PL-19-2137Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue :Date. 09/20/2019
Parcel Number
1234 NE 94 ST, Miami Shores, FL 1132050100210
Contacts
Permit No.: PL-09-19-2137
Permit Type: Piumbing - Re5idet
Work Classification: Septic/Drainfield
Permit Status, approved
Expiration: 03/18/2020
MARIA GABRIELA CONTRERAS Owner ELI BRAVO Owner
1200 NE 97 ST, MIAMI SHORES, FL 33138 1200 NE 97 ST, MIAMI SHORES, FL 33138
Other:3059492371 Other:3054942371
MARIA GABRIELA CONTRERAS Applicant A&C PORTELA PLUMBING INC Contractor
1200 NE 97 ST, MIAMI SHORES, FL 33138 DAVID PORTELA
Other: 3059492371 2655 SW 33 RD, MIAMI, FL 33133
Business: 7865474611
Description: PLUMBING PERMIT FOR SEPTIC SYSTEM Valuation: $ 5,000.00 Inspection Requests:
305-762-4949
Total Sq Feet: 1,500.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$3.00
DBPR Fee
$2.63
DCA Fee
$2.00
Education Surcharge
$1.00
Permit Fee
$125.00
Scanning Fee
$3.00
Technology Fee
$4.38
Total:
$191.01
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$191.01
Check # 9754
09/16/2019 $50.00
Check # 10361
09/20/2019 $141.01
Amount Due:
$0.00
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zonings Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner
/ Applicant / Contractor / Agent
Date
September 20, 2019 Page 2 of 2
Miami Shores Village I ED
Building Department SE 1 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 BY
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No. �c -11- C) C' 3
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
IfiPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: UJ a 1 V z q a S+
City: Miami Shores County: Miami Dade Zip: 3 132
Folio/Parcel#: 1 � -?)�S — 010 — Qa� Q Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FIFE:
OWNER: Name (Fee Simple Titleholder):EkI0 ,, C-�0106 ttCj l PYk VNW a Phone#:
Address: I /��J Zvi✓ (A SA
City: Iv" lJA I' QNDf- !? S State: !F11" Zip: 53
Tenant/Lessee Name:
Email
hone#:
CONTRACTOR: Company Name:
. PPrt.,CA
P
a*b) jr T�1G Phone#: r7$()S4 1-461 �
Address: 2,�(J 5 S �S"
&&
City: bA.1 aiw
State:
Zip: 5 3 )33
(fir' , Nd Q1
1
n
f i'Q tCG
Qualifier Name:
f2
Rhone# : r .
State Certification or Registration #:
U—G 1 14
6 (�
Certificate of Competency #:
DESIGNER: Architect/Engineer:
- Phone#:
Address: q� City: State: Zip:
Value of Work for this Permit: � Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:.
Submittal Fee $ S O i i Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $
z � s
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 1 q I • V 1
(Revised02/24/2014)
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 f �h� �I 1L—
OWNER or AGENT
The foregoing instrument was acknowledged before me this
VkA day of Q�M h" ,20 tq by
CDIA+f IM S who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Signature�)V., Z-
CONTRACTOR
The 3 fore,Bping instrument was acknowledged before me this �f1 da of 2 e 20 , by
who' personally know to
as me or who has produced
Sign: � '
Print: CI I
Seal: ►i�i.
ANALUCIATILLIT
MY COMMISSION 0 GG 345M
;Y. Aga
EXPIRES: APrq 23, 2023
TMu UAI� Pubb UrAgnrtNers
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
P , t. p c
aY 0 No ary Public State of Florida
Yheyling Y Montero Delgado
My Comnpssion GG 146392
k� ntl� Expires 09/26/2021
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APPROVED BY i-� �1 9 Plans Examiner
Structural Review
as
###################
Zoning
Clerk
(Revised02/24/2014)