PL-19-139Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 01/18/2019
Location Address Parcel Number
55 NE 100 ST, Miami Shores, FL 33138 1132060131420
Contacts
Permit ivo.: PL -0149-139
Permit Type: Numbing - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 07/17/2019
MICHAEL & DOROTHY ESSINGTON Owner MICHAEL & DOROTHY ESSINGTON Applicant
55 NE 100 ST, MIAMI SHORES, FL 33138 55 NE 100 ST, MIAMI SHORES, FL 33138
Home: 3052984673 Home: 3052984673
RJ QUALITY PLUMBING CORP Contractor
RAYVELJACAS
8416 NW 103 ST, HIALEAH GARDENS, FL 33016
Business: 9549198382
Description: NEW PLUMBING FOR A BATH (WATER REPIPING) Valuation: $ 2,500.00 Inspection Requests:
ICE MAKER FOR KITCHEN, REMOVE AND REPLACE KITCHEN 305-762-4949
SINK Total Sq Feet: 157.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Notary Fee
$5.00
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$116.90
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$116.90
Credit Card
01/18/2019 $116.90
Amount Due:
$0.00
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:p I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulatingdoagtruction And zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized SignatW.. Owner / Applicant / Contractor / Agent Date
January 18, 2019 Page 2 of 2
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
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
ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
EZE� 1 �1
JAN S 19
BY:
FBC 20
Master Permit No.�
Sub Permit No.
REVISION [:] EXTENSION [:] RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 55 N E 10 c) S+-
City:
TCity: 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): k pq' 11�:f Phone#: 3W 4 6-72)
Address:_ N L- loo 6+--•
City: W � a.N,t ' �2"W qrC 5 State: Zip: 3313
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: ;9 49� �Phone#:
Address: /3W35 Sri
City: �vm
Qualifier Name:
State Certification or Rigistration #: c -f' /� Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ 2 �J Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ _Alltterationl ❑ New Re air/Replace
Description of Work:
Ir
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
Radon Fee $
Training/Education Fee $
A02t_
CCF $_
DBPR $
P: � 32
Zip:
❑ Demolition
CO/CC $
Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ I l6
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 war
construction in this jurisdiction. I understand that a separate
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC.....
k will be performed to meet the standards of all laws regulating
permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
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
O IR or AGENT
The foregoing instrument was acknowledged before me this
day of u n 20 19 by
Day *'i SSI Yui f.&I _ who is personally known to
me or who has produced FL-(DL-CL52 60 6Y q S -Sly' as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:-
Print:Yt1 yfy(Q moo'"aY Pia;;.,, IVONNE LANDERO
lori(
' 0 Commission # GG 006859
Seal: pF My Comm. Expires Jun 28, 20
Signature
CONTRACTOR
The foregoing instrum nt was acknowledged before me this
S y of A V1vQVV 20, by
ho is personally known to
e or who has produced / S`P as
Z
identification and who did take
************************************************************************
YANADY PRIEM
MY COMMISSION # FF 214031
EXPIRES: March 25, 2019
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)