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PL-17-2913Permit NO. PL-12-17-29`13 �sHO1s L,� Miami Shores Village Permit Type: Plumbing - Residential' 10050 N.E. 2nd Avenue NE a rl� Work Classification: Gas ,..�.. Miami Shores, FL 33138-0000 PPermit Status: APPROVED Phone: (305)795-2204 F�On Issue Date: 12115/2017 1 Expiration: 06/13/2018 Project Address Parcel Number Applicant 1201 NE 96 Street 1132060143830 Miami Shores, FL 33138-2553 Block: Lot: BKT HOLDING LLC Owner Information Address Phone Cell BKT HOLDING LLC 700 NE 90 Street MIAMI FL 33138- 2691 E OAKLAND PARK Boulevard FT. LAUDERDALE FL 33306- Contractor(s) Phone Cell Phone ALDAN PLUMBING INC (305)829-3031 Type of Work: gas line addition Type of Piping: Additional Info: gas line addition Bond Return : Classification: Residential Scanning: 4 Fees Due Amount CCF $3.00 DBPR Fee $3.38 DCA Fee $2.25 Education Surcharge $1.00 Permit Fee $225.00 Scanning Fee $12.00 Technology Fee $4.00 Total: $250.63 Valuation: $ 5,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-12-17-65875 12/15/2017 Credit Card $ 250.63 $ 0.00 Available Inspections: Inspection Type: Final Press Test 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 tha t r i information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futher re, You above -named contractor to do the work stated. December 15, 2017 Authorized Signatu : Owne / plicant / Contractor / Agent Date Building Department Copy December 15, 2017 1 Miami Shores Village���=� Building Department DEC 12 2017 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 T r Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 2014 BUILDING Master Permit No. 1661 PERMIT APPLICATION Sub Permit No. Zq 13 ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL -_§PPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1201 NE 96th St City: Miami Shores County Miami Dade zip: Folio/Parcel#:11-3206-014-3830 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): BKT HOLDING LLC Phone#: 305 904 1608 Address:2691 E OAKLAND PARK BLVD STE 201A City. FORT LAUDERDALE state: FL Zip: 33306 Tenant/Lessee Name: Phone#: Email: AB@BURKMIAMI.COM CONTRACTOR: Company Name: A(d, PC,4, , Phone#: Dl- 6a3-31 S3 Address: f1600 Nw 3l' ,y Cityg,, d State ��. Zip: 3<2y Qualifier Name: A(421) r .c� Phone#: 239-603-3 S-3 State Certification or Registration M A�c <<i2 (1 Certificate of Competency M DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $ .006 Square/linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace Description of Work: _L �Gq, 5 vl /ice, /V 121n J6 44, Zip: ❑ Demolition Specifjr color of color thru tile:- I " Submittal Fee $ r Permit Fee $ ' ! CCF $ CO/CC $ Scanning Fee $ Radon Fee $. 2- - 2-`� DBPR $ 3 • 39 • Notary $ Technology Fee $ Training/Education Fee $ Structural Reviews $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 0SO • (03 (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company'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 Signature 6M4 R or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this day of 20. by ho is personally known to me or who has produced as The foregoing instrument was acknowledged before me this _ ' day of ,p C6�`'`+rl ' 20 by �I����� who is personally known to me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBUC: Sign: Sign: Print: Q PS Print: S Seal: r;o,;«P�e••.; ISABEL VALDES Seal: `� ISABEL VALDES MY COMMISSION #FF101662 Pr o<•' '_+i'' MY COMMISSION #FF101662 h+ `+ XPIRES March 13. 2018 EXPIRES March 13. 2018 i►!!ii!►! #1 7)398-'##i###!iili# ii##►i######ii i#i####►i###!#i#i###! i#i i!!ii (407) 398.0153 Fto ida taryServtce.com a r�7 (407) 398-0153 Floridallotary of &*A" APPROVED BY Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) ■ complete items 1, 2, and 3. ■ Print your. name and address on the reverse so that we can retum the card to you. ■ Attach this card to the back of the mailpiece, or'on the front if space permits. 1. Article Address kk& Z TI: U W� �Pa I kx. a &oo mu-) Goo h R G JI�0.7.,� D. Is delkwy address different from item 17— u Te; If YES, enter delivery address below: ❑ No 3 We❑ Priority Mal Express® Express® 9402 4450 8248 3333 07MallO Del" � Mau Restricted Delivery ❑ for O Collect —�'rr—nafArfrnm service label) .— o0 Collect on Wery n 'Delivery Restricted Deliyery ❑ Signature ConfirmationTm ❑ Signature Confirmation 2. 7018 1130002 0904 7191 rai�taa teiiy ` ' Restricted oenvery F I t Domestic Return Recelpt PS Form 3811,.July`2015 PSN 7530-02-008-9053 ,r Flrst Class Mail Postage &Fees Paid Permit No. G-10 United States POStdj Serviceer lease print your name, address, and ZIP+4® in tt Ow► 2, l w�2rG�o K, S212vd L e-� . i . _ ,.)