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PL-18-1136`gKOR£s LMiami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 CORIDA Project Address 1199 NE 92 Street Miami Shores, FL REY WHITEHORN Permit NO. PL -4-18-1136 O Permit Type: Plumbing - Residential Work Classification: Pool - Private Permit Status: APPROVED Issue Date: 6/18/2018 1 Expiration: 12/15/2018 Parcel Number 1132050270330 Block: Lot: 1199 NE 92 Street MIAMI SHORES FL 33138- 1199 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone FLORIDA POOL PATIO CORP (305)815-0181 Type of Work: PLUMBING POOL Type of Piping: Additional Info: PLUMBING POOL Bond Return : Classification: Residential Scanning: 1 Fees Due Amount CCF $0.60 DBPR Fee $3.38 DCA Fee $2.25 Education Surcharge $0.20 Permit Fee $225.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $235.23 REY WHITEHORN Cell (954)612-8850 Valuation:$ 600.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PL -4-18-67347 04/30/2018 Credit Card $ 50.00 $ 185.23 06/18/2018 Credit Card $ 185.23 $ 0.00 Avaname inspections: Inspection Type: Main Drain 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 rt�tify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning ffutIVrmore, I authorize the above-named contractor to do the work stated. June 18. 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy June 18, 2018 1 Miami Shores VillageP Building Department TAPRO018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 $Y:Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC20 BUILDING Master Permit No. ?)-pp is PERMIT APPLICATION Sub Permit No. PL�a-03(6 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL VPLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: '1.6112-- K�� el[2- t5y 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): 2� Phone#: Address: t`-- � t\- City: l �l �y.\" 5V\0 Y'Q State: Zip: Tenant/Lessee Name: Phone#: Email CONTRACTOR: Company Name: TIVY'�G C�O�y Phone#: 3en-EIS-01-Y] Address: I' 2 -kA% '5-Q> Cn ST City: Ok 2Y -n% State: Zip: Qualifier Name: wyev'D Phone#: 3os-`-s State Certification or Registration #: CPC- 1 LIS& `8 �Certificate of Competency #: DESIGNER: Architect/Engineer: Address Value of Work for this Permit: $ RM City: State: Zip: Square/Linear Footage of Work: Type of Work: ❑ Addition qq❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: rY\r✓1Y1a1 Q©U1 Specify color of color thru tile: a Submittal Fee $ Permit Fee $ 22� Scanning Fee $ Radon Fee $ 2 • Zs Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ CO/CC $ DBPR $ -a " AS 9 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..a#--the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of-.su-h9fed notice, the inspection will not be approved and a reinspection fee will be charged. SignatureV444 Signatu OWNER or AGENT The foregoing instrument was acknowledged before me this 2� day of 2qIrt ( 20 �0 by who is personally known to me or who has produced �:� C.�^�`�as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: +`QA(Vy— 6'�VAS CONTRACTOR The foregoing instrument was acknowledged before me this -153 day of AQ V�,y 20 by C64)AL0 `J12Y---3 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: VV �, Seal ._ ... Seal: ; •'�Y'` NADINE AGUAS �•,,T '= MY COMMISSION # GG090407 I �= UAB ***** * ***** IRESAIO**20211 * ********************** * APPROVED BY ,/'60+`(/ Plans Examiner Structural Review (Revised02/24/2014) **************** Zoning Clerk