PL-17-2522Permit NO. PL -1 0-17-2622
sKO1 S 91 Miami Shores Village Permit Type: Plumbing - Residential
10050 N.E. 2nd Avenue NE' " tWorkClass�Cation: Addition/Alteration
Miami Shores, FL 33138-0000 Per
Phone: (305)795-2204
Permit Status: APPROVED
�ORtOp'
I$Sr nate:10/3012017 1 Expiration: 04/28/2018
Project Address Parcel Number Applicant
325 NE 104 Street 1121360130100
LUIS & CARRIE REYNOSO
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phony CPU
LUIS & CARRIE REYNOSO 325 NE 104 Street
MIAMI SHORES FL 33138-2017
Contractor(s) Phone Cell Phone
ABY PLUMBING 786/295/7415
Type of Work: ADD MASTER BATH AND BATH
Type of Piping:
Additional Info: ADD MASTER BATH AND BATH
Bond Return :
Classification: Residential Scanning: 1
Fees Due
Amount
CCF
$6.60
DBPR Fee
$5.25
DCA Fee
$3.50
Education Surcharge
$2.20
Permit Fee
$350.00
Scanning Fee
$3.00
Technology Fee
$8.80
Total:
$379.35
Valuation: $ 10,990.00
Total Sq Feet: 871.97
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL -10-17-65436
10/30/2017 Credit Card $ 329.35 $ 50.00
10/24/2017 Credit Card $ 50.00 $ 0.00
mvauaoie inspections:
Inspection Type:
Top Out
Final
Review Plumbing
Underground
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, MECHANryAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDA)6T: )I certify, that;/all the forg4oing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and z6pring'. Ft of ' a the above-named contractor to do the work stated.
October 30, 2017
Authorlfed Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
October 30, 2017
BUILDING
PERMIT APPLICATION
Miami Shores Village RtMVED
Building Department OCT 24 201
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 QL� 41
INSPECTION LINE PHONE NUMBER: (305) 762-4949 S
FB6 �O IQ
Master Permit No. T�— , " I—Sfi
{.�_
Sub Permit No. 1� 1 - 2..S -Z Z
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
LUMBING ❑ MECHANICAL F-] PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: 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): 1,�1$ 1�0,� Phone#: PY
Address: 2.5 IV G I c q (�
City: NI / am State: I Zip: Vd 33
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Na__m'e:TmY P umr ,,dA 4PA29 Phone#: -716 4 -245- r4 is
Address: J-45,14 !S 15S bV
City: M4041 State: 14 Zip: !37RSI 69i
Qualifier Name: 11w7i Phone#: %,96 '245--7$%�
State Certification or Registration #: G Fr— 54 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 10)090Square/Linear Footage of Work: ,.„,. .� ul I • �7
Type of Work: Addition ❑ Alteration _ ❑ New _ ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ . 53 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 $ '+
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.
Sign Signature
_(g,
NERo GE T CONTRACTOR
The 1* ng instrum nt w wledged before me this The foregoing instrument was acknowledged before me this
day day of !-?013M 20 %� by
ho is personally now o 041W2,who is personally kn 1yo
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:
Sign: �V^ Sign:
Print: -"• �7e'; Frank R. Camara print:
COMMISSION #W11 ,•`4� EU
Seal: '�� EXPIRES: J* 19, 2019 Seal: :' b°, Notary Public - State of Florrda
YYWWAARONNOTARY.COM • Commission # FF 237583
y Comm. Expires Jun 8, 2019
,�O�OF F`d;�•� Bonded through National Notary Assn.
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)