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PL-17-2588Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Permit No. PL-10-17-2588 Permit Type: Plumbing - Residential ' Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 11/7/2017 1 Expiration: 05/06/2018 Applicant 129 NW 96 Street 1131010250100 Miami Shores, FL 33138- Block: Lot: ERIK SACCOMANI Owner Information ' Address Phone Call ERIK SACCOMANI 129 NW 96 Street MIAMI SHORES FL 33150- 129 NW 96 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone ALL COUNTIES PLUMBING INC (786)402-6881 of Work: ADD PLUMBING FOR LAUNDRY, WASH SINK of Piping: onal Info: ADD PLUMBING FOR LAUNDRY, WASH SINK Return ification: Residential Scanning: 1 Fees Due Amount CCF $1.80 DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $0.60 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $167.05 Valuation: $ 2,500.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-10-17-65506 11/07/2017 Credit Card $ 117.05 $ 50.00 10/31/2017 Credit Card $ 50.00 $ 0.00 Avauame, inspections: Inspection Type: U 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 jithermore, I authorize the above -named contractor to do the work stated. November 07. 2017 AuthorizeW §.[aa6ture: Owner / Applicant / Contractor / Agent Building Department Copy November 07, 2017 1 BUILDING PERMIT APPLICATION Miami Shores Village Building Department RECEIVE. 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 OCT 31 2017 Tel: (305) 795-2204 Fax: (305) 756-8972 &20"-A INSPECTION LINE PHONE NUMBER: (305) 762-4949 Master Permit No. /I - V� f:� Sub Permit No. F' f 4_'—+ 2558 ❑ BUILDING 7 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL LUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP '' (( S-� CONTRACTOR DRAWINGS JOB ADDRESS: 17 �/ " - City: Miami Shores Cou/nty: Miami Dade Zip: Folio/Parcel#: ' 1 31 I - Q Z-� dl � Is the Building Historically Designated: Yes ^ NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: �' OWNER: Name (Fee Titleholder): F/ I K— C Phone#: jSimple Address: `O- I X� at -' s t City: M l a State: 2 Zip: f� 5-0 Tenant/Lessee Name: Phone#: -1 �p E C, Email: firkI CONTRACTOR: Company Name: JII-�e � � J�� Phone#: Address: A6ZI uJf J ` City: r G(Q I^State:(.. Zip: Z �n Qualifier Name: Phone#: State Certification or Registration #: [ q Zq3 7 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Z- S�> Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition ,J❑,(� % Description of Work: U I /GC we 5"/1 i✓) /C Specify color of color thru tile: r Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ 1, (Revised02/24/2014) Bonding Company's Name (if applicable) Boni ing Corpany's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. Signature ER or AGENT The foregoing instrument was acknowledged before me this day of . 20 by w n o``is pnerso y-9/n'ial y n o w n to me or who has produced ice\pp1 l�V Y� as identification and who did take an oath. Sign Print Seal PUBLIC. .P MAHARAI K. GONZALEZ - MY COMMISSION # GG 044602 EXPIRES: November 2, 2020 [fended Thru Notary Public underwriters L0,01 Signature CONT,�RRJPCTOR The foregoing instrument asll//cknowledged before me this _�� day of OC � 20 by who is personally known to Z ✓G� me or who oduced 1`1_ as identification and wh4di4 tJke an oath. NOTARY PUBL Sign:_ Print: MY COa1.",41S5 ( "'w1�tZ rrrv� r "YOHENORYPEL RIO EXPIRES G;0446n2 Seal: ( �`�� MY COMMISSION#FF198880 rJovAr,�,her < 020 Sunded Thru r EXPIRES: FEB 12, 2019 . ,.. =� " Bonded 111;3u h 1st State Insurance ************************************************************************************************************ APPROVED BY pal lltfV' ( 'I Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)