PL-19-391Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
PG'n If Ififuu
Issue Date: 03/26/201
Parcel Number
90 NE 91ST ST, Miami Shores, FL 33138 1131010200010
Contacts
Permit NO.: PL-02-19-391
Permit Type: Plumbing - Residential
Work Classification: Pool - Private
Permit Status: Approved
Expiration: 09/2 3/2019
STEPHEN PELLICCIA Owner DREAM DESIGN POOLS INC Contractor
90 NE 91 ST, MIAMI SHORES, FL 33138 RAFAEL PELLERANO
133771 N GARDEN COVE CIR, DAVIE, FL 33325
Business: 9549165337
Other:7864022253
Description: POOL PIPING Valuation: $ 1,300.00 Inspection Requests:
305-762-4949
Total Sq Feet: 650.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Plumbing - Pool - Residential
$100.00
Scanning Fee
$3.00
Technology Fee
$3.75
Total:
$162.35
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$162.35
Credit Card
02/20/2019 $50.00
Credit Card
03/26/2019 $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 AFFID )T: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating q4Kr, n ap4oning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Sig
/ Applicant / Contractor / Agent
Date
March 26, 2019 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd avenue, Mland shard, Florida 331M
Tei: (305) 79b-2204 Faoc (305) 756.5972
INSPECTION UNE PHONE NUMBER: (30S) 7624M
BUILDING -
PERMIT APPLICATION
r]BUIL m [] ELECTRIC . [] R00RNG
g�C]EIVED
FE `D02019
BY
FBC 20146�
Mow Permit No. lei - - b2 -(c1- 59 U
sub Permit No. 2 L-o2--1 - -:I>q1
®PWMBING [] MECHANICAL OPUBLK WOw 0 Omm OF
CONTRACTOR
jOa ADDRM 90 NE 9186'W
❑ EXTENSION RENEWAL
[] CANCELLATION [:] SHOP
DRAWINGS
City: Miami Shores County: MMrni Dade An:
Folio/ 11-3101-020-0010 It the bdft IlNtorlu* Dom: yes NO XX
OCWParcv Tvrw. 8FR Load. Cron Type: Food zone: BFE: FFE:
OWNM Name (Fee Simple TlfAeWde* SWOM POWa/Sergio Sin Phone#._-
`90 No 91 SbVW
may; Miami Shores Stow FL np: 33136
TenanVLemee Name: PhoneB:
Email .cam
COWPACTIOR: company Name: Dream Design Pools, Inc. Phoney. n6 402 2256
Addrds: 13771 N Queen Cove Cir.
Mr. Davie State: FL 33326
4uailAer Name: Rd" A Peltemllo PhorW% 786 402-2283
state Cw#60ti m or RegWratbn #: CPCO67031---Cerditte of Competency s:
Address: Cky*- stabs• Zip:
Wh*of Workfor0b Pernats $ 1 3 a V "' - - Sgwr%gkwor Footage of Worla
Type of Work M Add{tion ❑ Alteration ❑ New ❑ Repow/Repiace ❑ Demolition
briar Um of waorla Pool Piping
Specie► co1w Of GOw thm 0et
Submitted Fin $ • .� P�ermR Fee $ CCF $ CO/CC $
Seanninp Fie $ N set Ft, $ DBPR $ NO" $
Thy Fee $ Double Fee $
Sbuctwd It vbm $ __..—._ Bona $
TGTAL FEE NOW DUE $
Bonder company's Name (if appliabk)
Bonding CompaWs Address
city State
Mortpp lenders Name of applicable)
Mortgage lenders Address
Zip
zip
Application U hereby made to obtain a permit to do the work and Installadons as InclWad. I a rdiy that no work or Irwtalbtlon has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regiMng
corn in this Jurbdkdon. I understand thet a separate permit must be segued fior ELECTRIC, PLUMBING, SIGNS. POOLS,
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC.
OWNER'S AFFIDAVIT: 1 cerdfy that all the foregoing Information is aoourste and that a8 work will be done In compliaasoe with all
applicable laws regulating won 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.'
hlodw to Appltamnt. As a wod Um to the >issuance of a bu ldtng permit with an is If o Is value aaoeedhhp $2= On applkont must
promise In good faith that a Dopy of the notlae of conniencen and construction Sat law brochure will be deffmW to the person
whasa propatlr is srrlrjeet to attachment
nt Alas, o wed Dopy of the rernnded rhotke of cornmencernent must be pasted at the Job site
far the Kist tmpecOm whkh occurs M days ofter the budding permtt Is issued. In the absence of such posted naft the
hnpecdon will not bit apprwW agdp sflwfee wiU be charged
OWNER orAGENT
The foregoing �istrunsent was admowledged before me this
clay of .20 by
-Effi)i & who Is aersonaliv known to
Mar who has produced
Identifkation and who did take an oath. .
NOTARY PUBLIC
Seal: $fit Notary PuUYc State or FlorWa
Luis Adel Duarte
Mir0 M= 889581
Exp
The foregoing hwrument was admowk dged before me this
201�� by
I a is personally known to
as me or who has produced
Identification and who did take an oath.
u 'lL:1101�TI[--I
Prirs� olV (s 1J � Old P
Seal•
�,►i''' "+� Notary Puttlits State or Fbrida
Luis Ariel Duarte
� c / Expires 08/Qt 20 yt;9581-
APPROVED BY Plans Etramhter
Structural Review
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