, 2018 44, no Bonded ThN Budget Notary Services dC Zoning -- r • (Revised02/24/2014) Structural Review 4 Clerk