PL-17-2588 (2)Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Parcel Number
Permit No. PL-10-17-2588
Permit Type: Plumbing - Residential
' Work Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 11/7/2017 1 Expiration: 05/06/2018
Applicant
129 NW 96 Street 1131010250100
Miami Shores, FL 33138- Block: Lot: ERIK SACCOMANI
Owner Information ' Address Phone Call
ERIK SACCOMANI 129 NW 96 Street
MIAMI SHORES FL 33150-
129 NW 96 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone
ALL COUNTIES PLUMBING INC (786)402-6881
of Work: ADD PLUMBING FOR LAUNDRY, WASH SINK
of Piping:
onal Info: ADD PLUMBING FOR LAUNDRY, WASH SINK
Return
ification: Residential Scanning: 1
Fees Due
Amount
CCF
$1.80
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.60
Notary Fee
$5.00
Permit Fee
$150.00
Scanning Fee
$3.00
Technology Fee
$2.40
Total:
$167.05
Valuation: $ 2,500.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-10-17-65506
11/07/2017 Credit Card $ 117.05 $ 50.00
10/31/2017 Credit Card $ 50.00 $ 0.00
Avauame, inspections:
Inspection Type:
U
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 jithermore, I authorize the above -named contractor to do the work stated.
November 07. 2017
AuthorizeW §.[aa6ture: Owner / Applicant / Contractor / Agent
Building Department Copy
November 07, 2017
1
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department RECEIVE.
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 OCT 31 2017
Tel: (305) 795-2204 Fax: (305) 756-8972 &20"-A
INSPECTION LINE PHONE NUMBER: (305) 762-4949
Master Permit No. /I - V� f:�
Sub Permit No. F' f 4_'—+ 2558
❑ BUILDING 7 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
LUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
'' (( S-�
CONTRACTOR DRAWINGS
JOB ADDRESS: 17 �/ " -
City: Miami Shores Cou/nty:
Miami Dade Zip:
Folio/Parcel#: ' 1 31 I - Q Z-� dl � Is the Building Historically Designated: Yes ^ NO
Occupancy Type: Load: Construction Type:
Flood Zone: BFE: FFE:
�'
OWNER: Name (Fee Titleholder): F/ I K—
C Phone#:
jSimple
Address: `O- I X� at -' s t
City: M l a State:
2
Zip: f� 5-0
Tenant/Lessee Name:
Phone#: -1 �p E C,
Email:
firkI
CONTRACTOR: Company Name: JII-�e
� � J�� Phone#:
Address: A6ZI uJf J
`
City: r G(Q I^State:(..
Zip: Z
�n
Qualifier Name:
Phone#:
State Certification or Registration #: [ q Zq3 7
Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address:
City: State: Zip:
Value of Work for this Permit: $ Z- S�> Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New
❑ Repair/Replace ❑ Demolition
,J❑,(� %
Description of Work: U I
/GC we 5"/1 i✓) /C
Specify color of color thru tile:
r
Submittal Fee $ Permit Fee $
CCF $ CO/CC $
Scanning Fee $ Radon Fee $
DBPR $ Notary $
Technology Fee $ Training/Education Fee $
Double Fee $
Structural Reviews $
Bond $
TOTAL FEE NOW DUE $ 1,
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Boni ing Corpany'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.
Signature
ER or AGENT
The foregoing instrument was acknowledged before me this
day of . 20 by
w n o``is pnerso
y-9/n'ial y n o w n to
me or who has produced ice\pp1 l�V Y� as
identification and who did take an oath.
Sign
Print
Seal
PUBLIC.
.P MAHARAI K. GONZALEZ
- MY COMMISSION # GG 044602
EXPIRES: November 2, 2020
[fended Thru Notary Public underwriters
L0,01
Signature
CONT,�RRJPCTOR
The foregoing instrument asll//cknowledged before me this
_�� day of OC � 20 by
who is personally known to
Z ✓G�
me or who oduced 1`1_ as
identification and wh4di4 tJke an oath.
NOTARY PUBL
Sign:_
Print:
MY COa1.",41S5 ( "'w1�tZ rrrv� r "YOHENORYPEL RIO
EXPIRES
G;0446n2 Seal: ( �`�� MY COMMISSION#FF198880
rJovAr,�,her < 020 Sunded Thru r EXPIRES: FEB 12, 2019
. ,..
=� " Bonded 111;3u h 1st State Insurance
************************************************************************************************************
APPROVED BY pal lltfV' ( 'I Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)