PL-17-1725Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
mitt No: 1 i-7-17-1725
Perrnt,Type• Plumbing -Residential
Work Ciassifcation Pool - Private
Permit Status:, APPROVED
Issue Date:712412017, Expiration: 01/20/2018
Parcel Number
Applicant
118 NE 102 Street
Miami Shores, FL
1132060131890
Block: Lot:
KARON COLEMAN
Owner Information
Address
Phone
Cell
KARON COLEMAN
118 NE 102 Street
MIAMI SHORES FL 33138-
(305)987-8422
118 NE 102 Street
MIAMI SHORES FL 33138-
Valuation:
Total Sq Feet:
$ 300.00
0
Type of Work: POOL PIPING FOR NEW SWIMMING POOL
Type of Piping:
Additional Info: POOL PIPING FOR NEW SWIMMING POOL
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$3.38
$3.38
$0.20
$225.00
$3.00
$0.80
$236.36
Pay Date Pay Type
Invoice # PL-7-17-64481
07/24/2017 Check #: 1544
Amt Paid Amt Due
$ 236.36 $ 0.00
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 AFFIDAVIT: I certify that all the f
construction andFuore, I
egoing information is accurate and that all work will be done in compliance with all applicable laws regulating
bove-named contractor to do the work stated.
licant / Contractor / Agent
July 24, 2017
Date
Building -Department Copy
July 24, 2017
1
Miami Shores Village RECEIVED
Building Department JUL 052017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 S
FBC 201�
BUILDING Master Permit No. 1 / — / �3
PERMIT APPLICATION Sub Permit No._ 7\ 6l —I �Z 5
❑BUILDING ❑ ELECTRIC El ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
EgpLUMBING ❑ MECHANICAL El PUBLIC WORKS El CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: b /' N . l o 2 J
City: Miami Shores County: Miami Dade
Folio/Parcel#: �. � — �,Q b — 613 -- I 1
Zip:3313S
Is the Building Historically Designated: Yes NO
Occupancy TypdSt(�a ic-, Load: Construction Type: Flood Zone: k BFE: FFE:
fci 'Il J�((
OWNER: Name (Fee Simp?e Titlehoider):KCLko (irfi(Jn 3c hr' Phone#:bG ~ I t�
Address: 11 $ N
Ur(
City: l ►1 SY\ VR, _s
State: (,_ Zip:
Tenant/Lessee Name: N\ }� Phone#: A) 1,4
Email: l 1 C•�--Q.CA\M C,L,R�4�i �(.t11)Co •C_f PeN
f
CONTRACTOR: Company Name: OOLS b � � �• 00T Phone#: 7i(o-73 2:- C
Address: 12 315 Sc t_� ) 33 04 '
City: H Cer on State: Zip: 3 3 i
�7
Qualifier Name: u�1IQ(4 i(7 £ EJ,eL.
State Certification or Registration #: C P 1-J FS
Phone#:
g 45
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City:
Value of Work for this Permit: $ 3(�• Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
Description of Work:
-2'_ AJ;.•
ler, 3,5S-33 82
State: Zip:
New ElRepair/Replace n Demolition
pC�L fiipi'fl5 �c? r n �[.L) 5[,u i� nyi in 0,1
Specify color of color thru tile:
111$101 OJIM 3t13i110
goon to O?R12 • 9ito3Q lottot4
awe ii N notattimo )
Submittal Fee $ Permit Fee $ ? af' CCF $ .sos .$t as2 tatia
Scanning Fee $ Radon Fee $ DBPR $ ay
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ / •
TOTAL FEE NOW DUE $125,6 • 3 k3
(Revised02/24/2014)
Q3Vl333
Bonding Company's Name (if applicable)
Bonding Companjr'sAddress M\{�
NA A
City State Zip
Mortgage Lender's Name (if applicable) Well s ifQ,1R 66
Mortgage Lender's Address 0, vk G n &.1%
State 1 Zip-1 (a v 7)5?
City _ 0ca S
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
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of rQ.idrti• , 20
, by
ho is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
Seal:
as
Signature
The foregoing instrument was acknowledged before me this
n day of Jut'J ,20 1^7 ,by
lN41-QY1-t 0 V.0 who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
as
* MY COMMISSION t FF 165583
EXPIRES: October 5, 2018
fEa f�o�+°e Bonded Thru Budget Notary Services
****** *******************************************************************
APPROVED BY 7 4---/? Plans Examiner
Zoning
Structural Review
ry
(Revised02/24/2014)
Clerk