�?r?is3�l�e�.i3i,fl.f��:i�:,l�i�i f�f• ..i•� .. .. .. ... #.�iiif ii�iF}i�:tl�eliii�i��•ii � irali box• BUILDING PERMIT APPLICATION ❑ BUILDING PLUMBING 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 ❑ ELECTRIC ❑ ROOFING RF E' JAN i A BY: FBC20Q� Master Permit No.��,' 16 " 11A Sub Permit No. PL A ! 2� REVISION ❑ EXTENSION [:]RENEWAL ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1.,-0 I - q 6tr- City: Miami ShoresCounty: Miami Dade Zip: 33) 3f, Folio/Parcel#: f I — 3 D-� — 0 f 0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE: OWNER: Name (Fee Simple Titleholder): 194 Address: 9 �'f"1= City: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: Z 6 uJ 5 City: ~- W ne#: State: Zip: 3 313z Phone#: V N^ � �'►^ e yv�l'Lc ne#: '7 d62 '92 L D 3 Z. -FL-- Zip: ' 30 1 Qualifier Name: L - 1. a Phone#: State Certification or Registration #: C-PC_ ) It 2 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State Value of Work for this Permit: $ O am Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace Description of Work: (0 0 ✓1- t 1-6 Q S 0P/P I/'t4^ t 2 Specify color of color thru tile; Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ _ CCF $_ DBPR $ Zip: ❑ Demolition CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) f Bonding Company's Name (if applicable) Bonding Company'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. InM absence of uch posted notice, the inspection will not be approved and a reinspection fee will be charged. ' I / Signature - / OWNER or AGENT The foregoing instrument was acknowledged before me this day 20 by A c �— who is personally known to me or who has produced h�C, as identification and who did take an oath. NOTARY PUBLIC: n n OF SOP Print: Seal: �o�aaY Pa%, Notary Public State of Florida � Dennis Lefton ,!L _ My Commission GG 073636 �'�" Expires 02/15/2021 ********** APPROVED BY Signatu / /I CONTRACTOR The foregoing instru nt was tcknowledged before me this kdday of, cyw 20 16 by 1 UU^ 1 - ICE �`^ who is personally known to me or who has produced as identification and who did take an oath. Notary Public State NOTARY PUBLIC: Dennis Lefton toy Commission GG 0 Expires 0211512021 Sign: Print: C Vl0 w Seal: �o1�Y Pie°� Notary Public State of Florida Dennis Lefton o` My CommI$3lon GG 073635 ofi1.Expires 02/15/2021 a. Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014) HOME INTERIOR. Home Interior Services and Investment, Inc 1690 West 38 Place Suite B-1 Hialeah, FL 33012 info@homeinteriorservices.net December 5, 2018 Aldan Plumbing Inc. Alfredo Carmona, Jr 9600 NW 391h St Cooper City FL 33024 CERTIFIED MAIL REF NUMBER: REF: Client: Tracy Franklin Zazadze and Pol Zazadze Permit Number — 12-17-2913 at Miami Shores Village Dear Mr. Carmona, I refer to the above -referenced Permit Number for gas lines installed at 1201 NE 96 h Street Miami Shores FL 33138. As you may know, the General Contractor of this project has been replaced for Home Interior Services who was hired to completed the work. Plumber for the above permit has been changed to JC Plumbing Services. JC Plumbing is getting paid to complete the gas work. To this end, we are submitting a Change of Contractor form. SiWrelys Juta coCores Village; Tracy Franklin Zazadze and Pol Zazadze, Barbara Olivia 1450 NE 1031d Street Miami Shores, FL 33138 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT Permit N. (Z- 0- 2R AS Owner's Name (Fee Simple Title Holder): Owner's Address: ( 2071 OF I F City: 21, fa yy , \ _ Phone #: EL- Zip Code:3S j 39 Job Address (Of where work is being done): 1 Z©,l 0 6� 4 (Q -U- 4 City: Miami Shores State: —Florida Zip Code: Contractor's Company Name: Address: City: C Qualifier's Architect/ Engineer of Record Name: Address: City: Describe Work: Phone #: State: Y:: i Zip Code: v�t5u� a— Lic. Number: State: Phone #: Zip Code: hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless of all legal involvement. Signature Signature Owne r Agent Contractor or Architect The foregoi instrument was aknowledged before me The foregoing instrument was aknowledged before me this %day of 20 ,by --Sli` /y iv 7Gt&' f this day of 20 by Who is personally known to me or who has produced who is personally known to me or who has produced Notary Sign: Seal: L A as indentification. as indentification. rotor Notary Public State of Florida Dennis Leiton o` My Commission GG 073635 -tor �, Expires 02/15/2021 Notary Public: Sign: Seal: