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PL-18-824yS Miami Shores Village `gNOR 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 �YORIOp' Permit NO, PL-3-18-824 Permit Type: Plumbing - Residential tWork Classification: Gas Permit Status: APPROVED Issue Date: 4/1112018 1 Expiration: 10/08/2018 Project Address Parcel Number Applicant 1569 NE 104 Street 1122320320160 Miami Shores, FL Block: Lot: ALAIN & CARLY GONZALEZ Owner Information Address Phone Cell ALAIN & CARLY GONZALEZ 1569 NE 104 Street (786)277-9756 MIAMI SHORES FL 33138- 1569 NE 104 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone ORIGINAL PLUMBING INC (954)274-3041 of Work: RUN NEW GAS FOR 1 TANKLESS WATER HE of Piping: itional Info: RUN NEW GAS FOR 1 TANKLESS WATER HE Bond Return : Classification: Residential Fees Due Amount CCF $1.20 DBPR Fee $3.38 DCA Fee $2.25 Education Surcharge $0.40 Notary Fee $5.00 Permit Fee $225.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $247.83 Scanning: 3 Valuation: $ 1,200.00 Total Sq Feet: 0 Pav Date Pav Tvpe Annt Paid Amt Due I Invoice # PL-3-18-66977 04/11/2018 Credit Card 03/29/2018 Credit Card $ 197.83 $ 50.00 $ 50.00 $ 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 ce at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and g. uthe,more, authorize the above -named contractor to do the work stated. �� 9a�? �z Z April 11, 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy April 11, 2018 - -+VED Miami Shores Village MAR 29 2018 1 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 YBCV2d%`--r BUILDING Master Permit No. j PERMIT APPLICATION Sub Permit No. (BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP / p CONTRACTOR DRAWINGS JOB ADDRESS: I l N I Q' 11 C City: Miami Shores County: Miami Dade Zia: Folio/Parcel#: is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Phonini Address: City: I �G��l f �i.t`1�� State: Tenant/Lessee Name: Phone Email 1 CONTRACTOR: Company Name: O� 1 �-r1 ��/=l/l��l/1 �. l�r'1 `� -�-N6one#:T7�-�C��F� Address: City:TICI State: �L Zip: S -3 4 / Qualifier Name: k1 V', 1 �'( l L��[r'1 1 1C G Phone#: 9 `7z bI & - 30 q1 State Certification or Registration #: � �� D Certificate of Competency M DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ (Z©O Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Specify color of color thru tiler Submittal Fee $ Permit Fee $ ��`_�� CCF $ CO/CC $ _ Scanning Fee $ Y Radon Fee $ �" �� DBPR $ 3`� Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ / ` -) ' Q-3 (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." 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 J 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 J07706 - - t47,pA OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before a this The foregoing instrument was acknowledged before me this day of M aY C Y 20 by 2.n. day of .-s o�� 201g by j 1tiv C (� �_�_• who is personally known to 4G-t' C JV4+�1�I who is personally known to✓ me or who has produced j LSC� '�s me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC— NOTARY PU C: R.'(w.•.., MAHARAI K. GONZALEL MY COMMISSION 0 GO 044602 '.* EXPIRES: November 2, 2020 Sign. ": '`= Underwriters S' Print: Print: Seal: Seal: ,.�"nv P ANNETT L. BARNES Notary Public - State of Florida Commission # FF 939428 **sssssssssssass*ss*sss**s**ssssss*sssss*s*sss*****sssssssssssssss*s*s*sssssissFs��>ESs��a�Grsss*ssss*ss*ss APPROVED BY 3 (� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) CONFIRMATION OF DROP TEST Date 10/25/18 Permit Number PL-3-18-824 Address 1569 NE 104 ST Miami Shores FL 33138 EQUIPMENT USED: X MANOMETER TIME: START 4:33 PM FINISH 4:36 PM WC: 9.2" 9.2" D rep 1,5 ?419 I Dmitry Pressman as a Suburban Propane CSC Service Manger for the Miami Division have verified that Segundo Gonzalez, a qualified Suburban Propane Service Technician, has completed and documented the above mentioned drop test in accordance with NFPA 54 and Florida Building Code (Fuel Gas). STATE OF FLORIDA, COUNTY OF MIAMI-DADE Si¢7 atur /'LJ�'Y �r�sSvH A✓t Print Name Sworn to and subscribed before me this 05 da f O 0 8 Notary Pubk state of Florida Signature of Notary Public_ State of Flo Marie E. &eijo Seal: awE My Coi.w. Won GG 129054 21 <Pers�__�� C OR, Produced Identific lionaHdentt ication Produced SUBURBAN PROPANE 3800 NW59TH STREET, MIAMI, FL. 33142 (305)635-4427 FOUND DRILL HOLE FENCE 0.1'W SEAWALL CAP 0.4'N 0.6' W \\\ B.I',S'CAYWE D.RA.INAGB CANA T..� (75' RIGHT-OF-WAY) CONC 1.35' CON DAVITS SEA AP� 16.30' / a a� r 'L �n . 00 a 00 DOCK t 5.45' 90• --� f I S CONC SEAWALL 1,X. vx- .1./� • + . .+ ' .. C.B.S. // 0 L 1 �.1./' N WALL— , 15.1'Y, 35.1' .� �"-". , FENCE , + vi . • (M• + •~�- .apt .... L �� TTCOVERED AREA I r) 0.5'Ero 1/14.60"7,! Y 11.96' O.B�o _ i1a.GO' 5.0.,G 2 STORY C.B.S. m Ln ;:. RESIDENCE #1569 0) M. FINISH FLOOR ELEV.=7.29' r-- .GARAGE I FLOOR ELEV=5.72' X`� , ,r8.30 i 14.45',, —10.00' 0.6'E 1.98' 4.95'•N 0 '� / Ai> W to _0.1'W-- _._�� / I. OG ,�68RICK 6.65'� PLANTER I d ro NTRY -0/ `,1d 0 3.90' J �n �Qi g w � L r ��• to j y5o� 4 ASPHALT DRIVE 04 9.90' 11.45' 11.45 PLANTER LOT 17 N "BLOCK 3 ' N DRILL HOLE o/s 0.45'(N) 0.1'E 4' CHAIN LINK FENCE (TYPICAL) I`r) LO 0 of _..I m / 0 cr z G i" Q - 0.2'E L J e X �— F c 6..3' C w m 001r: 0 C!i Q G F FOUND 3/4" IRON PIPE o/s 0.14'(N) 'r1.' C0NC WALK' -.. • �. C)O ` ►, .: ! .: P.P. i � FOUND 1/2" SITE B.M..M. I- j �7 '.' IRON PIPE i o o/s 0.25'(N) SET N a " EI.EV.�3.79' I '- / / i O.tO'(E) I N t _ -- -- .4, N.E. / 104t ,�� STREo T :• :•:: � :�� (50' RIGHT-OF-WAY) SITE B.M. 18' ASPHALT PAVEMENT • w. SET NAIL • • E'V.=3��j • w w • • • • • • • • w • w • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • ••• • • r z o a H o U j � C a c c: O x na. � o J F~ z Q Q N 250.00'(C FOUND PK NAIL AT P.C. M .6b/Ve �/.> eL-- 0 �� 4) r "q c 1569 NE 104 St., Miami Shores, FI • .... . .. ..... •. .