PL-19-337Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 04/05/2019
Location Address Parcel Number
17 NE 106TH ST, Miami Shores, FL 33138 1121360060260
Contacts
Permit NO.: PL-02-19-337
Permit Type: Plumbing - Residential
Work Classification: Gas
Permit Status: Approved
Expiration: 08/12/2019
JUAN & MARIA SANCHEZ Owner PAU PLUMBING CONTRACTOR INC Contractor
REYNALDO SOTO
Other: 3053450202 358 W 38 ST, HIALEAH, FL 33012
Business: 3059342894
Inspection
Description: GAS LINE CONNECTION Valuation: $ 2,000.00 Requests:
1305-762-4949
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$50.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$111.10
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
04/05/2019 $111.10
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
re ting construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
�\�J f"'c (a co')0I43
uthorized Signature: Owner / Applicant / Contractor / Agent Date
April 05, 2019 Page 2 of 2
µ Miami Shores Village RECRIVE:13
r Building Department FEB 18 019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 I-1 (,0A
BUILDING Master Permit No. E7L---O2—i ci-33 S-
PERMIT APPLICATION Sub Permit No.fl— aZ- Pl 33—]
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[DCUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: ,--I , `e \C""pk" %��—
City: Miami Shores County: Miami Dade Zip: J3133
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Phone#:
Address: ► `1{#C/ lk, J .�
City: 1 ` `��` l "� State:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: —,nqo
Uj-
City:_ T1 a
Qualifier Name:
Zip:
� 3�50nr--\2
Phone#: ��
State: Zip:
Phone#:
State Certification or Registration #: Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#: _
Address: City: State
Value of Work for this Permit: $ L'000Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
G'-'a.s Vot) C onr�� ,00
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 $
TOTAL FEE NOW DUE $ `�' . Az
(Revised02/24/2014)
Bwding 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 $1500, 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 reinspecti fee will b harged.
loyn
Signature Signature
O rAGEN 14"CONTRACTOR
The foregoing instrument was acknowledged before his The foregoing instrument was acknowledged before me this
25 day of �G�`(�.� 20 by _ �' day of ��% 20 �, by
��QYIhU 1�Z!who is personally known to ( 0 who is personally known to
16
me or who has produced 7. as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
Seal: �Or�"'�
c
************
identification and who did
NOTARY PUBLIC:
Sign:
Print:
ary
rlo Cavelldtate or Florida Seal: No ry p liC State of Florida
Commission FF 245758 • : Ca to mi6sl 0
Ex Commission FF 245758
fires 06/30l2019 Expires 06/30/2019
*********** *&a*]L*A*L&&*4W**************
APPROVED BY a�`f'l9 Plans Examiner
Zoning
Structural Review
(Revised02/24/2014)
Clerk