PL-18-994bF�N'A
6
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO, PL -Y4-18-994
00 Permit Type: Plumbing - Residential
nm Work Classification: Addition/Alteration
Penvit'Status: APPROVED
Parcel Number
Issue Date: 4/23/2018 1 Expiration: 10/20/2018
Applicant
187 NE 100 Street 1132060132071
Miami Shores, FL Block: Lot: JESSICA WADE PFEFFER
Owner
JESSICA WADE PFEFFER
Address
187 NE 100 Street
MIAMI SHORES FL 33138-
187 NE 100 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
ARMANDO PENA (786)255-5474
of Work: REPLACE KITCHEN SINK RELOCATE DISHW
of Piping:
onal Info: REPLACE KITCHEN SINK RELOCATE DISHW
Return :
ification: Residential Scanning: 1
Fees Due
Amount
CCF
$3.00
DBPR Fee
$3.38
DCA Fee
$2.25
Education Surcharge
$1.00
Permit Fee
$225.00
Scanning Fee
$3.00
Technology Fee
$4.00
Total:
$241.63
Phone
(305)804-8424
Cell
Valuation:=5,000.00Total Scl Fee
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL -4-18-67173
04/13/2018 Check #: 115 $ 50.00 $ 191.63
04/23/2018 Check #: 117 $ 191.63 $ 0.00
Avaname
Inspection Type:
Top Out
Final
Review Plumb
Underground
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 zoning. Futhermore, I authorife ft above-named contractor to do the work stated.
Authorized Signature: Owner /
/ gXntractor / Agent
April 23, 2018
Building Department Copy
April 23, 2018 1
BUILDING
PERMIT APPLICATION
❑ BUILDING
PLUMBING
JOB ADDRESS:
❑ ELECTRIC
Miami Shores Village RECEIVEL
Building Department APR 13 2018
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 CiA L
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 01-1
FBC 120 t z -
Master Permit No. .� ` 6- �'��
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
. CONTRACTOR DRAWINGS
6-
X13
Folio/Parcel#: 11-32-09— Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood AL.
one: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): —se-SGI �y) Te Phone#:
Address: 1! c � 00
f �1- •
City: lQYNN� c�1i 1V�C S State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: "'e?"it/�js'!'Z�O .�� Phone#: 1 � �`✓ �cv—p��o �✓
Address: L9
City: State:
Qualifier Name:�i�i�'/157�
State Certification or Registration #:
DESIGNER: Architect/E
Ad
_Zip: l
ne#:
"O 'l" Certificate of Competency #:
A 1, 6t .'.
�' ter. �•�.�
Value of Work for this Permit: $ �U Square/Linear FooZ
of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ ew Rr/Replace ❑ Demol'tion
Description of Work: V �L. �1�
Submittal Fee $ Permit Fee $_ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ �• oZ DBPR $ V Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ SII • `o
(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
WE
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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was
acknowledged before me this The foregoing instrument was acknowledged before
me this
—2— day
,of� \_� 1 /��` �/ 20 �, by � day of 1- 20 le by
�P�S1Co V V �-4i"-f/��}�+Giio is personally known'to ih%Dy O�`� W who is personally known to
me or who has produced T 1 ` Qo ri as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seal:
MY COMMISSION # GG 044602
'Bonded Thru Notary Public underwriters
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
APPROVED BY �!�!0 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)