PL-19-2254Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Parcel Number
1079 NE 96TH ST, Miami Shores, FL 33138 1132060143670
Per of rio.: PL -09-19 2254
Permit Type: Plumbing - Residential
Work Clossifrcadon: Alteration
Permit status: Approved
Expiration: 03/24/2020
Contacts
JONATHAN FELDMAN Owner RC PLUMBING CONTRACTOR LLC Contractor
1079 NE 96 ST, MIAMI SHORES, FL 33138 RAFAEL CRESPO
Other: 7869720336 201 WEST PARK DR, MIAMI, FL 33172
Business: 7542353828
Description: KITCHEN REMODEL SINK AND FAUCET Valuation: $ 500.00 Inspection Requests:�—�
Total Sq Feet: 120.00
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 Department Copy
Payments
Date Paid Amt Paid
Total Fees
$110.30
Check # 1837
10/02/2019 $110.30
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: I certify that all the foregoing infor tion s accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorizie er�tractor to do the work stated.
Authorized Signature: Owner / Applicant
Date
October 02, 2019 Page 2 of 2
6`2\`°\ � Miami Shores Village RECEIVEDSEP 26nis
q� Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 /`
INSPECTION LINE PHONE NUMBER: (305) 762-0949 '6 4
FBC 20cc-�_�
BUILDING Master Permit No.-�-1- 1G - ►S2G
PERMIT APPLICATION Sub Permit No.'P,-CC
r-] BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
rv)UMBING EY ECHANICAL [:]PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION [:]SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: kl ICA 111J C- G lD SkQA?e;+_
City: Miami Shores County: Miami Dade Zip: 9_
Folio/Parcel#: ) 1— �� — h1L� — Is the Building Historically Designated: Yes NO ✓
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder)�Jf)Cr�-Yr»n Phone#:
Address: 1C1q Gcc
City:G►_IA 2(?`Se_ State: X—? I Zip:
Tenant/Lessee Name: Phone#:
Email: Idt,-c% a � 62l>LG � � t� v Cc�� t
T—
CONTRACTOR: Company Name: _ 7`�" ���� C Phone#: 4 S_� 215 r3'9 ZS
Address:
City: �k,�.....�
Qualifier Name:
State:
Phone#:
State Certification or Registration #: C �C �Z� J 3 3 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address
Zip
14 $ Z_
City: State: Zip:
Value of Work for this Permit: $ (�00.00&quare/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
❑ Demolition
Specify 60lor of -.color thru, tile..,:.'
Submittal FL1'e-'$ Perrfit°fere $ CCF
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
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
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
The foregoing instrumVnt was acknowledged before me this
day of20 RC1 by
To/MIA'., fie lOk A rt, who is ersonaliy know to
me or who has produced
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
clayof 1 l . 20 101 by
g F q P j G'P-S,4D, who i �aiwn to
as me or who has produced
identification and who did take an oath. identification and who did take an oath.
Y 1
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: W% Sig
Pri�t J�l� 111n 1-�CfZ2C1Y1�T2 A Pri
:v aha:, JASMIN MAllARESE
Seal: �.� = Seal:
::��Notary Public - State of Florida
Commission X GG 346758
S,ovrtie My Comm. Expires Jun 19, 2023
Bonded through National Notary Assn.
************* * * * * * *************************************
APPROVED BY Pc -/Ag Plans Examiner
Structural Review
(Revised02/24/2014)
4-1►Y�1 7�'�G'Z7C1
;:1y: au •.
JASMIN MAllARESE
Notary Public - State of Florida
Commission k GG 346758
My Comm. Expires Jun 19, 2023
Bonded through National Notary Assn.
as
Zoning
Clerk