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PL-19-8Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 02/14/2019 Location Address Parcel Number 550 NE 102ND ST, Miami Shores, FL 33138 1132060171041 rnnr2rtc Permit NO.: PL -01-19-8 Permit Type: Plumbing - Residential Work Classificaftar Pool - Prh ate Permit Stcaus, Approved Expiration: 07/01/2019 IRENE HEGEDUS Owner NATIONAL POOL DESIGN LLC Contractor 550 NE 102 ST, MIAMI SHORES, FL 331382455 ALFREDO RODRIGUEZ Other: 3057250672 2423 SW 147 AVE SUITE 212, MIAMI, FL 33185 Business: 3055591020 Mobile: 7862675595 Re Description: PLUMBING FOR POOL Valuation: $ 1,000.00 nests: 305-762-4Inspection ion Re Total Scl Feet: 160.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.20 Plumbing - Pool - Residential $100.00 Scanning Fee $9.00 Technology Fee $3.75 Total: $167.55 Payments Date Paid Amt Paid Total Fees $167.55 Check # 1537 01/02/2019 $50.00 Credit Card 02/14/2019 $117.55 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 annrict ' conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. Ina pti grmit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are re uireCTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFID I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co str do an mg. Futhermore, I authoriizz-etlthe ab a named contractor to do the work stated. 7TH Z- 2-/`/. 101 Autl or ignature: OwnV/ Applicant / Contractor / Agent Date February 14, 2019 Page 2 of 2 Miami Shores Village RECEIVED Building Department pN 02 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 FBC 201_:� BUILDING Master Permit No.� PERMIT APPLICATION Sub Permit No.T' I 1 —6 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores -1 County: Miami Dade Zip: 33130 Folio/Parcel#: 11— 3 2ID6 - ®/ ` 091 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): _T� if GD Phone#: Address: 5576 N 6 0 2 J City: m4m �S 1ft P-65 State: � Zip: Tenant/Lessee Name: _ Email: :�a'C-K S ne#: CONTRACTOR: Company Name:/�� Ds42l `-" Phone#: 3. 5 J / 'L o �� Address: Z1 Z -S S� < YI� City: 1414y-1 l n- n, State: Zip: Qualifier Name: A L�i "O Pd d e � l)6Z Phone#: 3'-55;9. /� 2 State Certification or Registration #: (wi- lq 37? Certificate of Competency #: DESIGNER: Architect/Engineer: ne#: Address:City: State 4Value of Work for this Permit: $ O Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: uv ti 31 rv(r 7-7) 2 00® t Specify color of color thru the: Submittal Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $, DBPR $ Zip: ❑ Demolition CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ i{ 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. Signatu W OWNER or AGENT The fore Voi irig instrument was acknowledged before me this Zd day �f�0 , 20 A_, by l� �E'G `1 V`J who is personally known to me or who has produced P L_ as identification and who did take an oath. NOTARY PUBLIC: ` ."'Y'P��•.,, CRiSTINARObf11Gi1Crt!. ;a t NotaryPublic - State ofFlorida • : Commission n GG 105164 Sign: t ires May 16, 2021 Bcrded thrcugh Nalioral Notary Aw, Print: swq Seal: fedVJA- 4ZJJ7_JfV,4 . 1 I rj Signature A --,I CON ACTOR The foregoing instrument was acknowledged before me this day of 06 '6*1 O � , 20 15" , by Ae-fa-f1oa �OG Q IZ L;U2, who is personally known to me or who has produced ® I _ as identification and who did take an oath. NOTARY PUBLIC: ; tPRY'P� •. CRISTINA RODR GUEZ o Notary Public - State of Florida Commission GG 105164 My Comm. Expires May 16, 2021 OP,Fl`" BondedthrcucFNtBcralNewyAsw Sign: Print: Seal: APPROVED BY .� �/ L�— Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)