PL-17-2256y4tH�0
FtoR1vA
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. PL-9-17-2255
Permit Type: Plumbing - Residential
Penm Work Classification: Pool - Private
Permit Status: APPROVED
Parcel Number
issue Date:1214/2017 1 Expiration: 06/02/2018
Applicant
10125 BISCAYNE Boulevard 1132050190190
BISCAYNE 10125 LLC
Miami Shores, FL 33138-2647 Block: Lot:
Dwner Information Address
BISCAYNE 10125 LLC 10125 BISCAYNE Boulevard
MIAMI SHORES FL 33138-
10125 BISCAYNE Boulevard
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
FLORIDA POOL PATIO CORP (305)815-0181
Type of Work: NEW POOL PLUMBING
Type of Piping:
Additional Info: NEW POOL PLUMBING
Bond Return :
Classification: Residential Scanning: 1
Fees Due
Amount
CCF
$0.60
DBPR Fee
$3.38
DCA Fee
$2.25
Education Surcharge
$0.20
Permit Fee
$225.00
Scanning Fee
$3.00
Technology Fee
$0.80
Total:
$235.23
Phone
Valuation:
Total Sq F
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-9-17-65104
12/04/2017 Credit Card $ 185.23 $ 50.00
09/19/2017 Credit Card $ 50.00 $ 0.00
Available
Cell
(786)390-3177
$ 1,000.00
0
Inspection Type:
Main Drain
Final
Rough
Review Plumbinq
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 accu
construction and zoning. Futhermore, I authorize the above -named cgDb-c�i
Authorized Signature: Owner /
:9_�at all work will be done in compliance with all applicable laws regulating
do the work stated.
/ Agent
December 04, 2017
Building Department Cori
December 04, 2017 1
. 4 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
17
N
SJ--IA
FBC 2014
BUILDING Master Permit No. bp
PERMIT APPLICATION Sub Permit No. PL -Z Z 5lJ
❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
[PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1012.5 )3) Sc c vn e r3 1 ✓Gl
City: Miami Shores County: Miami Dade Zip: 330e2
Folio/Parcel#: 1 I - 32-0.5 bl �} - 01 9 a Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: F E:
OWNER: Name (Fee Simple Titleholder): 13) $GAVl1e, 101 2.5 LLC • Phone#: 0 5 (0 7
Address: 16SO ry l l 5+e, 910 p
City: M 16tiy) l Oec (,r
h State: r L Zip: 33 13 _l f
Tenant/Lessee Name: J Phone#:
Email: G la, %eneGt P+fi 9 %a 1 • com
_k -
CONTRACTOR: Company Name: O `-) "-`-' 00 1 P Phone#: vim" e 1���
Address: gL41
.1
City: 1 j�cj t N I Sta�� Zip:
1 Qualifier Name: c�T v Phone#:�
State Certification or Registration #: CP C (j [� I �u Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address
hone#:
City: State
Value of Work for this Permit: $ 0-0Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
Specify color of color thru tile:
S-a
Zip:
❑ Demolition
Submittal Fee $ Permit Fee $ n�S� CCF $ 0 ' � CO/CC $
Scanning Fee $ �Radon Fee $ oC . ps DBPR $ Notary $ �1
Technology Fee $ V '�� Training/Education Fee $ n • " Double Fee $ ([J
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ _
(Revised02/24/2014)
r.
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 exceedi $25 , the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law broth wil t delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of comme m must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. I h sence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
G
Signature Signature
WNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of -VI 1 20 11 by
who is personally known to
Mg -or who has produced MMM as
identification and who did take an oath.
NOTARY PUBLIC:
0 C�::�
Sign:
Print:
The foregoing instrument was
acknowledged before a this
day of � I , 20, by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: 'N V
Print:
as
Seal: �•ot►?�YP�9 Lorena River S
=_• �'Commiss;onFF05g65g NADINE AGUAS
y • -�•
i1 '`i Expires: Oct 03, 2017 MY COMMISSION # GG090407
;111******s*******r`sss*ss*��D�i'4R�iota***s***s*******s*****s
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)