PL-18-1718SµoRES t
yFG'�
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit No. PL-6-18-1 T18
Permit Type: Plumbing - Residential
t Pen' Work Classification: Addition/Alteration
Permit Status: APPROVED
Parcel Number
Issue Date: 7/9/2018 1 Expiration: 01/05/2019
Applicant
1280 NE 102 Street 1132050220030
MARK & DENISE JUANICO
Miami Shores, FL 33138-2618 Block: Lot:
Owner Information Address Phone Cell
MARK & DENISE JUANICO 1280 NE 102 Street
MIAMI SHORES FL 33138-2618
1280 NE 102 Street
MIAMI SHORES FL 33138-2618
Contractor(s) Phone Cell Phone
MG PLUMBING & SPRINKLER SERVI( (305)525-9236
Type of Work: REPLACE KITCHEN SINK. ADD SUPPLY F
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential Scanning: 1
Fees Due
Amount
CCF
$1.20
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$150.00
Scanning Fee
$3.00
Technology Fee
$1.60
Total:
$160.45
Valuation: $ 1,200.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-6-18-68020
07/09/2018 Check #: 7891 $ 110.45 $ 50.00
06/22/2018 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Final
Rough
Review Plumbing
Underground
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 zoning. FjAermore, I authorize the above -named contractor to do the work stated.
July 09, 2018
Authorialsrd'Signature:Owner / Applicant / Contractor / Agent
Building Department Copy
July 09, 2018
BUILDING
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
Master Permit No.
✓UN� �Fb
�?ore
FBC 20 n
PERMIT APPLICATION Sub Permit No. 1' 1 b— i I I d
[—]BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
(� �/_ %,ylCONTRACTOR DRAWINGS
JOB ADDRESS: /p� �`-' '" `"2 �7—
City: Miami Shores County: Miami Dade Zip: 33 /3 9
Folio/Parcel#: i i .— a �� t�^ � Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): qD Phone#?(? (0 a 01 3S l Cl
Address:
t 1�� zi����
City: �'�'j �S State: p:
Tenant/Lessee Name: Phone#:
Email: rAy 2_+c yc,1 d cnL •c000
CONTRACTOR: Company Name:
Address:
CityI1993!ir- A4-,3t5i,1.s' Sta
Qualifier
State Certification or Registration #:
Phone#: 36T J2� , `�
cry )-40 �-4 45'
te: Zip: 3?166�
Phone#:7sf�
of Competency #:
DESIGNER: Architect/Engineer: Phone#: -
Address: ^� City: State
Value of Work for this Permit: S • T Square/Linear Footage of Work:
Type of Work: ❑ Addition f ❑ Alterraation,,%,,' ❑ New _%�/ Repair/Rfe�place
Description of Work: �GOr��� '1 r ��� l� J �/ t� �/ LC� 141)114_ Siil�
Zip:
❑ Demolition
Specify color of color thru tile:
Submittal Fee $' • Permit Fee $ ---F-1 ^_ CCF $_ CO/CC $ .
Scanning Fee $ Radon Fee $ �,l iW DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $ _
Structural Reviews $
Bond $
TATAI FFF NAW nl IF 4 I !�
,A<
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
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 4-li _ Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before come this The foregoing instrument was acknowledged before me this
day of V 20 O by l,- day of j I -2lA C 20 by
who is personally known to / /V 1/d-ko%4 who is personally known to
me or who has produced 7f�-- (< '� as me or who has produced as
identification and who di take an oath. identification and who did take an oath.
NOTARY PUBLIC: I 1111111/11 NOTARY PUBLIC:
Sign: ti ti�arc B�-
Print: n � � �•,o ��: = Print:--&Zv. 9_tU—
Seal: �:Seal:
ES MERgjAT:d::':: TUERO
MY COMMISSION 14083
EXPIRES: April 10, 2019
it 111111
**s*******ss**********ssss*s*s**s***ss**s*sss*ssssssss*sssssss*sss "` R.IudTh PbUcU a ss********
llyAPPROVED BY 0 th 1x Plans Examiner Zoning
Structural Review Clerk