PL-19-371Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: PL- 2-1, 9-371
D 2 Permit Type: gibing - Residential
Work C/assifrcationt -Addition/Alteration
Permit Status: Approved
Issue Date:02/22/2019Expiration: 08/19/2019
Location Address Parcel Number
29 NE 109TH ST, Miami Shores, FL 33161 1121360040600
Contacts
JACQUELINE GONZALEZ Owner LONGUS PLUMBING CONTRACTORS INC Contractor
29 NE 109TH ST, Miami Shores, FL 33161 REMBERTO BELLO
Mobile: 3052818409 1300 SW 70 AVE, MIAMI, FL 33144
Business: 3052181004
Description: ROUGH INSTALLATION 2 WATER CLOSET 3 SINK 1 Valuation: $ 6,200.00 Inspection Requests:
TUB 2 SHOWER 1 WASHING MACHINE 1 KITCHEN SINK 1 305-762-4949
DOSPOSAL AND 1 DISHWASHER Total Sq Feet: 593.50
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.20
DBPR Fee
$3.26
DCA Fee
$2.17
Education Surcharge
$1.40
Permit Fee
$167.00
Scanning Fee
$3.00
Technology Fee
$5.43
Total:
$236.46
Payments
Date Paid Amt Paid
Total Fees
$236.46
Credit Card
02/19/2019 $50.00
Credit Card
02/22/2019 $186.46
Amount Due:
$0.00
Building Department Copy
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,copstruction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner ,/ / Applicant'/ Contractor / Agent Date
February 22, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
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
FEB 19 2019
(cif
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CLVI_-I-
Master Permit No. Q`t(; •%0q•/8•��/y
Sub Permit No.pj 19
❑BUILDING
❑ ELECTRIC
❑ ROOFING ❑ REVISION
❑ EXTENSION ❑RENEWAL
PLUMBING
❑ MECHANICAL
❑ PUBLIC WORKS ❑ CHANGE OF
❑ CANCELLATION ❑ SHOP
CONTRACTOR
DRAWINGS
JOB ADDRESS:
^ I . L •
) S�� e -e±
City:
Miami Shores
County: Miami Dade
Zip: :331<;.1
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): AJC)CgtAe''1�E Qh Za1e Z Phone#: 4?O5� r�� (- S�'i O
Address: all N E 10CL 5�.•c_.'t
City: M t CX
Tenant/Lessee Name:
Email: V\ C) wtcA51 e .
State: La -11-1 CL Zip:
_ Phone#:
Fez @:�? Q v,--va- 'L l • co -w,
V
CONTRACTOR: Company Name: Zfdft4
V r, 1,21Uwiv71 i1 l�12��� Phone#: D -2/0 vU 5
Address: (2"u 5c") %U / I-✓ k-,
City: rState: Zip: ;;qj Yq
Qualifier Name: /� P wl - if Phone#:
State Certification or Registration #: C rc V -;� kd O CO Certificate of Competency #: '
DESIGNER: Architect/Engineer: Phone#:
Address:
City:
Value of Work for this Permit: $ &zoo Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Zip:
❑ Demolition
Description of Work: 04 �ns� �� :ar. flC 2. vai tr L%%3,, .k 3 : i n►� t l ♦v` 2 S%%ow..r
1 %rwt1+� vr►aeti ijt l 'l�,i�aftia.. t�.�� 1 �1�SPes..\ ��,��� disbt✓w�1,ar
Specify color gfcolor, thi4lfi
Submittal Fee $ ::, ,Zr.&..- ,P
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
iit'Fee $
Radon Fee $
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $,
Double Fee $
Bond $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
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 thea nce of such posted notice, the
inspection will not be appy ved and einspection fee will be charged.
1
Signature Signature
0 NER or A ENT C NTR CTOR
The foregoing instrume was acknowledged before me this
rtA day of bVQQ 20 9 by
IAA kwh • personally known to
eorwhohas roduced rlVQr 1IC�MS`Q as
identification tnd wh did tak an o
NO AR4PUB
Sign:
Print:
Seal:
• R
APPROVED BY
(Revised02/24/2014)
YANADY PRUO
MY COMMISSION # FF 214031
The foregoing instrument was acknowledged before me this
i_dayof t tbr.rar
Mmarp b RE LLA
me or who has produced
,20 101 by
i ersonally kno o
as
identification and who did take an oath.
NOTARY PUBLIC:
Pririt'. r
Seal: Yidy
NOTARY PUBLIC
STATE OF FLORIDA
. Carrw* FF&OM
-D It5Vq Plans Examiner
Structural Review
Zoning
Clerk