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PL-19-1002Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: Location Address Parcel Number 1460 NE 103 ST, Miami Shores, FL 1132050310060 Contacts Permit No.: PL -05-1 9-1002 Permit Type: It biig - geSideritial Work Clossilkation: Gas Permit Status: Approved Expiration: 11/12/2019 ------------- CHRISTOPHER SAVITS Owner CHRISTOPHER SAVITS Applicant 1460 NE 103 ST, MIAMI SHORES, FL 331382626 1460 NE 103 ST, MIAMI SHORES, FL 331382626 CLIVE G NELSON PLUMBING INC Contractor CLIVE GEORGE NELSON 10218 SW 23 CT, MIRAMAR, FL 33025 Business: 9549345151 Description: CONNECT GAS COOK TOP Valuation: $ 100.00 Inspection Requests: 4949 Total Sci Feet: 250.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $50.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $110.30 Building In consideratior pertaining there Village. In 4ccE permits are/regr OWN regul, Payments Date Paid Amt Paid Total Fees $110.30 Credit Card 05/16/2019 $60.30 Credit Card 05/06/2019 $50.00 Amount Due: $0.00 epA!uan�-opy thethis permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations ,Pd in sity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores g thisme responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate I for E LUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. �1 . 1ll the foregoing information is accurate and that all work will be done in compliance with all applicable laws ionhermore, I authorize the above named contractor to do the work stated. r / Applicant / Contractor / Agent Date May 16, 2019 Page 2 of 2 RE Miami Shores Village `. Building Department BY:_ 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 PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING 0 612019 Master Permit No. B ` /�, - 2SS00 Sub Permit No. PL - OS- 9 -1 go 2 ❑ REVISION ❑ EXTENSION ❑ RENEWAL Y PLUMBING F_� MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP U/CONTRACTOR DRAWINGS JOB ADDRESS: I7 f0 � � s QYL 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):X M 0 hl'C_Q� +��1 V i` J 5 Phone#: 3 a � 7/a ' ► g S Address: x fy(9d %y�g /n i?, 3 T City: Y M l 4 A-1 54 v fP <, State: �! �G Zip: '\� 33,---3?, Tenant/Lessee Name: Phone#: Email: II � CONTRACTOR: Company NameO��� �• Al - 49'or.J �-C ''"S e Phone#: Address:1QZle > .AI Z-3 .4,, - City: ' ' /� '�"� State: ��d '�� d A Zip: 330.;t Qualifier Name: �'Cl✓� 4 ���'''J Phone#:%� ���� ��� State Certification or Registration #: C`�©, ��� Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ %fid Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ElRepair/Replace ❑ Demolition Description of Work: o lv►vee4 GQ g ( %A L L0 12 - Specify color of color thru tile: ItpSubmittal Fee $ 1 Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee $ Structural Reviews $, (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 3b 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. Signature Signatur f OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged beforemethis 2� day of R I 20 by day of 20 by k MO Vi CA who is personal) kn wn to � 'y''�% who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: ry Sign: : ota Eublk55oaFlorldaMEZ Sign: 4..���„ %, I BERLYPEYNADO Print: CommissiontGPrint: /`¢�"B otar P a y omm. res;Commission N GG 12029 Bonded through Nation�Seal: Seal: ., &t..osa:•` • My Comm. Expires Jun 15, 2020 ************************************************************************************************************ APPROVED BY <� 54A Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)