PL-18-13776
OFt..
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. PL-5-18-1377
Permit Type: Plumbing - Residential
Per I' t Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 611512018 1 Expiration: 12/12/2018
Project Address Parcel Number Applicant
670 NE 97 Street 1132060171630
Miami Shores, FL 33138- Block: Lot: JOHN BARBICK
Owner Information Address Phone Cell
JOHN BARBICK 670 NE 97 Street (305)754-6966
MIAMI SHORES FL 33138-2471
Contractor(s) Phone Cell Phone
REGOSA ENGINEERING SERVICES M (786)262-2964 (786)344-8720
Type of Work: KITCHEN REMODELING (SAME EXISTING
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential Scanning: 1
Fees Due
Amount
CCF
$0.60
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.20
Permit Fee
$150.00
Scanning Fee
$3.00
Technology Fee
$0.80
Total:
$158.85
Valuation: $ 750.00
Total Sq Feet: 0
Available Inspections:
Inspection Type:
Top Out
Final
Review Plumbing
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-5-18-67628
06/15/2018 Credit Card $ 108.85 $ 50.00
05/21/2018 Credit Card $ 50.00 $ 0.00
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.;oning. Futhermore, I authorize the above -named contractor to do the work stated.
June 15, 2018
,Xtnorizeci Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
1
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
BUILDING
PERMIT APPLICATION
F—IBUILDING ❑ ELECTRIC ❑ ROOFING
M Y 2 1 2018
BY•
-�F7�BC 20 l�
Master Permit No.!� N (e
Sub Permit NoL
❑ REVISION ❑ EXTENSION RENEWAL
Q■ PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 670 NE 97 STREET
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3206-017-1630 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): MARGARET & JOHN BARBICK
Address:670 NE 97 STREET
City: MIAMI SHORES State: FL
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: REGOSA ENGINEERING SERVICES, INC
Address: 15700 NE 2 AVE
City: MIAMI State: FL
Qualifier Name: GUSTAVO VELEZ
State Certification or Registration #: CFC-1427292
DESIGNER: Architect/Engineer:
Phone#:
Zip: 33138
Phone#:
Phone#: 786-262-2964
hone#:
Certificate of Competency #:
one#:
Zip: 33162
786-262-2964
Address: City: State: Zip:
Value of Work for this Permit: $ ���' Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition
Description of work. KITCHEN REMODELING (SAME EXISTING LAYOUT)
iAIr7-Pa, ROAo •,1516-W -TIAI L" , A164-W ;rNvC15-r-
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ S� CCF $ ' ' _; `' CO/CG'$
Scanning Fee $ Radon Fee $ Co DBPR $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
Bond
TOTAL FEE NOW DUE $ (V V CTiJ
(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."
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 .I be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commenceme st be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the ab nc of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
AwaSignature � A, Signature
0 NER or AGENT NT CTOR
The foregoing instrument was acknowledged before me this
—,W dayof HO 20 /1 by
ex1Ltp 5 .S, who i ersonally know. to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
The foregoing instrument was acknowledged before me this
17 day of MAY 20 18 by
GUSTAVO VELEZ who i persona ly known
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
ci
Print: 0 J
Seal: Seal:
as
LUZ EDITH 61RALDO
NOTARY PUBLIC • STATE OF FLORA
COMMISSION # FF2034S6
arch 22, 2019
Jodi Ellis Cardenas
NOTARY PUBLIC
? Com" GG185696
APPROVED BY ONCE �e Expires 2/14/2022 Plans Examiner Zoning
s Z3
Structural Review Clerk
,r
(Revised02/24/2014)