PL-18-939y�
Miami Shores Village
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10050 N.E. 2nd Avenue NE
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Miami Shores, FL 33138-0000
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Phone: (305)795-2204
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Permit NO. PL-4-18-939
O Permit Type: Plumbing - Residential
Wont Classification: Pool - Private
Permit Status: APPROVED
Issue Date: 5/1512018 1 Expiration: 11/11/2018
Project Address Parcel Number Applicant
639 NE 97 Street 1132060171880
JUAN DIAZ
Miami Shores, FL 33138-2470 Block: Lot:
Owner Information Address Phone Cell
JENNIFER DIAZ 639 NE 97 ST
MIAMI SHORES FL 33138-2470
Contractor(s) Phone Cell Phone
FLORIDA POOL PATIO CORP (305)815-0181
Type of Work: SWIMMING POOUSPA PIPING
Type of Piping:
Additional Info:
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
Valuation: =750.00
Total Sq Fee
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-4-18-67119
05/15/2018 Credit Card $ 185.23 $ 60.00
04/10/2018 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Main Drain
Final
Rough
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 that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning_ Ftuthermore, I authorize the above -named contractor to do the work stated.
May 15, 2018
Authorized Sic nature owner / Applicant / Contractor / Agent
Building Department Copy
BUILDING
PERMIT APPLICATION
BUI ❑ ELECTRIC
❑■ PLUMBING MECHANICAL
JOB ADDRESS: 639 NE 97 ST
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
FBC 20 1`��
Master Permit No.
Sub Permit No. ?Lk PJ 9�
ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip: 33138
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): JUAN CARLOS DIAZ Phone#: 305-934-7406
Address: 639 NE 97 ST
City: MIAMI SHORES
Tenant/Lessee Name:
Email:
State: FL
n
33138
CONTRACTOR: Company Name: FLORIDA POOL PATIO CORP Phone#: 3058150181
Address: 12241 SW 99 ST
City: MIAMI State: FL Zip: 33186
Qualifier Name: CLAUDIO VALERO Phone#: 3058150181
State Certification or Registration #: CPC1458182 Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address:
ne#:
City: State:
Value of Work for this Permit: $ 7�0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑■ New ❑ Repair/Replace
Description of work: SWIMMMING POOL/SPA PIPING
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Zip:
❑ Demolition
Permit Fee $ CCF $ CO/CC $
Radon Fee $ DBPR $ S ' 39 Notary $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Double Fee $ _
Bond $ [�
TOTAL FEE NOW DUE $ L/ S
(Revised02/24/2014)
Bond ng 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 o notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of r—r-n , 20 1 by
h L D( 32 who is personally known to
me or who has produced (A ckv, �-c as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED BY
r—
CONTRACTOR
The foregoing instrument was acknowledged before me this
r J1 day of 120 by
&LO-YOwho is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
as
Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk