PL-19-981Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
QF
Fp-��Iyn-n U , L�
Issue Date: 08/08/2019
Location Address Parcel Number
960 NE 95TH ST, Miami Shores, FL 33138 1132050070130
Contacts
Permit NO.: PL-05-19-981
Permit Type: Plumbing - Residential
Work Classification: Pool - Private
Permit status: Approved
Expiration: 02/04/2020
PAUL WEIMER Owner ROSMEL POOLS INC Contractor
960 NE 95 ST, MIAMI SHORES, 33138 WILFREDO JR LEIVA
9300 NW 25 ST 103, DORAL, FL 33172
Business: 3055927900
Description: POOL RENOVATION Valuation: $ 2,000.0Inspection Requests:
0 305-762-4949
Total Sq Feet: 0.00
Fees
Application Fee - Other
CCF
DBPR Fee
DCA Fee
Education Surcharge
Plumbing - Pool - Residential
Scanning Fee
Technology Fee
Total:
Amount
$50.00
$1.20
$2.00
$2.00
$0.40
$100.00
$3.00
$3.75
$162.35
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$162.35
Check # 15225
05/02/2019 $50.00
Check # 15236
08/08/2019 $112.35
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 AFFIDAV T: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulati onstr o an oning. Futhermore, I authorize the above named contractor to do the work stated.
AuthorizeKignature:Aner / Applicant / Contractor / Agent
08, 2019
Date
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
MBUILDING ❑ ELECTRIC ❑ ROOFING
RECEIVED
MAY 02 1019.
CA't�
FBC 2014
Master Permit No. �-l�� Iq -q 80
Sub Permit No.
❑ REVISION
QPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
JOB ADDRESS: Q(o0 IJ 9 J5 4-
❑ EXTENSION ❑RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade Zip: 33 1 3 $- 2:%.3
Folio/Parcel#: 11-32-105-007-0/30 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �Q✓ v�IccMe( Phone#:
Address:41(o0 fJ c �j5 sf
City:��^"` 5bw�'l State:- Zip: 33138
Tenant/Lessee Name: 0 1 A Phone#:
Emai
I. IJ/A
CONTRACTOR: Company Name:—RO.5M*j Ao-G(5 Phone#: 30S519-Z`7900
Address: 4Z34025Al 5-)-- la3
City: '1>1>� State: }'L zip: 3 3 I 2
Qualifier Name: Wl1+.e-Ao 4.&..-`'"Q -jf. Phone#:
State Certification or Registration #: < PC. IMF 5 60111 Certificate of Competency #:
DESIGNER: Architect/Engineer: Q• Gsfar� ' Phone#:7SkI'-JS- --14-135
Address: 7{ 4 fJ S .w . �0 [,N tJ1►c�rni City: State: �L Z. 33 ��{ �j
Value of Work for this Permit: $ Square/linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: QA21 1��y-4-i o
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
Radon Fee $
_Training/Education Fee$
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 11 Z
(Revised02/24/2014)
Bonding Company's Name (if applicable) 13 1 A
Bonding Company's Address 1J I A
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
J/A
Jill
State 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 —
Signature
OWNER or AGENT CONTR OR
The foregoing instrument was acknowledged before me this
` day of 11 20 � by
�� `(�C_ wh Is personally known to
me or who has produced
as
identification and who did take an oath.
NOTARY
Sign:
Print:
Seal:
ADRMNATRUJILL0
The foregoing instrument was acknowledged before me this
L'�!—> day of I 20 19 by
VI W-V4 , who is ersonally known to
me or who has produced as
identification and who did take—
:'ti�Y °qe'. DORIS ANAYS MARTINEZ
NOTARY PUBLIC: Notary Public - State of Florida
A: Commission # GG 250751
My Comm. Expires Feb 14, 2021
Print:ir'l
EXPIRES: Apol*25, 2019 : Seal:
r. WW TAru star Pubfic undawritds 1
*«****«*****««««*s«*s«*s*«**ssssssss«**«sss««s«««s«ss*««««s«*ss«*«sssss***«ssss««ss«ss«sss««s*s«s«s««ss««ss«
APPROVED BY 5 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)