PL-18-3296Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit No.: PL-10-18-3296
Y-
[1^_ — Permit Type: Plumbing - Residential
E I
f Work Classijicataon: Addition/Alteration
Permit Status: Approved
issue Date:10/29/2018 ( Expiration: 04/24/2019
Parcel Number
70 NE 99 ST, Miami Shores, FL 33138 1132060131050
Contacts
JAY YAGODA Owner JAY YAGODA Applicant
70 NE 99 ST, MIAMI SHORES, FL 33138 70 NE 99 ST, MIAMI SHORES, FL 33138
Other:3056577859 Other:3056577859
PLUMB TECH GROUP INC Contractor
RAMON RODRIGUEZ
Business: 3054288685
Description: ROUGH AND SET OF 1 WATER CLOSET 1 SHOWER Valuation: $ 4,000.00 Inspection Requests:
AND 2 LAVATORIES 305-762-4949
TotalSq Feet: 216.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$2.40
DBPR Fee
$2.10
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee
$90.00
Scanning Fee
$3.00
Technology Fee
$3.50
Total:
$153.80
Payments Date Paid
Amt Paid
Total Fees
$153.80
Check # 199 10/29/2018
$103.80
Credit Card 10/26/2018
$50.00
Amount Due:
$0.00
Building Department Copy
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 4oning. Futhermore, I authorize the above named contractor to do the work stated.
/ \, Applicant / Contractor / Agent Date
October 29, 2018 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
T 2 9 A2018
11N
INSPECTION LINE PHONE NUMBER: (305) 762-4949 %, tv
�
FBC 201�
BUILDING Master Permit No. /j_`,/0 r 2
PERMIT APPLICATION Sub Permit No.:? Le— 312_! Lc
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
Folio/Parcel#: / / 3 02.060 /.�/es� Is the Building Historically Designated: Yes NO
Occupancy Type: Load: ConstructionType: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):J
ol1 y Phone#:
Address: 76 k-w— / S
City: H! qc-!" 4
State:
Tenant/Lessee Name: Phon
Email:
CONTRACSpR: Company Na
Address: / 6 <--- ll!—f`fff---
City:
Qualifier Name: ti
State Certification or Registration'#: CSC i
•
DESIGNEJhArchitett/Eneirieer:
Value of Work for this Permit:
P' 3Mz _
ne#:3 ds Va fcd'-5
_Zip!33�ss
Certificate of Competency #:
ne#:
City: State:
Square/Linear Footage of Work:
Zip:
Type of Work: ❑ A dition [ / teration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: U cco 14
e,
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ "CO/CC
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ ' 3
(Revised02/24/2014)
City
Bonding Company's Name (if applicable)
Bonding Company's Address
., 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,&ceeding $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 comm en "t must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issIn a abs nce of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature \ik '/
W R r AGENT
The foregoing instrument was acknowledged before me this
L 9 day of .(3 COZY_.—(2- , 20 ( & by
who is personally known to
me or who has produced �A"Lia I,LC�n`as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: ;?`' :_ SINDU► ALVAREZ
MY COMMISSION # GG 238273
EXPIRES. September 3, 2022
Bonded Tt ru Notary Public Uri
****ss*ssss*sssssss
APPROVED BY
CONTRACTOR
The foregoing instrumentwas acknowledged before me this
day of 20J by
mo � o I personally known to
me or who has produced 1� S� as
identification and who did take an oath.
NOTARY PUBLIC:
Print: " o
N Seal: #: MY COMMISSION # GG 044602
r•a - EXPIRES: November 2, 2020
Bonded Thru Notary public Underwriters
**s*ssssssssssss**ss*s*****ssss**s*sssssss**.ssss:****«sssss
Plans Examiner
Structural Review
Zoning
Clerk
(Revised02/24/2014)