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PL-17-782Miami 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-3-17-782 Permit Type: Plumbing - Residential WorkClassification: Pool - Private PemtitStatus: APPROVED slue Date: 412/2017 Expiration: 10/09/2017 Applicant 311 NE 103 Street Miami Shores, FL 33138- Owner Information Address 1121360130240 Block: Lot: Phone SERGIO SIGALA Cell SERGIO SIGALA 311 NE 103 Street MIAMI SHORES FL 33138- 311 NE 103 Street MIAMI SHORES FL 33138- Contractor(s) ROSMEL POOL INC Phone (305)592-7900 Cell Phone Valuation: (786)546-1356 $ 2,000.00 Total Sq Feet: 832 Type of Work: POOL PIPPING Type of Piping: Additional Info: POOL PIPPING Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $3.38 $3.38 $0.40 $225.00 $3.00 $1.60 $237.96 Pay Date Pay Type Invoice # PL-3-17-63409 04/12/2017 Check #: 14282 03/22/2017 Check #: 14180 Amt Paid Amt Due $ 187.96 $ 50.00 $ 50.00 $ 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 foregoing information is accurat,. that ork will done incompliance with all applicable laws regulating ow construction and zoning. Futhermore, I authorize the above-ed co do the rk t 'April 12, 2017 Authorized Signature: Owner / Applicant "/ "Cori, ctor / Ag Date Building Department Copy April 12, 2017 1 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC PLUMBING ❑ MECHANICAL JOB ADDRESS: 311 NE 103 ST 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 RiPCRIVED MAR 2 2 2017 ((�FBC20 Master Permit No. t P -(�7 8 . Sub Permit No. PL Z ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION CONTRACTOR ❑ RENEWAL ❑ SHOP DRAWINGS City: Miami Shores Folio/Parcel#:11-2136-013-0240 County: Miami Dade Occupancy Type: Load: Construction Type: Zip: 336SI? Is the Building Historically Designated: Yes NO Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): SERGIO SIGALA Phone#: Address: 311 NE 103 ST City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: ROSMEL POOLS INC. Phone#: 305-592-7900 Address: 9300 NW 25 ST State: FL Zip:: 33172 �' Phone#: rc)-3 - WO_ Certificate of Competency #: DESIGNER: Architect/Engineer: -t Address: 711 S•(,l7 • )�• . Value of Work for this Permit: $ Di COD-Q City: DORAL Qualifier Name: WILFREDO LEIVA JR. State Certification or Registration �#: yr C, ((15 11 ion Q © 1 1• 4-1.c63 }` Phonem---7Irj=7)0.5 City: /41 CUM State: 'FL Zip: 33)21L) Square/Linear Footage of Work: o i� SQ T• Type of Work: ❑ Addition Description of Work: —gyp\ Alteration 1� New El Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ FD01(( Permit Fee $ 7—S CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ {� TOTAL FEE NOW DUE$ IC7. • 9.6 (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 . �.. i 4 { State Zip 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 approve and a reinspection fee will be charged. Signature NER or AGENT The foregoing instrument was acknowledged before me this 16 day of JANUARY 17 ,20 ,by k ' 0 o is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: MA Seal: APPROVED BY :ION FF Cu•J ^-,•,L.;y15,2017 BondedTl:ruNotaryPub!w un 3-2311 as Signature CONTTOR The foregoing instrument was acknowledd before me this 16 day of JANUARY 20 17 by -who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: - Jj)1G Print: MAR bR7t1stZ>_ ap4'' .. ;b's r,inr i�.+,j i ti, 114HH I iN� Seal: ;o. tr FFC08989 ' pF''• '. 017 „'h•, ' o �:•a r.i � ,�� UnCenvriters •.n._vs'ss`�.ic�a:a�zic";�'-:nsr'<_.s�e�.s•aw Sign: Plans Examiner ° Structural Review as Zoning Clerk (Revised02/24/2014)