PLC-19-444Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit No.: PLC -02-19-444
Permit Type: Pktrnbing - Commercial
Work Classification. Addition/Alteration
Permit Status: Approved
Issue Date: 03/25/2019 L.Upiration: 09/23/2019
Location Address Parcel Number
726 NE 92ND ST 12L, Miami Shores, FL 33138 1132060440500
Contacts
Jeffery Rabalais Owner WM PLUMBING SEPTIC TANK & GREASE Contractor
726 NE 92 12L TRAP
Business: 9542619513 JOSHINFTL@YAHOO.COM GABRIEL FRAGA
1825 PONCE DE LEON BLVD 232, CORAL GABLES, FL 33134
Business: 3054950629
Other: 3054950629
Description: PAINT BATHROOM CEILING /WALLS AND INSTALL Valuation: $ 600.00 Ins ection Requests:
TILE OVER EXISTING TILE WALLS. 305-762-4949
Total Sq Feet: 0.00
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
Payments
Date Paid Amt Paid
Total Fees
$110.30
Credit Card
02/27/2019 $50.00
Credit Card
03/25/2019 $60.30
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
regul f ink+struk4 `acd �ning. Futhermore, I authorize the above named contractor to do the work stated.
Owner / Applicant / Contractor / Agent
Date
March 25, 2019 Page 2 of 2
Miami Shores Village RECEIVED
..Building Department FEB 27 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
F13CZO (i
BUILDING Master Permit No. C( tp r2 S C�
PERMIT APPLICATION Sub Permit No. IJ l C A- u� 1
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS [-]CHANGE OF [--]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 7 Z CO N E 61 `L---AaeEi , U N I t: 1 -LL
City: Miami Shores County: Miami Dade Zip: 172,->P-126
Folio/Parcel#: Is the Building Historically Designated: Yes —NO—)(
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:OWNER: Name (Fee Simple Titleholder):�_ 6MSFZY FAEAI.A IS Phone#: qS` . 2 W.'I'fI 3
Address: M IEJ Cl 2 `yi'IZP. zt V Al IT: 12L
City: I�r»"<I �4ortEs State:r—G Zip:
Tenant/Lessee Name: nn Phone#:
Email: \t?`��+i rl '� (RJ Nk�100• Co W,
CONTRACTOR: Company Name: Phone#:3o
Address: M02.5 a, �rJ3 13z
City:
Qualifier Name: C--,7 L-4- :—/
State Certification or Registration #:
G Zip:.33/3y
Phone#:yyP 0-'Z i
- 7 °Y Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Add
City:
Value of Work for this Permit: $ (00 Square/Linear Footage of Work:
State: Zip:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ElDemolition
Description of Work: PAIkrr '1'.t*mlzdjom Cewfj� !WALS AUDI sr-ti.L 71 Lx-,- oubm L'Yyl EM
i 4
Specify color of color thru tile: = ✓
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ ""d Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ CIO - :50
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lenders 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 is e . 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 f egoing instru ent was acknowledged befor a this The fore oing instru s cknowledged before this
d of 20 by - day of 20 , by
I o is personally known to t d who is rsonally known to
me or w as produced as me or who has produced as
identification and who did take an oath.
identification and who did take an oath.
NOTARY P
Sign:_
Print:
�"�� ROSA BARBARA VILLAR
Seal: MY COMMISSION # GG264991
� _ _ �� EXPIRES' December 03, 2022
o GG234772 • 7E
APPROVED BY ���� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)