PL-18-1601 (4)Miami Shores Village L
�
X, Building Department
f o 0 o1g
g p �
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
\� Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (30S) 762-4949
jFBC 20 BUILDING Master Permit No. « / —3 ()o `o
PERMIT APPLICATION Sub Permit No. PL - 6 —1-9 —/60 /
❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
(PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
p� '/ CONTRACTOR DRAWINGS
JOB ADDRESS: Z / h' I � S'J�
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): Lr�/`� �"1 (� �� Phone#:
Address: �- ` N 1� c7 -? s
City: ►� _�/A ) ��� KS State:
Tenant/Lessee Name: Phone#:
Email: q r
CONTRACTOR: Company Name: 1 �I/u� Phone#: Z",
Address: "� '� C5 ✓�`� 2 f`l�
City: Vy State: Z Zip:
Qualifier Name: �� �� �VA--(,- Phone#:
State Certification or Registration M K rG 44 Z-V) Certificate of Competency M
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit:
State: Zip:
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration FiNew [ ❑ Rep r/Replace ❑ Demolition
Description of Work: �Vb C.?t f� YII v� i'i r7
S� te-eavv� frt�►jL
Specify color of color thru tile:
Submittal Fee $ _ Permit Fee $ m CCF $ 476— — CO/CC $
Scanning Fee $ 3 Radon Fee $ �� DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ 6. TOTAL FEE NOW DUES a Od
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lenders Address
City
Zip
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 ted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the abs ce ch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT
The f(o�regoing instrument was acknowledged before me this
day of 6f� /4"( 2011 by
L� � �✓ �� ,who is personally know_ n t
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seal:
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of p i�v'7 l� 20 ---I-- by
n iJ ✓}Z , w is persona�kno
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
MY COMMISSION Il OG 115825
EXPIRES. Odour 18. 2021 11
Seal:
Bonded Thru Notary PW* Lw wrh n
MY COMMISSION 100 1151125
EXPIRES: Odobec 18, 2021
Bonded Thm Notary Public UnderwrNM
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
RICK SCOTT, GOVERNOR
10NATHAN ZACHEM, SECRETARY
a
dbpr
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
THE BUILDING CONTRACTORHEREIN IS CERTIFIED UNDER THE
PROVISIONS OF CHAPTER 489, FLORIDA STATUTES
DI,AZ DAVI D
D & D PLUMBING CORP.
3145 S W 19TH STREET
MIAMI FL 33145
LICENSE NUMBER: CBC1262239
IXPIRATION DATE AUGUST 31, 2020
Always verify licenses online at MyFloridaLicense.com
Do not alter this document in any form.
This is your license. It is unlawful for anyone other than the licensee to use this document.
014203
Local Business Tax Receipt
Miami -Dade County, State of Floridav
-THIS IS NOT A BILL - DO NOT PAY
5268586 EXPIRES
RECEIPT NO.
BUSINESS NAME/LOCATION RENEWAL SEPTEMBER 30, 2019
D & D PLUMBING CORP 5505483 Must be displayed at place of business
3890 NW 2 TER Pursuant to County Code
MIAMI FL 33126 Chapter BA - Art. 9 & 10
SEC. TYPE OF BUSINESS PAYMENT RECEIVED
OWNER 196 PLUMBING CONTRACTOR BY TAX COLLECTOR
o& D PLUMBING CORP CFC1426173 $45.00 07/06/2018
DAVID DIAZ, QUALIFIER CREDITCARD-18-050241
Workers) t
This Local Business Tax Receipt only confirms payment of the Local .the businessusiness Tax..
co Receipt is not a ,
Permit,
Of a Certification
ertinmec rion of the ory taws and requirements which to do business.
pp y to s. Holder must comply with any governmental
The RECEIPT NO. above must be displayed on all commercial dada ales
ovhexcol e' de Code Sec 8a-276.
For more information, visit