PL-18-2300Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. PL-8-18 2300
Permit Type: Plumbing - Residential
eri Work Classification: Gas
Permit Status: APPROVED
Parcel Number
Issue Date: 9112t2018 I Expiration: 03/11/2019
Aoolicant
1037 NE 91 Terrace 1132050010050
Miami Shores, FL Block: Lot: ALISON HARKE
Owner
ALISON HARKE
1037 NE 91 TERR
MIAMI SHORES FL 33138-3401
Contractor(s) Phone Cell Phone
YERBILLAS SERVICES INC (786)488-5212
Type of Work: NEW GAS LINE FOR BBK RANGE POOL HEA
Type of Piping:
Additional Info: NEW GAS LINE FOR BBK RANGE POOL HEA
Bond Return
Classification: Residential Scanning: 3
Fees Due
Amount
CCF
$2.40
DBPR Fee
$3.75
DCA Fee
$2.50
Education Surcharge
$0.80
Permit Fee
$250.00
Scanning Fee
$9.00
Technology Fee
$3.20
Total:
$271.65
Cell
Valuation: $ 3,500.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-8-18-68712
09/12/2018 Credit Card $ 221.65 $ 50.00
08/28/2018 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Press Test
Review Plumbing
In consideration of the issuance to me of this perrr,t, 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. Futhermore, I authorize the above -named contractor to do the work stated.
September 12, 2018
Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
September 12, 2018
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
RECEIVED
AUG 2 8 2018
9--tQLI
FBC 20 �L)
BUILDING Master Permit No. Ic i LO— I t
PERMIT APPLICATION Sub Permit No. Fj 1 13 — 23010
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR
DRAWINGS
JOB ADDRESS: l e 3 7 NP 21 Fe g R- Ac e-
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): A `/ 6 ey i�4 9zLe Phone#:
Address: I O ye 9/ 1-re R RAC r
City: All 5Hal if 5 State: F'(1_ Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Vrx/y/11/ �[�(//G �� �Ulvc • Phone#:
Address: .2`7'.23 SW 99%_L
City: 14 / ft / State: FLI- Zip
Qualifier Name: 0age C Phone#:
State Certification or Registration #: CF(f l / 1 y2-PIC Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: City: State:
Value of Work for this Permit: $ �, 6D Square/Linear Footage of Work:
33165-
Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New,Q p )/ ❑ Repair/Replace / ❑ Demolition
Description of Work: Alf W 4 S LZ N C ZG� /� /��'c �w)yi-y'_ A/%i) (%
1<cx Aft/ *47c2t �Ye�
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ sG CCF $ CO/CC $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $ Z - Sb DBPR $ " -4'7p— Notary $
Training/Education Fee $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ _ 2 1 - G5
400
4
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
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.
C
Signatur
X4,(Ik-
OWNE r A ENT
The foregoing instrument was acknowledged before me this
/ c day of kaj,— N , 20 �J by
� so r) A � Fe who is personal known to
me or who has produced
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of ki R Cf� 20 !Jo' by
(7-,0,CGC/✓ho is personally known to
as = or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
as
Sign: � Sign:
Print: C\
-�-vr0 Print: CO/R -V
Seal: Seal: raG'r' •: 10AGECCI
Notary Public State of Florida Notary Public - State of Fbrira
Dfone Iturria `N Commission 4 GG 1930"
`•',a nd My Comm. Expires Feb.5, 2M.
o � MY Commission FF 240546 ga, thrque R�,:c,r� NotanF•Assn.
APPROVED BY/�'� Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk