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PL-18-1232Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 01/07/2019 Location Address Parcel Number 10540 NE 2 PL, Miami Shores, FL 33138 1122310130540 Contacts Permit AfO.: PL-5-18-1232 Permit Type: Plumbing - Residential Work Classification: Pool - Private Permit Status: Approved Expiration: 07/08/2019 CHRISTIAN TUPPER Owner CHRISTIAN TUPPER Applicant CUSTOM POOLS Contractor DAGOBERTO CABRAL 13250 SW 131 ST 100, MIAMI, FL 33186 Business: 3052255315 Other:3052555315 Description: POOL PIPING Valuation: $ 1,000.00 Inspection Requests: 305-762 4 §1 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 Check # 28090 05/08/2018 $50.00 Credit Card 01/07/2019 $108.85 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 certi at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating cq structi an; A i 9 F ermore, I authorize the above named contractor to do the work stated. I i 1 rti _- — IR /-, r .h, 11 ---1 _ 19 Authorized Signatkfi;J(Si ner ' / Applicant / Contractor / Agent January 07, 2019 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 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20/' BUILDING (Master Permit No. — I PERMIT APPLICATION Sub Permit No. jL 18 - `'— BUILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL PLUMBING MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP 1 ` CONTRACTOR DRAWINGS JOB ADDRESS: 4054© Nec ? City: Miami Shores 2 4County: Miami Dade zip: 33I 38 Folio/Parcel#: 1- 2 7-3 f " 013 " CIS 0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: / ff Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): ill STI`..in i,Ojar Ar .LTT tree F-j--AO rAOPhone#: 305 -206 `'IV6 NU Address: ,©5 2 7L C City: I"lt wwi LWC03 State: FLor i-, Zip: 3'J Tenant/ Lessee Name: Kr-L ( j Phone#: Email: F-a.lcyr lArUAx- a 4.A1P t -O-V% CONTRACTOR:: Company Name: V Address: 6 , ) City: Y-Y)t Qualifier Name: 1)20 State Certification or Regist tion #:`f' W 30.5 9 s 3 5-1/-3 one#: 30 6716 l W Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: n, City: State: Value of Work for this Permit: $ V Square/Linear Footage of Work: _ Type of Work: Addition Alteration New Repair/Replace Description of Work: ILL I Specify color of color thru tile: Submittal Fee $ 0 CCF $ ' oPermitFee $ ' Scanning Fee $ Technology Fee $_ Structural Reviews $ Radon Fee $ Training/ Education Fee $ DBPR $ Zip: Demolition CO/ CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 1 b& - Ct'J 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 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. Signatur " rignature- A OWNER or G T C NVRCTOR Th Mgoing instrument was acknowledged before I this day of by who is p nally known t me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Th foregoing instrument was acknowledged before a this day of 20 C , by kMo is personally known to me who has produced as identification and who did take an oath. NOTARY PUBLIC: APPROVED BY 1(—:2—dd Plans Examiner Zoning Structural Review Clerk Revised02/24/2014)