PL-19-440Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Permit NO.: PL-02-19440
Permit Type, plumbing - Residential
f17—j Work Classification: Addition/Alteration
Permit status: Approved
�fts"' 02 `/20 9 I Expiration: 08/26/2019
Parcel Number
1234 NE 94 ST, Miami Shores, FL 1132050100210
Contacts
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: NEW PLUMBING FOR EXISTING HOME Valuation: $ 25,000.00 Inspection Requests:
r
-762-49j 9
Total Sq Feet: 1,500.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$15.00
DBPR Fee
$13.13
DCA Fee
$8.75
Education Surcharge
$5.00
Permit Fee
$825.00
Scanning Fee
$3.00
Technology Fee
$21.88
Total:
$941.76
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$941.76
Credit Card
02/27/2019 $941.76
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 zoni_gg--futF lKMVre, I authorize the above named contractor to do the work stated.
Authorized Signature: Owff6r� / Applicant / ' Contractor / Agent `" Date
February 27, 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 cj'l41
INSPECTION LINE PHONE NUMBER: (305) 762-4949 (j-h
FBC 20 P
BUILDING Master Permit No. 6 12' 11- 299 3
PERMIT APPLICATION Sub Permit No. ?I - 02- �q -�q0
BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION MRENEWAL
El'PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS M CHANGE OF ❑ CANCELLATION ❑ SHOP
u CONTRACTOR DRAWINGS
JOB ADDRESS: 2 ���h fAlr'e� i:... IkA:,... C6 rn: ty. Miami nano Tin- 33 I3tQ7 /
Folio/Parcel#: I " �?-aS— ��Dy a -I V is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
1 � 1 .�LfaS
OWNER: Name (Fee Simple Titleholder): i3YQ VO J r" UIa (0C b0'eJ0( ��d) Phone#:
Address: Z 3 H 1,)L q q Sf i t a✓r
City: d i Q M i —'D' hots State' +
Tenant/Lessee Name:
Email:
hone#:
CONTRACTOR: Company Name: O _:rAC, Phone#: 0&
Address: 96 S 5 5 t c) 33 Ad!,
City: ptQ fni , State: —Zip- 33) 3 �7
Qualifier Name:
one#: �3e'5 fri5 - 0
State Certification or Registration #: CTf ICI 2 p6 I —7 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ ci 5, 000 Square/Linear Footage of Work:
Type of Work: ❑ Addition
Description of Work:
❑ Alteration ❑ New ❑ Repair/Replace
Specify color of color thru tile:,
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $
DBPR $
Zip:
❑ Demolition
CO/CC $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
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.
Signature /1� �� Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
�c7�J day of e a L 20 ' by
Yid g & owho i ersona�knowo
meor who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: h
Seal:
***************
APPROVED BY
as
CONTRACTOR
The foregoing instrument was acknowledged before me this
25 da of <, e �__, 20 by
b/uy L°i who isilersonally known o
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
6 4 Print:
- " - - - - — W�lwNOWY PuW Stall d Florid✓
r2lrotary Pudic Stab. of FlorWa Seal: . Yh*Wq Y MMM DNpedo
ik. Yheyling Y Monbero DeVedo My Camrt %sw GG 146992
MY CommistIM GG 146392 %qr V Expkes 09l2612021
"q, V EVIM OW26=21 ����
*******************************************************
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review
Clerk