PLC-18-2106Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date:10/05/2018
Parcel Number
Permit No.: PLC-8-18 21i
Permit Type.. Plumbing - Commercial
Work Classification. Seotic
Permit Status: Approved
Expiration: 10/23/2019
Project
9801-9845 NE 2 AVE, Miami Shores, FL 33138 1132060134380 NE 2 AVE SEWER CONNECTION
Contacts
PARK LLC Owner PARK LLC Applicant
4141 NE 2 AVE, MIAMI, FL 33137 4141 NE 2 AVE, MIAMI, FL 33137
A SUNNY PLUMBING COMPANY Contractor
OSIRIS CHAVIANO
6800 SW 17 ST, MIAMI, FL 33155
Business:3052817317 ASUNNYPLUMBING@YAHOO.COM
Description: SEPTIC TANK ABANDONMENT Valuation: $ 1,000.00 Inspection Requests:
fo5-76z-�9a
Total Sq Feet: 0.00
Fees
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
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$158.85
Credit Card
04/26/2019 $158.85
Amount Due:
$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 foregoin orm tion is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I a orizd th above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / �onodctor /// Agent
April 26, 2019
Date
Page 2 of 2
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
Miami Shores Village rBY-:
8�
�61�
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 l
FBC 20 1
Master Permit No.1PL—Q- I I
Sub Permit No.T(--C( P 2—(OG
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
AP LUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
V
JOB ADDRESS: 1 `�-� I j AK%jE
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load
OWNER: Name (Fee Simple Titleholder)
`-I
Address: � A t �—C= z
_ Construction Type: Flood Zone
BFE: FIFE:
Phone#: q;d,� —1-1 1-4 el- �'g 49y)
City: 1 "�1 CA—&—k-1 State: PA Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Nam
Address:
ne#: 5�a C-& I ? � I?
City: N't (� I ( State: L Zip: :�i
Qualifier Name: Q 0-t) Phone#:.1i50T-
State Certification or Registration #: C—i—'L \ �2 ZZ Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ BOO Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: S�- j G ' I tiCGkL (=(61,5( X� Q$ n
I
Specify color of color thru tile: i SO
Submittal Fee $ ^r Permit Fee $ rCCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ 2' 25 Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ ) � 4�3z " v0 �
(Revised 02/24/2014)
C
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 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.
r
i
Signature Signature
OWNE or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day
of v 20 _, by
4N-& who is personally known to
me or who h4s produced
identificatAn aid who did take anjoath.
NOTARY PU
Sign-
Print: C`O� ►-��
The foregoing instru ent was ac nowledged before me this
day of 20 1 elJ by
� IY"1S (1&tG bo is personally known to
as me or who has produced
identification anCv�hho did take
NOTARY PUB
Print:
as
.... F,=
nderwnters
Seal: �"" Seal:••'• ��: ��° Bond.d Thru Notary Public U
�a''°<R •. CAR
OLINA R. HERNANDEZ
MY COMMISSION # FF 923131
EXP!RES: October 15, 2019
APPROVED BY O 1cf Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)