PL-20-371Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
I TV n - L
?D-�2 i-r� I
Issue Date: 02/21/2020
Location Address Parcel Number
82 NW 98TH ST, Miami Shores, FL 33150 1131010330230
Contacts
Permit NO.: PL-02-20-371
Permit Type: Plumbing - Residential
Work Classification: Alteration
Permit Status: Approved
Expiration: 08/17/2020
BLUE DOT HOMES LLC Owner HCD DEVELOPERS LLC (PL) Contractor
82 NW 98 ST, MIAMI SHORES, FL 33150 TOMAS GONZALEZ
Home: 9549800623
Description: REPLACE AND RELOCATE NEW SINK IN MASTER Valuation: $ 1,200.00 Inspection Requests:
BEDROOM
TotalSq Feet: 1,500.00
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: 0
$111.10
Payments
Date Paid Amt Paid
Total Fees
$111.10
Credit Card
02/19/2020 $50.00
Credit Card
02/21/2020 $61.10
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 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 construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
A,&,;r.-w oto �w - � z ZLo
Signature: Owner / Adplicant / Contractor / Agent
Date
February 21, 2020 Page 2 of 2
Miami Shores Village RECEIVED
Building Department F B 19 2020
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JBY'
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 l!'
FBC 20 F�
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. TL—
F-IBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
urcJMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: � � 0 U,J 1. d �
City: Miami Shores County: Miami Dade zip:
Folio/Parcel#:� 3 0 t 3 0 Z 30 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: I _ ,-Flo,,odZone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Ivy DO f �'�U`� ►'BLS Phone#: 47-4 - 4Z3�
Address:( Wc) k) e, ptq._ 5r 40- IS-0 6
City: 1 ✓!/�-(`
Tenant/Lessee Name: _
Email:
State:
CONTRACTOR: Company Name: M 1 6
Address: 14 0 U 't)
ne#:
Phone#:
Zip: -�-3 (3
City: 10 i Q State: tq— Zip: -33( -? --
Qualifier Name: Phone#:
G� D
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ t -ZOO Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ElDemolition
Description of Work: ReA t(L O►M A QC10 f 4eW 51'A% ) k A44t2tZ 651- 0 44
f
Specify co'for of color thru tile:
Submittal Fee'$ � � Permit Fee $ '' CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $
Structural Reviews $
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ �� ! O
(Revised02/24/2014)
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 lue exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien loH brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded n ce of co encement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permi is is ued. n the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. 41
Signature% G��(
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
The foregoing
k. C�who is per y no to
me or ho has produced as
identification and who did take an oath.
NOTARY
or who has
R
ment was acknowledged before me this
is ersonally kno to
as
identification and who did take an oath.
NOTARY PUBLIC:
Si
Sign:
Print Cy P,
Print:
Ivelisse Teresa zalez
Seal.. My Commission GG 30202d
Seal:
Notary Publi S to or Fiorrda
Ivelisse Te
02I1412U23
L4O
sa Gonzalez�AExpues
My Commission GG 302028
Expires 02/14/2023
APPROVED BY 3 //q�
Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)