PL-19-1507Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date: 08/29/2019
Parcel Number
1296 NE 99TH ST, Miami Shores, FL 33138 1132050090140
Contacts
Permit NO.: PL-07-19-1507
Permit Type: Plumbing - Residential
Work Classification: Pool - Private
Permit Status: Approved
Expiration: 02/24/2020
FELIPE VISSER Owner
1296 NE 99 ST
Business: 3057937279 INFO@VCLOSETS.COM
KISO POOLS LLC Contractor
HIROKI KVRENUMA
Business: 3052985343 LANAE@KISOGROUP.COM
Mobile: 7867175003
Description: NEW SWIMMING POOL PLUMBING Valuation: $ 3,000.00 inspection Requests:
305-762-4949
TotaISq Feet: 400.00
Fees
Amount
Application Fee -Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Plumbing - Pool - Residential
$100.00
Scanning Fee
$3.00
Technology Fee
$3.75
Total:
$163.15
Payments
Date Paid Amt Paid
Total Fees
$163.15
Credit Card
08/28/2019 $163.15
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 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 AFF AVIT: I certify all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating cgcfion and zoni . Fut rmore, I authorize the above named contractor to do the work stated. n I i I ^
Applicant / Contractor / Agent
August 28, 2019 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL PUBLIC WORKS
JOB ADDRESS:
JUL 01 1019
FB��C 2200N �`
Master Permit No. c�Q� 1 i - n -I l -" 51) -"
Sub Permit No. -7" 19
❑ REVISION ❑ EXTENSION RENEWAL
CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Folio/Parcel#: 1 I — 3 oa — 2)pf - l714 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
y<A OWNER: Name (Fee Simple Titleholder): 1 I D-G V1 Phone#:
Add
City: IY►(IImi SMIS State: Zip: 63.132
Tenant/Lessee Name: Phone#: 3
Email: �� ( ,+
CONTRACTOR: Company Name: r' fl 61 _�i(, �i Phone#: [-7
3
Address: � ZZ U l� 32— Ci
City:
• �11'S��J�ii�7'S�/IId11L�� � - • Na�11l�i�•�►Zir]iN:
State Certification or Registration #: CPG I`TS 3ZA Certificate of Competency #: `
DESIGNER: Architect/Engineer: ?_dyt_- Phone#:(=)loDg YSO
Address: 2 City: State: Zip:
Value of Work for this Permit: $ Ji DOD. 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 $ `U Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $,
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ 1 G 3 • ! S
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. 1 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.
r
Signature r eglvo uA::)
OWNER or AGENT
The foregoing instrument was acknowledged befor me this
day of 20, by
0-5_kA,who is personally known to
me or who has produced as
identification and who did take an oath.
Signature ZJ - A�t4�
CONTRAC R
The foregoing instrument was acknowledged before me this
day of 20 � by
W!�-V,l &-9fJ12 irho is personally known to
me or who has produced
identification and who did take an oath.
as
******sss***
APPROVED BY /� T��j Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)